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CPT 68505 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Exc Lacrimal Glnd,Not-Tumor;Partial
Key FactDetail
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

RT - Right side of body

LT - Left side of body

Complexity LevelHigh

National average reimbursement for CPT 68505 by major payers:

bcbs

$1,275.34

uhc

$1,273.80

aetna

$1,414.70

cigna

$1,681.93

Preview provider-level rates for...
For billing codeCPT 68505
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 68505

United
68505$2050.001154034429 - CROSSINGS SURGERY CENTER, LLC881346867 - (RI) CROSSINGS SURGERY CENTER LLCRIAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$2076.001629517800 - NORTHWEST SURGERY CENTER, LLC352210163 - LEWIS & CLARK ORTHOPAEDIC, LLC 401(K) PLANCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$3347.001881905792 - SURGCENTER PINELLAS, LLC271372259 - (FL) SURGCENTER PINELLAS, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$2220.001093230450 - CENTER FOR UROLOGIC SURGERY LLC822344535 - (MO) CENTER FOR UROLOGIC SURGERY LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$2799.001750970869 - BSC CHANDLER LLC853443457 - (AZ) BSC CHANDLER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$1215.001215931134 - CUMBERLAND VALLEY SURGICAL CENTER, LLC611348280 - (KY) CUMBERLAND VALLEY SURGICAL CENTER LLCKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$885.001609983477 - NORTH GEORGIA ENDOSCOPY CENTER INC582070246GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$3308.001255787867 - THE METROHEALTH SYSTEM, METROHEALTH SYSTEM PARMA AMBULATORY SURGERY CENTER346004382OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$600.001962869446 - FAYETTEVILLE GASTROENTEROLOGY ENDOSCOPY CENTER, LLC473997859 - (NC) FAYETTEVILLE GASTROENTEROLOGY ENDOSCOPY CENTER LLCNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$1142.001215038252 - RED LION SURGICENTER, LLC204914143 - (PA) RED LION SURGICENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$1595.001609896539 - CEDAR HILLS AMBULATORY SURGERY CENTER LLC, CEDAR HILLS SURGERY CENTER680580628 - (OR) CEDAR HILLS AMBULATORY SURGERY CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$2658.001821047499 - RIVERSIDE SURGERY CENTER, INC.680400319 - (CA) RIVERSIDE SURGERY CENTER INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$1735.091588749204 - JOHN HOLEMAN350593390 - DEACONESS HOSPITAL INCSCHospitalist Physician (208M00000X)
United
68505$1096.161851444079 - SOUTH MEADOWS ENDOSCOPY CENTER, LLC208148996 - (NV) SOUTH MEADOWS ENDOSCOPY CENTER LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
68505$3570.001053714758 - TEXAS PRECISION SURGERY CENTER471332895 - (TX) TEXAS PRECISION SURGERY CENTER LTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 68505 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 68505 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 68505 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.

CodeComplexityDescription
68400-CPTModerateIncis, Drainage Of Lacrimal Gland
68440-CPTLowSnip Incision Of Lacrimal Punctum
68500-CPTHighExc Lacrimal Gland Ex Tumor Total
68505-CPTHighExc Lacrimal Glnd,Not-Tumor;Partial

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 68505 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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