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See a sample rate comparisonCPT 66250 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.
Revision Or Repair Of Operativ, Revision Or Repair Of Operative Wound Of Anterior Segmentany Type Early Or Late Major Or Minor Procedure
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 66250 |
| Medicaid Fee Schedule | View Medicaid rates for 66250 |
National average reimbursement for CPT 66250 by major payers:
$877.21
$955.44
$1,036.42
$1,162.14
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CPT 66250
5 of 25 sample ratesHigher to lower in this preview
Amarillo Endoscopy Center, Lp
Amarillo Endoscopy Center Lp
$2,859.00Published rateParkwest Surgery Center Lp
$1,837.00Published rateRadius Surgery Center LLC
$1,329.00Published rateSurgery Center At St. Vincent, LLC, East Pavilion Surgery Center
Surgery Center At St Vincent LLC
$576.00Published rateSouth Austin Surgery Center Ltd
$355.00Published rate
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See a sample payer proposalCPT 66250 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 66250 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 66250 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 |
|---|---|---|
| 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 |
| 66500-CPT | Moderate | Surgery On Iris To Drain Fluid, Surgery To Open Up The Colored Portion Of The Eye (Iris). The Procedure Drains Fluid That Is Increasing Pressure Inside The Eyeball. |
| 66505-CPT | Moderate | Surgery On Iris To Drain Fluid, Surgery To Open Up The Colored Portion Of The Eye (Iris). The Procedure Drains Fluid That Is Increasing Pressure Inside The Eyeball. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 66250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 66250 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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