CPT 68020 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 | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 68020 by major payers:

$164.56

$160.16

$165.40

$205.92
| 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 68020 | ||||||
United | 68020 | $1749.00 | 1568427151 - PLANO AMBULATORY SURGERY ASSOCIATES, LP | 621560420 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $2307.00 | 1326424144 - IU HEALTH EAST WASHINGTON AMBULATORY SURGERY CENTER, LLC, EAST WASHINGTON SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $825.00 | 1679134795 - GREELEY ENDOSCOPY CENTER, LLC, NORTHERN COLORADO ENDOSCOPY CENTER | 842114924 - (CO) GREELEY ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $3010.00 | 1427049352 - CENTER FOR AMBULATORY SURGERY, LLC, THE CENTER FOR AMBULATORY SURGERY | 223638149 - (NJ) THE CENTER FOR AMBULATORY SURGERY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $98.70 | 1508269432 - ANGI KIEWEL | 350593390 - DEACONESS HOSPITAL INC | IN | Gerontology Nurse Practitioner (363LG0600X) |
United | 68020 | $573.00 | 1548223654 - SPARTAN HEALTH SURGICENTER LLC | 251898641 - (PA) SPARTAN HEALTH SURGICENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $471.00 | 1417405812 - BIENVILLE SURGERY CENTER, LLC | 454254156 - (MS) BIENVILLE SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $1233.00 | 1154387710 - WARNER PARK SURGERY CENTER LLC, CENTER FOR ADVANCED SURGERY | 752824260 - (AZ) WARNER PARK SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $1276.00 | 1245529189 - CAPITOL SURGICAL CENTER LLC | 275067646 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $1039.00 | 1780764829 - NOVAMED SURGERY CENTER OF ST PETERS LLC, ST PETERS AMBULATORY SURGERY CENTER | 205579933 - (MO) NOVAMED SURGERY CENTER OF ST PETERS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $360.00 | 1013011162 - BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | 593213374 - (FL) BAY AREA ENDOSCOPY CENTER LIMITED PARTNERSHIP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $1286.00 | 1689216152 - BAPTIST HEALTH SURGERY CENTER LLC | 843280181 - (KY) BAPTIST HEALTH SURGERY CENTER, L | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $98.70 | 1801076120 - STEFANIE LANGENBERG | 350593390 - DEACONESS HOSPITAL INC | PA | Certified Registered Nurse Anesthetist (367500000X) |
United | 68020 | $1179.00 | 1326527680 - INTRACOASTAL SURGERY CENTER, LLC | 824525706 - (FL) INTRACOASTAL SURGERY CENTER LL | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68020 | $430.00 | 1750333746 - NORTH PINELLAS SURGERY CENTER LLC | 593759228 - (FL) NORTH PINELLAS SURGERY CENTER, LLC | FL | 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 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.
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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