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See a sample rate comparisonCPT 65290 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 Wound Xtraocular Muscl Tndon &/Or Tenons Capsule, Repair Of Wound Extraocular Muscle Tendon And/Or Tenons Capsule
| 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 |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 65290 |
| Medicaid Fee Schedule | View Medicaid rates for 65290 |
National average reimbursement for CPT 65290 by major payers:
$640.19
$627.61
$666.25
$785.52
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CPT 65290
5 of 25 sample ratesHigher to lower in this preview
Texas Health Surgery Center Chisholm Trail, LLC
Texas Health Surgery Center Chisholm Trail LLC
$6,342.00Published ratePhoenix Orthopaedic Ambulatory Center, LLC, Gateway Surgery Center
Phoenix Orthopaedic Ambulatory Center, LLC
$2,855.00Published rateUpstate Orthopedics Ambulatory Surgery Center LLC, Upstate Orthopedics Asc
$1,716.00Published ratePueblo Co Ophthalmology Asc LLC, Rocky Mountain Laser & Surgery Center
$1,420.00Published rateBel Clair Ambulatory Surgical Treatment Center, Ltd., Bel Clair Surgical Center
Bel Clair Ambulatory Surgical Treatment Center Ltd
$960.00Published rate
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See a sample payer proposalCPT 65290 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65290 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 65290 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 |
| 65290-CPT | Moderate | Rpair Of Wound Xtraocular Muscl Tndon &/Or Tenons Capsule, Repair Of Wound Extraocular Muscle Tendon And/Or Tenons Capsule |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65290. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65290 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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