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CPT 65285 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Rep Lac Cornea/Sclera Perforat+Uvea
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Eye and Ocular Adnexa

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelHigh

National average reimbursement for CPT 65285 by major payers:

bcbs

$1,488.90

uhc

$1,398.44

aetna

$1,506.09

cigna

$1,792.90

Preview provider-level rates for...
For billing codeCPT 65285
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 65285

United
65285$2795.001164513149 - ENDO-SURGI OF UNION ASC LLC223248249 - (NJ) ENDO-SURGI CENTER, P.A.NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$1168.001588603351 - PHYSICIAN'S DAY SURGERY CENTER710623198ARAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$1418.001982211728 - FT SCOTT SURGERY CENTER LLC853127325KSAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$900.001346349164 - SOUTHERN ALABAMA SURGERY CENTER LLC, SURGERY CENTER SOUTH621827534 - (AL) SOUTHERN ALABAMA SURGERY CENTER, LLALAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$1734.001780218115 - SURGERY CENTER OF FORT WAYNE825163478 - (IN) SURGERY CENTER OF FORT WAYNE LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$975.001417142084 - MID- AMERICA SURGERY CENTER, LLC204494200 - (MO) MID AMERICA SURGERY CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$1968.001023604931 - ADVANCED SPINE AND PAIN SURGERY CENTERS LLC854282481 - (AZ) ADVANCED SPINE AND PAIN SURGERY CENTERS LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$1568.001013138536 - WESTERN WASHINGTON MEDICAL GROUP, INC, PS, DBA: GATEWAY SURGERY CENTER911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$2595.001801987805 - ENDO SURGI CENTER OF OLD BRIDGE LLC223679920 - (NJ) ENDO-SURGI CENTER OF OLD BRIDGE, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$1026.001083030597 - TRIAD SURGERY CENTER, LLC, TRIAD EYE INSTITUTE473510624OKAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$1976.971093178113 - KALEEM KHAN350593390 - DEACONESS HOSPITAL INCPAInternal Medicine Physician (207R00000X)
United
65285$1345.001508210378 - APEX MEDICAL SURGERY CENTER, LLC471906463 - (GA) APEX MEDICAL SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$860.001023123296 - ASSOCIATES SURGERY CENTERS, LLC510492139 - (PA) ASSOCIATES SURGERY CENTERS LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$900.001669621496 - CPM SURGERY CENTER 3, LLC263297851 - (GA) CPM SURGERY CENTER 3 LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65285$2408.001356965750 - PROLIANCE SURGERY CENTER AT VALLEY, LLC842108616 - (WA) PROLIANCE SURGERY CENTER AT VALLEY LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 65285 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 65285 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 65285 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.

CodeComplexityDescription
65275-CPTModerateRep Lac Cornea Nonperforated
65280-CPTModerateRep Lac Cornea/Sclera Perforated
65285-CPTHighRep Lac Cornea/Sclera Perforat+Uvea
65286-CPTModerateRepair Lacerat'n;Apply Tissue Glue,Corne

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 65285 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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