CPT 65785 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 65785 by major payers:
$2,396.76
$2,980.38
$3,071.56
$3,667.83
| 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 65785 | ||||||
United | 65785 | $1368.00 | 1083654636 - PLASTIC SURGERY SPECIALISTS, PC, NORTH ARUNDEL PLASTIC SURGERY SPECIALISTS | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $1648.00 | 1033222989 - EMPIRE SURGERY CENTER | 770581233 - (CA) EMPIRE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $2500.00 | 1720359151 - ST JOHN SURGERY CENTER INC | 454271780 - (CA) ST JOHN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $2958.00 | 1063459451 - CARROLL COUNTY AMBULATORY SURGICAL CENTER | 522165022 - (MD) CARROLL COUNTY AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $3711.00 | 1568840528 - ALPHARETTA SURGERY CENTER LLC | 208459286 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $4200.00 | 1528145778 - OVERLAKE AMBULATORY SURGERY CENTER, LLC, OVERLAKE SURGERY CENTER LLC | 911925618 - (WA) OVERLAKE AMBULATORY SURGERY CENTER, | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $3283.00 | 1679022636 - NORTHWEST COMMUNITY FOOT AND ANKLE CENTER LLC | 352567039 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $1567.00 | 1114952686 - NORTH RICHLAND HILLS ENDOSCOPY CENTER LLC, DIGESTIVE HEALTH CENTER OF NORTH RICHLAND HILLS | 203711547 - (TX) NORTH RICHLAND HILLS ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $6286.00 | 1659793040 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $853.00 | 1770557233 - MESA AZ ENDOSCOPY ASC LLC, DESERT ENDOSCOPY CENTER | 510426858 - (AZ) THE MESA AZ ENDOSCOPY ASC, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $3681.00 | 1619972791 - AMBULATORY SURGERY CENTER OF SPARTANBURG, LLC | 571128350 - (SC) AMBULATORY SURGERY CENTER OF SPARTANBURG | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $11291.00 | 1992395388 - IU HEALTH SOUTHWEST FORT WAYNE AMBULATORY SURGERY CENTER LLC, IU HEALTH SURGERY CENTER FORT WAYNE | 842206388 - (IN) IU HEALTH SOUTHWEST FORT WAYNE AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $1100.00 | 1801320510 - JOHNS CREEK CENTER FOR PAIN AND SPINE | 814348805 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $1737.00 | 1881704237 - WATERFRONT SURGERY CENTER LLC | 251898743 - (PA) WATERFRONT SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65785 | $1278.00 | 1902070832 - GASTRO OPERATING COMPANY LLC, (DBA) MEADOWBROOK ENDOSCOPY CENTER | 202432134 - (NY) GASTRO OPERATING COMPANY, LLC | NY | 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 65785 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65785 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 65785 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 |
|---|---|---|
| 65778-CPT | High | Placement Of Amniotic Membrane On The Ocular Surface; Without Sutures- Rn Review>=6/30/2019; Deny Inv/N10<=3/9/2011 |
| 65779-CPT | High | Placement Of Amniotic Membrane On The Ocular Surface; Single Layer, Sutured- Rn Review>=6/30/2019; Deny Inv/N10<=3/9/2011 |
| 65780-CPT | Moderate | Ocular Surface Reconstruction; Amniotic Membrane Transplantation, Multiple Layers |
| 65785-CPT | High | Implantation Of Intrastromal Corneal Ring Segments |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65785. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65785 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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