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See a sample rate comparisonCPT 66225 Fee Schedule
Last Verified: October 2026
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.
Repair The Surface Of The Eye, Surgery To Repair One Or More Blood Vessels Bulging Out Through The Tough White Outer Shell Of The Eye (Sclera). The Procedure May Involve Use Of A Graft.
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 66225 |
| Medicaid Fee Schedule | View Medicaid rates for 66225 |
National average reimbursement for CPT 66225 by major payers:
$1,191.38
$1,192.51
$1,281.05
$1,493.75
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CPT 66225
5 of 25 sample ratesHigher to lower in this preview
Westminster Surgery Center
Westminster Surgery Center LLC
$2,859.00Published rateRegenerative Orthopaedics Surgery Center, LLC
Regenerative Orthopaedics Surgery Center LLC
$1,862.00Published rateGenortho, LLC, Crow Valley Orthopaedic Surgery Center
Genortho LLC
$1,475.00Published rateCataract & Surgical Center Of Lubbock LLC
Cataract Surgical Center Of Lubbock LLC
$1,117.00Published ratePlattsburgh Asc LLC, Cataract Cetner For The Adirondacks
Plattsburgh Asc LLC
$825.00Published rate
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See a sample payer proposalCPT 66225 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 66225 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 66225 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 |
|---|---|---|
| 66184-CPT | Moderate | Adjust Eye Shunt (Drainage), Surgery To Adjust Shunt (Tube That Drains Fluid From One Part Of The Body To Another) That Drains Fluid From Within The Eye. |
| 66185-CPT | Moderate | Adjust Eye Shunt (Drainage), Surgery To Adjust Shunt (Tube That Drains Fluid From One Part Of The Body To Another) That Drains Fluid From Within The Eye. |
| 66225-CPT | High | Repair The Surface Of The Eye, Surgery To Repair One Or More Blood Vessels Bulging Out Through The Tough White Outer Shell Of The Eye (Sclera). The Procedure May Involve Use Of A Graft. |
| 66250-CPT | Moderate | Revision Or Repair Of Operativ, Revision Or Repair Of Operative Wound Of Anterior Segmentany Type Early Or Late Major Or Minor Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 66225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 66225 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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