CPT 68360 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 | 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 68360 |
National average reimbursement for CPT 68360 by major payers:
$655.23
$682.00
$741.62
$659.94
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 68360 | $6342.00 | 1235752643 - TEXAS HEALTH SURGERY CENTER SOUTHWEST FORT WORTH, LLC | 843814490 - (TX) TEXAS HEALTH SURGERY CENTER SOUTHWEST FORT WORTH LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $1960.00 | 1639164916 - THE SURGERY CENTER AT SACRED HEART MEDICAL PARK, DESTIN, LLC | 562315052 - (FL) THE SURGERY CENTER AT SACRED HEART MEDICAL PARK DESTIN LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $12000.00 | 1427585280 - PINNACLE SURGERY CENTER, INC | 812354493 - (CA) PINNACLE SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $1429.00 | 1023088473 - PANAMA CITY SURGERY CENTER,LLC | 481255983 - (FL) PANAMA CITY SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $1977.00 | 1477886406 - BILTMORE SURGICAL PARTNERS, LLC, DEER VALLEY SURGICAL AND ENDOSCOPY CENTER | 264509307 - (AZ) BILTMORE SURGICAL PARTNERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $9765.00 | 1053361642 - DEACONESS HOSPITAL, INC. | 350593390 - DEACONESS HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 68360 | $5124.00 | 1417534207 - MEDICAL CITY SURGERY CENTER OF FRISCO, LLC | 822432064 - (TX) MEDICAL CITY SURGERY CENTER OF FRISCO LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $6904.00 | 1598769481 - MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD, LTD., DOCTORS UNITED SURGERY CENTER | 752832459 - (TX) MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $2363.00 | 1073713004 - ADVANCED EYE SURGERY CENTER | 205045500 - (CA) ADVANCED EYE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $3623.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $2459.00 | 1750709358 - EASTSIDE MEDICAL GROUP, LLC | 451231126 - (WA) EASTSIDE MEDICAL GROUP | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $1063.00 | 1356654610 - ENDO-SURGICAL CENTER OF FLORIDA | 272047909 - (FL) ENDOSURGICAL CENTER OF FLORIDA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $2974.00 | 1033635206 - MEDSTAR SURGERY CENTER AT TIMONIUM, LLC | 821874292 - (MD) MEDSTAR SURGERY CENTER AT TIMO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $2229.00 | 1437106846 - ANTIETAM UROSURGICAL CENTER LLC ASC | 522006832 - (MD) ANTIETAM UROSURGICAL CENTER LLC ASC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68360 | $2256.00 | 1053362343 - SODERSTROM DERMATOLOGY CENTER S C, PEORIA AMBULATORY SURGERY CENTER | 371001642 - (IL) SODERSTROM DERMATOLOGY CENTER, S.C. | IL | 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 68360 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68360 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 68360 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 |
|---|---|---|
| 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. |
| 68340-CPT | Moderate | Repair Of Symblepharon Divisi, Repair Of Symblepharon Division Of Symblepharon With Orwithout Insertion Of Conformer Or Contact Lens |
| 68360-CPT | Moderate | Surgery On Surface Of The Eye, Surgery To Construct A Flap For The Conjunctiva The Protective Membrane Covering The Eye Surface. |
| 68362-CPT | Moderate | Conjunct Flap; Total (Such As Gunderson Thin Flap Or Purse String, Conjunctival Flap; Total (Such As Gunderson Thin Flap Or Purse String |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68360. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68360 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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