What is a CPT code and why is it important for understanding medical costs?

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. It's crucial for understanding medical costs because it standardizes the description of services, allowing for consistent billing and reimbursement. When looking up prices for a specific procedure, knowing its CPT code can help you get more accurate information and compare costs effectively.

How can I find out the cost of a specific medical procedure before I have it?

To find out the cost of a specific medical procedure, you'll need the procedure's CPT code and your specific location. You can then use tools designed to provide pricing information. For a comprehensive search based on CPT code and specific location, you should use Payerprice's fee schedule lookup tool. This tool can help you understand the potential costs, whether you're insured or paying out-of-pocket, by providing access to detailed fee schedules.

What is a medical fee schedule, and how does it affect what I pay?

A medical fee schedule is a comprehensive listing of the fees that a healthcare provider or insurance company will charge or reimburse for specific medical services and procedures. It's essentially a price list. What you pay is affected by the fee schedule because your insurance plan will negotiate rates with providers based on these schedules. If you're paying out-of-pocket, the provider's standard fee schedule will apply, though you may be able to negotiate. Understanding the fee schedule helps you anticipate costs.

My insurance deductible is high. How can I get an estimate for common services?

If you have a high deductible, getting estimates for common services is important. Start by asking your healthcare provider for an estimate for the CPT codes of the services you anticipate needing. For a broader understanding of costs based on specific CPT codes and your location, you can utilize Payerprice's fee schedule lookup tool. This will help you plan for potential out-of-pocket expenses by providing detailed fee schedule data.

Is there a public resource to look up healthcare prices?

While there are some public resources that provide general healthcare price information, for specific, localized pricing based on CPT codes, it's best to use dedicated tools. For accurate and detailed fee schedules specific to CPT codes and your location, Payerprice offers a fee schedule lookup tool. This tool is designed to help users find specific pricing information relevant to their situation, which is often more precise than general public databases.

CPT 65855 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.

Laser Surgery For Glaucoma, Laser Surgery To Drain Fluid Out Of The Front Part Of The Eye Decreasing Pressure In The Eye. This Is A Treatment For Glaucoma.

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	Moderate
Medicare Fee Schedule	View Medicare rates for 65855
Medicaid Fee Schedule	View Medicaid rates for 65855

National average reimbursement for CPT 65855 by major payers:

$334.55

$362.26

$382.19

$430.16

Compare published rates across providers.

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CPT 65855

5 of 25 sample ratesHigher to lower in this preview

Lindustries, LLC, Seventh Avenue Surgery Center
Lindustries LLC
NEAmbulatory Surgical Clinic/CenterNPI 1699252395Tax ID 82-5145499
$2,190.06Published rate
Houston Surgery Center
Houston Surgery Center Lp
TXAmbulatory Surgical Clinic/CenterNPI 1558782268Tax ID 46-4007273
$702.00Published rate
Tosc, LLC, Osc-Hmhp, LLC
The Orthopaedic Surgery Center
OHAmbulatory Surgical Clinic/CenterNPI 1689679680Tax ID 10-724836
$503.00Published rate
Advanced Surgical Care Of Maryland, LLC
Advanced Surgical Care Of Maryland LLC
MDAmbulatory Surgical Clinic/CenterNPI 1679149330Tax ID 86-1991275
$376.00Published rate
St. Petersburg Outpatient Surgery Center, LLC
St Petersburg Outpatient Surgery Center LLC
FLAmbulatory Surgical Clinic/CenterNPI 1649911470Tax ID 84-2007777
$233.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 65855 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 65855 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 65855 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
65800-CPT	Low	Remove Fluid Or Blood From Eye, Surgery To Aspirate (Remove Using A Needle) Blood Or Fluid From The Anterior Chamber Of The Eye (Space Between The Iris And Cornea).
65810-CPT	Moderate	Paracentesis Of Anterior Chamb, Paracentesis Of Anterior Chamber Of Eye (Separateprocedure) With Removal Of Vitreous Andor Discission Of Anterior Hyaloid Membrane With Or Withoutair Injection
65815-CPT	Moderate	Remove Fluid Or Blood From Eye, Surgery To Aspirate (Remove Using A Needle) Blood Or Fluid From The Anterior Chamber Of The Eye (Space Between The Iris And Cornea).
65855-CPT	Moderate	Laser Surgery For Glaucoma, Laser Surgery To Drain Fluid Out Of The Front Part Of The Eye Decreasing Pressure In The Eye. This Is A Treatment For Glaucoma.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65855. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 65855 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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CPT 65855 Fee Schedule

Lindustries, LLC, Seventh Avenue Surgery Center

Houston Surgery Center

Tosc, LLC, Osc-Hmhp, LLC

Advanced Surgical Care Of Maryland, LLC

St. Petersburg Outpatient Surgery Center, LLC