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See a sample rate comparisonCPT 68200 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.
Inject Medication Into The Eye, Injection Of Medication Into The Space Beneath The Conjunctiva. This Is The Mucous Membrane Lining Of The Eyeball And Inside The Eyelid.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 68200 |
| Medicaid Fee Schedule | View Medicaid rates for 68200 |
National average reimbursement for CPT 68200 by major payers:
$55.36
$54.88
$59.22
$59.47
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CPT 68200
5 of 25 sample ratesHigher to lower in this preview
Riverview Surgery Center At The Navy Yard Lp
$1,304.00Published rateBriarcliff Ambulatory Surgery Center Lp, Briarcliff Surgery Center
Briarcliff Ambulatory Surgery Center Lp
$633.00Published rateWest Lakes Surgery Center LLC
West Lakes Surgery Center, LLC
$397.00Published rateDigestive Health Center LLC
Digestive Health Center, Ltd.
$123.00Published rateGastroenterology & Hepatology Consultants, PA, Wake Forest Endoscopy Center
Gastroenterology And Hepatology Consultants, P.A.
$71.00Published rate
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See a sample payer proposalCPT 68200 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68200 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 68200 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. |
| 68040-CPT | Low | Remove A Bump From The Eyelid, Procedure To Remove Grain-Like Bumps Caused By Irritation (Follicles) From The Inside Of The Eyelid. |
| 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. |
| 68200-CPT | Low | Inject Medication Into The Eye, Injection Of Medication Into The Space Beneath The Conjunctiva. This Is The Mucous Membrane Lining Of The Eyeball And Inside The Eyelid. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68200 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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