CPT 66821 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 • 11 - Office |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 66821 by major payers:
$424.61
$416.42
$455.24
$541.66
| 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 66821 | ||||||
United | 66821 | $586.65 | 1225022866 - VENKATA YELAMANCHILI | 350593390 - DEACONESS HOSPITAL INC | IN | Interventional Cardiology Physician (207RI0011X) |
United | 66821 | $586.65 | 1982810990 - JOSEPH JENKINS | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 66821 | $586.65 | 1316407596 - VICKY SANDHU | 350593390 - DEACONESS HOSPITAL INC | CA | Hospitalist Physician (208M00000X) |
United | 66821 | $269.54 | 1962641431 - LARESSA BAZZELL | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 66821 | $2417.12 | 1851851836 - MARIO TORRES-SOLANO | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Hospitalist Physician (208M00000X) |
United | 66821 | $2417.12 | 1629521042 - YAN LI | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | FL | Rheumatology Physician (207RR0500X) |
United | 66821 | $1269.31 | 1548295389 - JOHN TRUMMEL | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Anesthesiology Physician (207L00000X) |
United | 66821 | $1101.90 | 1306123955 - DANIEL CHENTORYCKI | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Surgical Physician Assistant (363AS0400X) |
United | 66821 | $2417.12 | 1912093121 - JONATHAN LURIE | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Internal Medicine Physician (207R00000X) |
United | 66821 | $1296.36 | 1811075047 - SARA MAYO | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Surgery Physician (208600000X) |
United | 66821 | $2417.12 | 1629512413 - RAYMOND SCHULTZ | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Physician Assistant (363A00000X) |
United | 66821 | $1269.31 | 1134200348 - JESSICA PAYTON | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Pediatrics Physician (208000000X) |
United | 66821 | $2417.12 | 1912093121 - JONATHAN LURIE | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Internal Medicine Physician (207R00000X) |
United | 66821 | $1101.90 | 1063199198 - ANGELA EGMON | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Physician Assistant (363A00000X) |
United | 66821 | $1296.36 | 1619955242 - WILLIAM SCHANLABER | 222519596 - DARTMOUTH-HITCHCOCK CLINIC | NH | Podiatrist (213E00000X) |
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 66821 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 66821 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 66821 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 | Moderate | Discission Of Secondary Membranous Cataract (Opacified Posterior Lens Capsule And/Or Anterior Hyaloid); Stab Incision Technique (Ziegler Or Wheeler Knife) |
| 66821 | Moderate | Discission Of Secondary Membranous Cataract (Opacified Posterior Lens Capsule And/Or Anterior Hyaloid); Laser Surgery (Eg Yag Laser) (One Or More Stages) |
| 66825 | Moderate | Reposit Iol Prosth W/Incision |
| 66830 | 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 66821. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 66821 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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