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See a sample rate comparisonCPT 65280 Fee Schedule
Last Verified: October 2026
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.
Rpair Of Lacerat; Cornea &/Or Sclera Perforating Not Invol, Repair Of Laceration; Cornea And/Or Sclera Perforating Not Involving
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 65280 |
| Medicaid Fee Schedule | View Medicaid rates for 65280 |
National average reimbursement for CPT 65280 by major payers:
$884.48
$857.28
$932.32
$1,072.52
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CPT 65280
5 of 25 sample ratesHigher to lower in this preview
University Of Minnesota Health Clinics And Surgery Center, Inc., M Health Clinics And Surgery Center
University Of Minnesota Health Clinics And Surgery Center Inc
$3,550.00Published rateSurgical Specialty Center Of Mid Atlantic, LLC
Surgical Specialty Center Of Mid-Atlantic, LLC
$2,307.00Published rateBiltmore Surgical Partners, LLC, Deer Valley Surgical And Endoscopy Center
Biltmore Surgical Partners LLC
$1,380.00Published rateLee Healthcare Investments, LLC, Lee Health Urology Surgery Center
$1,150.00Published rateAdvanced Surgery Center Of Arizona, LLP, Advanced Surgery Center Of Arizona
$750.00Published rate
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See a sample payer proposalCPT 65280 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65280 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 65280 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 |
|---|---|---|
| 65275-CPT | Moderate | Rpair Of Lacerat; Cornea Nonperforating W//W/O Remval, Repair Of Laceration; Cornea Nonperforating With Or Without Removal |
| 65280-CPT | Moderate | Rpair Of Lacerat; Cornea &/Or Sclera Perforating Not Invol, Repair Of Laceration; Cornea And/Or Sclera Perforating Not Involving |
| 65285-CPT | High | Rpair Of Lacerat; Cornea &/Or Sclera Perforating W/ Repositi, Repair Of Laceration; Cornea And/Or Sclera Perforating With Repositi |
| 65286-CPT | Moderate | Repair Deep Cut In Eyeball, Surgical Repair Of Laceration (Deep Cut) Of The Cornea (Clear Tissue That Covers The Front Of The Eyeball) Or Sclera (White Part Of The Eye). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65280. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65280 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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