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CPT 66130 Fee Schedule

Last Verified: January 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.

Exc Lesion Sclera
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Eye and Ocular Adnexa

Common Place of Service

24 - Ambulatory Surgical Center

11 - Office

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelModerate

National average reimbursement for CPT 66130 by major payers:

bcbs

$889.56

uhc

$900.03

aetna

$953.13

cigna

$1,141.97

Preview provider-level rates for...
For billing codeCPT 66130
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 66130

United
66130$1074.001396870028 - BRAZOSPORT EYE FACILITY, INC., BRAZOSPORT EYE INSTITUTE760106449 - (TX) BRAZOSPORT EYE FACILITY INCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$2007.001881339133 - BSC SHEA PARK LLC881850069 - (AZ) BSC SHEA PARK LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$3427.001447608088 - IRVINE ENDOSCOPY PARTNERS LLC812267690 - (CA) IRVINE ENDOSCOPY PARTNERS LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$1171.001134777832 - PETERS ENDOSCOPY CENTER, LLC842583326 - (NC) PETERS ENDOSCOPY CENTER LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$3150.001578530226 - PHYSICIANS SURGICAL CENTER OF FT. WORTH LLP, BAYLOR SCOTT & WHITE SURGICARE FORT WORTH208303422 - (TX) PHYSICIANS SURGICAL CENTER OF FT WORTH LLPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$1879.001588604391 - HAMILTON AMBULATORY SURGERY CENTER582654791 - (GA) HAMILTON AMBULATORY SURGERY CENTER INCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$1011.001508419474 - NORMAN REGIONAL HOSPITAL AUTHORITY, WEST NORMAN ENDOSCOPY736048282OKAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$2307.001396211264 - PALM BEACH SURGICAL SUITES LLC830558319 - (FL) PALM BEACH SURGICAL SUITES LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$1140.001568469328 - WYOMISSING SURGICAL SERVICES INC.731647840 - (PA) WYOMISSING SURGICAL SERVICES INCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$650.001205804697 - GOLDSBORO ENDOSCOPY CENTER INC562003095 - (NC) GOLDSBORO ENDOSCOPY CENTER INCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$6548.331619096161 - THE WESTERN PENNSYLVANIA HOSPITAL, FORBES REGIONAL CAMPUS250969492 - (PA) HIGHMARK HEALTHPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$2285.001780331769 - ASC SURGICAL VENTURES, LLC351995261INAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$900.001841672615 - ALLIANCE SURGERY CENTER AT AUGUSTA, LLC474382081 - (GA) ALLIANCE SURGERY CENTER AT AUGUSTA LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$2307.001881697522 - RIVERSIDE PARK SURGICENTER LLC593106055 - (FL) RIVERSIDE PARK SURGICENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
66130$2307.001023349909 - PICCARD SURGERY CENTER, LLC270433723 - (MD) PICCARD SURGERY CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 66130 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 66130 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 66130 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.

CodeComplexityDescription
65810-CPTModerateParacentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Vitreous And/Or Discission Of Anterior Hyaloid Membrane, With Or Without Air Injection
65815-CPTModerateParacentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Blood, With Or Without Irrigation And/Or Air Injection
65930-CPTModerateRemov.Blood Clot,Anter.Segment Eye
66130-CPTModerateExc Lesion Sclera

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 66130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 66130 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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