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See a sample rate comparisonCPT 68020 Fee Schedule
Last Verified: October 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.
Surgery To Drain An Eye Cyst, Surgery To Drain A Cyst (Fluid-Filled Sac) On The Conjunctiva The Clear Mucous Membrane That Covers The Eye.
| Key Fact | Detail |
|---|---|
| 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 Level | Low |
| Medicare Fee Schedule | View Medicare rates for 68020 |
| Medicaid Fee Schedule | View Medicaid rates for 68020 |
National average reimbursement for CPT 68020 by major payers:
$164.56
$160.16
$165.40
$203.41
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CPT 68020
5 of 25 sample ratesHigher to lower in this preview
Mt Kisco Surgery Center LLC, The Ambulatory Surgery Center Of Westchester
Mount Kisco Surgery Center, L.L.C.
$2,018.00Published rateBrightside Surgical, LLC
Brightside Surgical LLC
$1,028.00Published rateThomas Eye Surgery Center LLC
$672.00Published rateAmerican Access Care Of Florida Asc LLC, Azura Surgery Center Plantation
American Access Care Of Florida Asc LLC
$475.00Published rateJoshua Johnson
Deaconess Hospital Inc
$98.70Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 68020-CPT | Low | Surgery To Drain An Eye Cyst, Surgery To Drain A Cyst (Fluid-Filled Sac) On The Conjunctiva The Clear Mucous Membrane That Covers The Eye. |
| 68100-CPT | Moderate | Biopsy Of Eye Membrane, Surgery On The Eye Membrane (Conjunctiva) To Remove A Sample Of Tissue For Testing (Biopsy). The Conjunctiva Is A Clear Membrane That Covers The Eye. |
| 68110-CPT | Moderate | Remove Growth From The Eye, Surgery To Remove A Growth Of Abnormal Tissue From The Clear Covering Of The Eye (Conjunctiva). |
| 68115-CPT | Moderate | Remove Growth From The Eye, Surgery To Remove A Growth Of Abnormal Tissue From The Clear Covering Of The Eye (Conjunctiva). |
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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