CPT 66852 Fee Schedule
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.
| 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 66852 by major payers:

$1,062.73

$1,076.32

$1,129.50

$1,374.72
| 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 66852 | ||||||
United | 66852 | $1502.02 | 1023577848 - KHANG LAM | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 66852 | $1502.02 | 1417382250 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Sleep Disorder Diagnostic Clinic/Center (261QS1200X) |
United | 66852 | $1502.02 | 1316407596 - VICKY SANDHU | 350593390 - DEACONESS HOSPITAL INC | CA | Hospitalist Physician (208M00000X) |
United | 66852 | $690.11 | 1417606468 - SUMMER EL-KHODARY | 350593390 - DEACONESS HOSPITAL INC | IN | Physician Assistant (363A00000X) |
United | 66852 | $1502.02 | 1083970016 - JOSEPH MANSOUR | 350593390 - DEACONESS HOSPITAL INC | IN | Internal Medicine Physician (207R00000X) |
United | 66852 | $1502.02 | 1649264383 - VENKATESH MADADI | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 66852 | $690.11 | 1336165521 - SUMMER SWINNEY | 350593390 - DEACONESS HOSPITAL INC | MS | Certified Registered Nurse Anesthetist (367500000X) |
United | 66852 | $1502.02 | 1467415117 - MARLON JORDAN | 350593390 - DEACONESS HOSPITAL INC | IL | Cardiovascular Disease Physician (207RC0000X) |
United | 66852 | $9513.00 | 1841303484 - DEACONESS HOSPITAL, INC, <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | KY | Psychologist (103T00000X) |
United | 66852 | $690.11 | 1063101368 - OLIVIA CODY | 350593390 - DEACONESS HOSPITAL INC | IN | Physician Assistant (363A00000X) |
United | 66852 | $1502.02 | 1932631520 - QUANG NGUYEN | 350593390 - DEACONESS HOSPITAL INC | KY | Sleep Medicine (Internal Medicine) Physician (207RS0012X) |
United | 66852 | $1502.02 | 1174788756 - REBECCA HOPPER | 350593390 - DEACONESS HOSPITAL INC | IN | Pediatrics Physician (208000000X) |
United | 66852 | $690.11 | 1639250616 - TODD AUD | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 66852 | $690.11 | 1578002028 - MICHELLE RUDOLPH | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 66852 | $1502.02 | 1386091767 - DAVID CORADIN | 350593390 - DEACONESS HOSPITAL INC | FL | Geriatric Medicine (Internal Medicine) Physician (207RG0300X) |
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 66852 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 66852 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 66852 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 |
|---|---|---|
| 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) |
| 66840 | Moderate | Rem Lens Material W Aspiration |
| 66850 | High | Removal Of Lens Material; Phacofragmentation Technique (Mechanical Or Ultrasonic) (Eg, Phacoemulsification), With Aspiration |
| 66852 | High | Rem. Lens Mater.;Pars Plana Appr.;W/Wo V |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 66852. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 66852 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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