CPT 66920 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 | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 66920 by major payers:
$947.16
$955.17
$1,026.53
$1,221.23
| 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 66920 | ||||||
United | 66920 | $967.00 | 1881276319 - TEXARKANA PAIN SURGERY CENTER LLC | 844941902 - (AR) TEXARKANA PAIN SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $2007.00 | 1750970869 - BSC CHANDLER LLC | 853443457 - (AZ) BSC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $892.00 | 1801859970 - LOS GATOS SURGICAL CENTER, A CALIFORNIA LIMITED PARTNERSHIP | 942909203 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $898.00 | 1316976137 - CENTRAL MARYLAND ENDOSCOPY LLC | 201580201 - (MD) CENTRAL MARYLAND ENDOSCOPY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $864.00 | 1922625995 - NATIONAL SURGICAL CENTERS STOCKTON, LLC | 842979070 - (CA) NATIONAL SURGICAL CENTERS STOCKT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $3348.22 | 1609343052 - ADVANCED MEDICAL IMAGING SURGERY CENTER, LLC | 831444320 - (NE) ADVANCED MEDICAL IMAGING SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $2621.00 | 1366515504 - RIVERSIDE AMBULATORY SURGERY CENTER, LLC, THE ENDOSCOPY & COLONOSCOPY CENTER | 205227186 - (MO) RIVERSIDE AMBULATORY SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $1335.00 | 1053385856 - JACKSON OPHTHALMOLOGY ASC LLC, PHYSICIANS SURGERY CENTER | 752842260 - (TN) JACKSON OPHTHALMOLOGY ASC, LLC DBA PHYSICIANS SUR | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $922.00 | 1891133302 - HANFORD SPECIALTY SURGERY CENTER, PC | 454954590 - (CA) HANFORD SPECIALTY SURGERY CENTER PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $864.00 | 1194966051 - FIRST STREET SURGERY CENTER INC. | 263375664 - (CA) FIRST STREET SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $1379.00 | 1295720530 - ELMIRA ASC LLC | 161549510 - (NY) ELMIRA ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $1144.00 | 1780683797 - LOVELAND ENDOSCOPY CENTER, LLC, SKYLINE ENDOSCOPY CENTER | 421589159 - (CO) LOVELAND ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $892.00 | 1003017351 - CARLSBAD SURGERY CENTER, LLC | 201413484 - (CA) CARLSBAD SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $1168.00 | 1518592021 - FIRST SURGERY CENTER, INC. | 842066148 - (CA) FIRST SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 66920 | $864.00 | 1518280684 - NORTHWEST SURGERY CENTER, INC. | 364663721 - (CA) NORTHWEST SURGERY CENTER INC | CA | 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 66920 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 66920 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 66920 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 |
|---|---|---|
| 66920 | Moderate | Extract Lens Intracapsular |
| 66930 | High | Extr.Lens W/Wo Irid;Intracap,Disloc |
| 66940 | Moderate | Extract Lens Extracapsular Other |
| 66982 | High | Extracapsular Cataract Removal With Insertion Of Intraocular Lens Prosthesis (1-Stage Procedure) Manual Or Mechanical Technique (Eg Irrigation Andaspiration Or Phacoemulsification) Complex Requ-Iring Devices Or Techniques Not Generally Used In Routine Cataract Surgery(Eg Iris Expansion Device Suture Support For Intraocular Lens Or Primary Posterior Capsulorrhexis) Or Performed On Patientsin The Amblyogenic Developmental Stage; Without Endoscopic Cyclophotocoagulation(Desc Rvsd 1/1/20) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 66920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 66920 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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