CPT 66820 Fee Schedule
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.
| 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 | • LT - Left side of body • None • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 66820 by major payers:
$539.62
$537.69
$589.12
$734.85
| 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 66820 | ||||||
United | 66820 | $177.00 | 1548399561 - DES PERES EYE SURGERY CENTER, LLC, ST LOUIS EYE SURGERY AND LASER CENTER | 208491493 - (MO) DES PERES EYE SURGERY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $131.00 | 1972694982 - RALEIGH NC ENDOSCOPY ASC LLC, RALEIGH ENDOSCOPY CENTER - NORTH | 200864597 - (NC) RALEIGH NC ENDOSCOPY ASC LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $1245.00 | 1073569562 - GRAMERCY SURGERY CENTER, INC | 204336660 - (NY) GRAMERCY SURGERY CENTER, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $110.00 | 1407335458 - MERRITT ISLAND OUTPATIENT SURGERY CENTER, LLC | 821391712 - (FL) MERRITT ISLAND OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $1681.00 | 1952516684 - POTTSTOWN HOSPITAL COMPANY LLC, POTTSTOWN MEMEORIAL MEDICAL CENTER | 822132538 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $200.00 | 1316326242 - ST. MINA INTERVENTIONAL PAIN CENTER, INC, MINA PAIN CENTER | 473803677 - (OH) ST MINA INTERVENTIONAL PAIN CENTER INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $250.00 | 1023072824 - SOUTH JERSEY EYE PHYSICIANS, LLC, THE SURGICAL CENTER AT SOUTH JERSEY EYE PHYSICIANS, PA | 222116946 - (NJ) SOUTH JERSEY EYE PHYSICIANS, PA | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $758.00 | 1861052896 - PREMIER ADULT AND CHILDRENS SURGERY CENTER LLC | 651005912 - (FL) SUMMERLIN BEND SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $200.00 | 1760794218 - NSC MANAGEMENT COMPANY, INC., ENDEAVOR SURGICAL CENTER | 954683164 - (CA) NORTHRIDGE SURGERY AND PAIN MANAGEMENT CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $366.00 | 1770048225 - BAPTIST SURGERY AND ENDOSCOPY CENTERS, LLC | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $6623.00 | 1508169921 - SAINT LUKES-GI DIAGNOSTICS LLC | 274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $92.00 | 1598809758 - CALIFORNIA EYE CLINIC | 680024090 - (CA) CALIFORNIA EYE CLINIC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $131.00 | 1285630160 - NOVAMED EYE SURGERY CENTER OF NORTH COUNTY, LLC, WOODCREST SURGERY CENTER | 364111316 - (MO) NOVAMED EYE SURGERY CENTER OF NORTH COUNTY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $95.00 | 1871729111 - RIVERVIEW AMBULATORY SURGICAL CENTER, LLC | 900456643 - (PA) RIVERVIEW AMBULATORY SURGICAL CE | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66820 | $566.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | 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 66820 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 66820 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 66820 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 |
|---|---|---|
| 66820-CPT | Moderate | Discission Of Secondary Membranous Cataract (Opacified Posterior Lens Capsule And/Or Anterior Hyaloid); Stab Incision Technique (Ziegler Or Wheeler Knife) |
| 66821-CPT | Moderate | Discission Of Secondary Membranous Cataract (Opacified Posterior Lens Capsule And/Or Anterior Hyaloid); Laser Surgery (Eg Yag Laser) (One Or More Stages) |
| 66825-CPT | Moderate | Reposit Iol Prosth W/Incision |
| 66830-CPT | Moderate | Removal Of Secondary Membranous Cataract (Opacified Posterior Lens Capsule And/Or Anterior Hyaloid) With Corneo-Scleral Section, With Or Without Iridectomy (Iridocapsulotomy, Iridocapsulectomy) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 66820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 66820 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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