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CPT 68020 Fee Schedule

Last Verified: November 2025

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 LevelModerate

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$1749.001568427151 - PLANO AMBULATORY SURGERY ASSOCIATES, LP621560420TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$2307.001326424144 - IU HEALTH EAST WASHINGTON AMBULATORY SURGERY CENTER, LLC, EAST WASHINGTON SURGERY CENTER352072586INAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$825.001679134795 - GREELEY ENDOSCOPY CENTER, LLC, NORTHERN COLORADO ENDOSCOPY CENTER842114924 - (CO) GREELEY ENDOSCOPY CENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$3010.001427049352 - CENTER FOR AMBULATORY SURGERY, LLC, THE CENTER FOR AMBULATORY SURGERY223638149 - (NJ) THE CENTER FOR AMBULATORY SURGERY LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$98.701508269432 - ANGI KIEWEL350593390 - DEACONESS HOSPITAL INCINGerontology Nurse Practitioner (363LG0600X)
United
68020$573.001548223654 - SPARTAN HEALTH SURGICENTER LLC251898641 - (PA) SPARTAN HEALTH SURGICENTER, LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$471.001417405812 - BIENVILLE SURGERY CENTER, LLC454254156 - (MS) BIENVILLE SURGERY CENTER LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$1233.001154387710 - WARNER PARK SURGERY CENTER LLC, CENTER FOR ADVANCED SURGERY752824260 - (AZ) WARNER PARK SURGERY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$1276.001245529189 - CAPITOL SURGICAL CENTER LLC275067646MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$1039.001780764829 - NOVAMED SURGERY CENTER OF ST PETERS LLC, ST PETERS AMBULATORY SURGERY CENTER205579933 - (MO) NOVAMED SURGERY CENTER OF ST PETERS LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$360.001013011162 - BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP593213374 - (FL) BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIPFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$1286.001689216152 - BAPTIST HEALTH SURGERY CENTER LLC843280181 - (KY) BAPTIST HEALTH SURGERY CENTER, LKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$98.701801076120 - STEFANIE LANGENBERG350593390 - DEACONESS HOSPITAL INCPACertified Registered Nurse Anesthetist (367500000X)
United
68020$1179.001326527680 - INTRACOASTAL SURGERY CENTER, LLC824525706 - (FL) INTRACOASTAL SURGERY CENTER LLFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68020$430.001750333746 - NORTH PINELLAS SURGERY CENTER LLC593759228 - (FL) NORTH PINELLAS SURGERY CENTER, LLCFLAmbulatory 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
68020LowIncis Of Conjunctiva, Drain Cyst
68040LowExpression Conjunctival Follicles
68100ModerateBiopsy Of Conjunctiva
68110ModerateExc 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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