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See a sample rate comparisonHealthcare 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 |
| Medicare Fee Schedule | View Medicare rates for 68110 |
| Medicaid Fee Schedule | View Medicaid rates for 68110 |
National average reimbursement for CPT 68110 by major payers:

$282.05

$300.50

$322.18

$375.62
Choose a payer to see a sample of rates for CPT 68110.
St Josephs Outpatient Surgery Center LLC
Pinnacle Orthopaedics Surgery Center Woodstock LLC
Deaconess Hospital Inc
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 68110 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68110 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 68110 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 68110. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68110 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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