CPT 65275 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 65275 by major payers:
$691.76
$725.96
$791.05
$946.21
| 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 65275 | ||||||
United | 65275 | $580.00 | 1013999580 - INTEG HEALTH SYSTEM, P.C., BLOOMINGTON SURGERY CENTER | 352045236 - (IN) INTEG HEALTH SYSTEM PC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $6734.00 | 1215307012 - BAY AREA SURGICENTER, LLC, BRANDON SURGERY CENTER | 474961128 - (FL) BAY AREA SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $1910.00 | 1457725392 - THE ENDOSCOPY CENTER OF QUEENS INC | 262427823 - (NY) THE ENDOSCOPY CENTER OF QUEENS INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $1321.00 | 1376092205 - ADVANCED INTERVENTIONAL PAIN SURGERY CENTER LLC | 812830135 - (AR) ADVANCED INTERVENTIONAL PAIN SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $2490.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $863.00 | 1083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $11615.00 | 1528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $1850.00 | 1760947717 - ADVANCED ORTHOPAEDIC SURGERY CENTER, LLC, LAS VEGAS INSTITUTE FOR ADVANCED SURGERY | 832874360 - (NV) ADVANCED ORTHOPAEDIC SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $1675.00 | 1750456539 - WIREGRASS RANCH ASC HOLDINGS, WIREGRASS RANCH AMBULATORY SURGERY CENTER | 991010158 - (FL) WIREGRASS RANCH ASC HOLDINGS | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $1385.00 | 1316969058 - BETHESDA ENDOSCOPY CENTER, LLC | 521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $1500.00 | 1710420120 - AMERICAN ACCESS CARE OF MIAMI ASC LLC, AZURA SURGERY CENTER MIAMI | 814118495 - (FL) AMERICAN ACCESS CARE OF MIAMI ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $2080.00 | 1639668080 - ZAZEN SURGERY CENTER, LLC | 823788213 - (TX) ZAZEN SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $3976.00 | 1740673953 - MANCHESTER AMBULATORY SURGERY CENTER LP, DES PERES SQUARE SURGERY CENTER | 205953313 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $1417.00 | 1164469086 - SAME DAY SURGICARE OF NEW ENGLAND, INC., SAME DAY SURGICLINIC | 42808359 - (MA) SAME DAY SURGICARE OF NEW ENGLAND, INC. | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65275 | $1800.00 | 1871868422 - PARAMOUNT SURGERY CENTER, LLC, THE CENTER FOR SPECIALIZED SURGERY | 452232749 - (FL) PARAMOUNT SURGERY CENTER LLC | 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 65275 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65275 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 65275 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 65275. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65275 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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