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CPT 68020 Fee Schedule

Last Verified: January 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.

Incis Of Conjunctiva, Drain Cyst
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Eye and Ocular Adnexa

Common Place of Service

11 - Office

24 - Ambulatory Surgical Center

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelLow

National average reimbursement for CPT 68020 by major payers:

bcbs

$164.56

uhc

$160.16

aetna

$165.40

cigna

$205.92

Preview provider-level rates for...
For billing codeCPT 68020
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 68020

United
68020$430.001750333746 - NORTH PINELLAS SURGERY CENTER LLC593759228 - (FL) NORTH PINELLAS SURGERY CENTER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$1179.001427152073 - PATIENT PARTNERS LLC201400198 - (TN) PATIENT PARTNERS LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$672.001588663512 - THOMAS EYE SURGERY CENTER LLC582464498 - (GA) THOMAS EYE SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$750.001457670648 - THE RETINA SURGERY CENTER LLC, THE RETINA SURGERY CENTER853784941WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$1000.001396089108 - TRIANGLE ORTHOPAEDICS SURGERY CENTER275268935 - (NC) TRIANGLE ORTHOPAEDICS SURGERY CENTERNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$214.831710036892 - MARCUS OBEIUS350593390 - DEACONESS HOSPITAL INCINEmergency Medicine Physician (207P00000X)
United
68020$874.001427094945 - TRI-STATE SURGERY CENTER LLC562317091 - TRI STATE SURGERY CENTER, LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$214.831700855244 - THOMAS GREEN350593390 - DEACONESS HOSPITAL INCNCInternal Medicine Physician (207R00000X)
United
68020$448.001588667208 - BRADFORD PARKWAY SURGERY AND LASER CENTER20562180 - (MO) BRADFORD PARKWAY SURGERY AND LASER CENTERMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$510.001770724122 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$470.001780658245 - ROGERS AR OPHTHALMOLOGY ASC LLC, BOOZMAN-HOF EYE SURGERY & LASER CENTER753069680 - (AR) ROGERS AR OPHTHALMOLOGY ASC LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$2018.001831274208 - MT KISCO SURGERY CENTER LLC, THE AMBULATORY SURGERY CENTER OF WESTCHESTER134158313 - (NY) MOUNT KISCO SURGERY CENTER, L.L.C.NYAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$475.001528501939 - AMERICAN ACCESS CARE OF FLORIDA ASC LLC, AZURA SURGERY CENTER PLANTATION814131878 - (FL) AMERICAN ACCESS CARE OF FLORIDA ASC LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$98.701457769978 - JOSHUA JOHNSON350593390 - DEACONESS HOSPITAL INCTNCertified Registered Nurse Anesthetist (367500000X)
United
68020$1028.001962059915 - BRIGHTSIDE SURGICAL, LLC831888619 - (ND) BRIGHTSIDE SURGICAL LLCNDAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 68020 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 68020 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 68020 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.

CodeComplexityDescription
68020-CPTLowIncis Of Conjunctiva, Drain Cyst
68040-CPTLowExpression Conjunctival Follicles
68100-CPTModerateBiopsy Of Conjunctiva
68110-CPTModerateExc Lesion Conjunctiva 1 Cm

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 68020 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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