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CPT 68520 Fee Schedule

Last Verified: November 2025

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.

Excis Of Lacrimal Sac-Dacryocystec
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

LT - Left side of body

RT - Right side of body

Complexity LevelModerate

National average reimbursement for CPT 68520 by major payers:

bcbs

$937.35

uhc

$893.23

aetna

$979.36

cigna

$1,177.74

Preview provider-level rates for...
For billing codeCPT 68520
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 68520

United
68520$4735.001356878052 - PAVILION SURGERY CENTER LLC814376492 - (CA) PAVILION SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$2052.001891175188 - PHOENIX SPINE GOODYEAR ASC, LLC, PHOENIX SPINE SURGERY CENTER853605981AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1300.001225497019 - LANGLEY HOLDINGS, LLC473550370OKAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1250.001699328146 - ALLIANCE SURGERY CENTER, LLC824278461 - (MI) ALLIANCE SURGERY CENTERMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$679.001881616357 - CINCINNATI HEALTH CARE GROUP PSC621719097KYAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$5513.001952364499 - DENTON REGIONAL AMBULATORY SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DENTON200270605 - (TX) DENTON REGIONAL AMBULATORY SURGERY CENTER LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$3212.001710945787 - UPLAND OUTPATIENT SURGERY CENTER LP, ONTARIO ADVANCED SURGERY CENTER330812827 - (CA) UPLAND OUTPATIENT SURGERY CENTER LPCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1402.001194214510 - SPECIALTY SURGERY & LASER CENTER822989454 - (MS) SPECIALTY SURGERY LASER CENTERMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1397.001598815110 - EXECUTIVE ENDOSCOPY, INC., ENDOSCOPY CENTER OF SAN JOSE770583401 - (CA) EXECUTIVE ENDOSCOPY INCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$4192.001245820042 - ALOE SURGICAL CENTER SCOTTSDALE, LLC845112576 - (AZ) ALOE SURGICAL CENTER SCOTTSDALE LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1792.001740771708 - EAST FORT LAUDERDALE ASC LLC, FT. LAUDERDALE HEART & RHYTHM SURGERY CENTER821945127 - (FL) EAST FORT LAUDERDALE ASC LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$985.001295708964 - COLUMBIA TN ENDOSCOPY ASC LLC, MID-SOUTH ENDOSCOPY CENTER810558898 - (TN) COLUMBIA TN ENDOSCOPY ASC LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1180.001770724122 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$9098.001154454460 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORDTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$5329.001568427151 - PLANO AMBULATORY SURGERY ASSOCIATES, LP621560420TXAmbulatory 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 68520 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 68520 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 68520 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
68420ModerateI&D Lacrimal Sac
68500HighExc Lacrimal Gland Ex Tumor Total
68505HighExc Lacrimal Glnd,Not-Tumor;Partial
68520ModerateExcis Of Lacrimal Sac-Dacryocystec

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 68520 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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