CPT 65273 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 65273 by major payers:
$495.05
$483.63
$518.39
$618.14
| 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 65273 | ||||||
United | 65273 | $1093.00 | 1508005976 - SOUTH SHORE SC, LLC | 341997077 - (NY) SOUTH SHORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $200.00 | 1356718514 - WACO AMBULATORY SURGERY CENTER, LP, WACO CARDIOLOGY CATH LAB & SURGERY CENTER | 473337811 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $1028.00 | 1093985525 - SURGERY CENTER OF CORAL GABLES LLC, CORAL GABLES SURGERY CENTER | 204843518 - (FL) SURGERY CENTER OF CORAL GABLES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $3078.00 | 1447203161 - AMBULATORY SURGICAL CENTER OF STEVENS POINT LLC | 202043506 - (WI) AMBULATORY SURGICAL CENTER OF | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $725.00 | 1699328369 - GEORGIA UROLOGY, PA | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $673.00 | 1154867562 - UROLOGIC AMBULATORY SURGERY CENTER, LLC | 814904405 - (MS) UROLOGIC AMBULATORY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $653.00 | 1215204128 - MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, P.C., ALLSPINE SURGERY CENTER, P.C. | 274395849 - (GA) MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $572.00 | 1285690073 - BIRMINGHAM OUTPATIENT SURGERY CENTER LTD, OUTPATIENT CARECENTER | 630984076 - (AL) BIRMINGHAM OUTPATIENT SURGERY CENTER LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $384.00 | 1336605351 - KURESMART PAIN MANAGEMENT SURGERY CENTER, CLEARWAY SURGERY CENTER OF DUNDALK | 832407319 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $274.00 | 1447748470 - CTS SURGICAL ASSOCIATES LLC, CEDAR TREE SURGICAL CENTER | 825298503 | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $500.00 | 1750920591 - HAYDEN SURGICAL CENTER LLC | 844085494 - (AZ) HAYDEN SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $2302.00 | 1821249616 - LINCOLN SURGERY CENTER LLC | 261790900 - (CO) LINCOLN SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $700.00 | 1336510486 - SACRAMENTO HEART AMBULATORY SURGERY CENTER, INC | 475284840 - (CA) SACRAMENTO HEART AMBULATORY SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $150.00 | 1255894051 - NEW JERSEY INTERVENTIONAL ASSOCIATES LLC | 262178516 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65273 | $1049.00 | 1003813221 - UNIVERSITY SURGERY CENTER LTD | 742894406 - (FL) UNIVERSITY SURGERY CENTER LTD | FL | 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 65273 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65273 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 65273 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65273. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65273 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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