CPT 65920 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 65920 by major payers:
$1,004.76
$1,001.41
$1,054.36
$1,288.54
| 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 65920 | ||||||
United | 65920 | $1379.00 | 1700842358 - THE EYE SURGERY CENTER OF THE CAROLINAS LP | 205562797 - (NC) THE EYE SURGERY CENTER OF THE CAROLINAS LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $1482.00 | 1841884731 - EYE MD OF NICEVILLE SURGERY LLC | 862163581 - (FL) EYE MD OF NICEVILLE SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $1401.13 | 1356636575 - BRENT MCDANIEL | 350593390 - DEACONESS HOSPITAL INC | IN | General Practice Physician (208D00000X) |
United | 65920 | $1401.13 | 1417308867 - AHMED TAHA | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 65920 | $656.00 | 1528572815 - SUN SURGERY CENTER HUNTINGTON LLC | 822382700 - (CA) SUN SURGERY CENTER HUNTINGTON LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $1291.00 | 1104233014 - TAMPA MINIMALLY INVASIVE SPINE SURGERY CENTER, LLC | 471211888 - (FL) TAMPA MINIMALLY INVASIVE SPINE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $643.76 | 1942224001 - KRISTI COTTRELL | 350593390 - DEACONESS HOSPITAL INC | CA | Nurse Practitioner (363L00000X) |
United | 65920 | $1401.13 | 1750696068 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Pain Medicine Physician (208VP0000X) |
United | 65920 | $643.76 | 1871925057 - DEWEY DRISCOLL | 350593390 - DEACONESS HOSPITAL INC | ID | Certified Registered Nurse Anesthetist (367500000X) |
United | 65920 | $1578.00 | 1679728901 - ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | 263777820 - (NJ) ESSEX SPECIALIZED SURGICAL INSTITUTE LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $656.00 | 1023159860 - THOUSAND OAKS SURGERY CENTER, LLC | 272867027 - (CA) THOUSAND OAKS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $1840.00 | 1134431323 - BETHESDA CHEVY CHASE SURGERY CENTER, LLC | 272875760 - (MD) BETHESDA CHEVY CHASE SURGERY CEN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $1236.00 | 1306476197 - EAMC-LANIER AMBULATORY SURGERY CENTER, LLC | 843468862 - (AL) EAMCLANIER AMBULATORY SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $1150.00 | 1083228365 - REFOCUS SURGERY CENTERS, LLC | 851258648 | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65920 | $2046.00 | 1548984263 - ALLINA HEALTH SURGERY CENTER | 883732480 | MN | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 65920 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65920 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 65920 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 | Low | Paracentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Aqueous (Rvsd 1/1/13) |
| 65810 | Moderate | Paracentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Vitreous And/Or Discission Of Anterior Hyaloid Membrane, With Or Without Air Injection |
| 65815 | Moderate | Paracentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Blood, With Or Without Irrigation And/Or Air Injection |
| 65920 | High | Rem Implant Ant Segment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65920 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 65920) and we'll show you how you compare in 15 minutes or less.
Medicare Reimbursement Lookup Tool
PayerPrice provides a free medicare lookup tool for physician fee schedule, drug ASP, MS-DRG weights, anesthesia conversion factors and other medicare related data.