CPT 65220 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | • 23 - Emergency Room • 20 - Urgent Care Facility |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 65220 |
National average reimbursement for CPT 65220 by major payers:
$74.32
$79.39
$86.68
$104.33
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 65220 | ||||||
United | 65220 | $217.00 | 1528261195 - ORCHARD CREEK SURGERY CENTER | 770498874 - (CA) ORCHARD CREEK SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $82.00 | 1932207669 - EYE SURGICAL CENTER OF MISSISSIPPI | 200669972 - (MS) EYE SURGICAL CENTER OF MISSISSIPPI | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $89.00 | 1396030664 - CATARACT INSTITUTE OF OKLAHOMA LLC | 452035458 - (OK) CATARACT INSTITUTE OF OKLAHOMA LLC 401(K) PLAN AND TRUST | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $47.90 | 1497723449 - JEANETTE SCHMIDT | 350593390 - DEACONESS HOSPITAL INC | IN | Family Nurse Practitioner (363LF0000X) |
United | 65220 | $139.00 | 1144499633 - FOOTHILL SURGERY CENTER LP | 510453471 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $249.00 | 1194822411 - GREEN BAY SURGICAL CENTER | 391280079 - (WI) GREEN BAY SURGICAL CENTER | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $555.00 | 1316947609 - AMARILLO ENDOSCOPY CENTER, LP | 752893120 - (TX) AMARILLO ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $293.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $750.00 | 1366647968 - NORTH POINTE SURGERY CENTER, LP | 204435545 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $633.00 | 1780128553 - CAROLINAS ENDOSCOPY CENTER LLC | 814599818 - CAROLINAS ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $250.00 | 1720129893 - PACIFIC GASTROENTEROLOGY ENDOSCOPY CENTER | 330898866 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $76.00 | 1831167329 - THIBODAUX ENDOSCOPY LLC | 810548522 - (LA) THIBODAUX ENDOSCOPY, L.L.C. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $81.00 | 1205853041 - EUCLID ENDOSCOPY CENTER, LP | 203197449 - (CA) EUCLID ENDOSCOPY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $250.00 | 1962059915 - BRIGHTSIDE SURGICAL, LLC | 831888619 - (ND) BRIGHTSIDE SURGICAL LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65220 | $530.00 | 1295988731 - BAPTIST EASTPOINT SURGERY CENTER, LLC | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 65220 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65220 code is part of the Surgery services used for Surgical Procedures on the Eye and Ocular Adnexa. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 65220 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 65175-CPT | Moderate | Rem Implant Ocular |
| 65205-CPT | Low | Remove F.B.,Extern Eye Conjunctival Supe |
| 65210-CPT | Low | Removal Of Foreign Body, External Eye; Conjunctival Embedded (Includes Concretions), Subconjunctival, Or Scleral Nonperforating |
| 65220-CPT | Low | Remove F.B.,External Eye;Corneal,W/O Sli |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65220 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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