CPT 65900 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 | • 24 - Ambulatory Surgical Center • 11 - Office |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 65900 by major payers:
$1,277.89
$1,236.94
$1,341.99
$1,599.99
| 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 65900 | ||||||
United | 65900 | $1332.00 | 1972141455 - FALLSGROVE ENDOSCOPY CENTER, LLC | 842186338 - (MD) FALLSGROVE ENDOSCOPY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $2353.00 | 1487716650 - CARONDELET ST. MARY'S NORTHWEST, LLC, CARONDELET FOOTHILLS SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $1061.00 | 1336255827 - ROCKVILLE EYE SURGERY CENTER, LLC, PALISADES EYE SURGERY CENTER | 43713185 - (MD) PALISADES EYE SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $1150.00 | 1730789231 - ZEO SURGICAL CENTER LLC, LENZA SURGICAL CENTER | 853310734 - (TX) ZEO SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $2620.00 | 1639261365 - SPECIALISTS ONE- DAY SURGERY LLC, SPECIALISTS ONE-DAY SURGERY | 161601940 - (NY) SPECIALISTS ONE DAY SURGERY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $868.00 | 1164083911 - EVERETT ROAD ASC, LLC, EVERETT ROAD SURGERY CENTER | 833542382 - (NY) EVERETT ROAD ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $2353.00 | 1477569069 - FISH POND SURGERY CENTER, LLC | 742901471 - (TX) FISH POND SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $1083.00 | 1255347050 - MARYLAND EYE SURGERY CENTER, L.L.C., THE SURGERY CENTER | 522205280 - (MD) MARYLAND EYE SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $439.00 | 1902428477 - EASTSIDE SURGERY CENTER, LLC | 261980849 - (AZ) PAINMDS AMBULATORY SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $1453.00 | 1437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC | 582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $1490.00 | 1992248512 - LUBBOCK VASCULAR ACCESS CENTER | 352344583 - (TX) LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $2877.00 | 1447995311 - NEW ENGLAND BAPTIST SURGERY CENTER LLC | 874311329 - (MA) NEW ENGLAND BAPTIST SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $2158.00 | 1609887413 - CSS JV, LLC, CENTER FOR SPECIALTY SURGERY | 263638838 - (OR) CSS JV LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $806.40 | 1023162831 - SEATTLE REPRODUCTIVE SURGERY CENTER | 342014245 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65900 | $1500.00 | 1619071214 - RADS OF AMERICA, LLC, PREMIER RADIOLOGY PAIN MANAGEMENT CENTER | 200597581 - (TN) RADS OF AMERICA LLC | TN | 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 65900 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65900 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 65900 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 |
|---|---|---|
| 65860 | Moderate | Sever Adhesions Ant Seg Laser Tech |
| 65865 | Moderate | Severing Adhesions Of Anterior Segment Of Eye, Incisional Technique (With Or Without Injection Of Air Or Liquid) (Separate Procedure); Goniosynechiae |
| 65870 | Moderate | Severing Adhesions Of Anterior Segment Of Eye, Incisional Technique (With Or Without Injection Of Air Or Liquid) (Separate Procedure); Anterior Synechiae, Except Goniosynechiae |
| 65900 | High | Remv Epithelial Downgrwth,A.Chamber |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65900 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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