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See a sample rate comparisonCPT 68320 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 Free Eyelid, Surgery Using Grafts To Reconstruct Or Repair The Eyelid Lining And Membrane Covering The Eye. This Frees The Eyelid To Move Without Restriction.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 68320 |
| Medicaid Fee Schedule | View Medicaid rates for 68320 |
National average reimbursement for CPT 68320 by major payers:
$895.01
$924.67
$988.20
$865.07
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CPT 68320
5 of 25 sample ratesHigher to lower in this preview
Southhealth Asc, LLC, Edina Specialty Surgery Center
Southhealth Asc LLC
$3,616.00Published rateOverlake Ambulatory Surgery Center, LLC, Overlake Surgery Center LLC
Overlake Ambulatory Surgery Center,
$2,000.00Published rateVenture Ambulatory Surgery Center
$1,518.00Published ratePocono Ambulatory Surgery Center Ltd
$1,297.00Published rateCentral Ohio Gastroenterology Associates,LLC, Mid Ohio Surgery Center
Central Ohio Gastroenterology Associatesllc
$562.00Published rate
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See a sample payer proposalCPT 68320 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68320 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 68320 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 |
|---|---|---|
| 68320-CPT | Moderate | Surgery To Free Eyelid, Surgery Using Grafts To Reconstruct Or Repair The Eyelid Lining And Membrane Covering The Eye. This Frees The Eyelid To Move Without Restriction. |
| 68325-CPT | Moderate | Surgery To Free Eyelid, Surgery Using Grafts To Reconstruct Or Repair The Eyelid Lining And Membrane Covering The Eye. This Frees The Eyelid To Move Without Restriction. |
| 68326-CPT | Moderate | Surgery To Free Eyelid, Surgery Using Grafts To Reconstruct Or Repair The Eyelid Lining And Membrane Covering The Eye. This Frees The Eyelid To Move Without Restriction. |
| 68328-CPT | Moderate | Surgery To Free Eyelid, Surgery Using Grafts To Reconstruct Or Repair The Eyelid Lining And Membrane Covering The Eye. This Frees The Eyelid To Move Without Restriction. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68320. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68320 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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