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CPT 68520 Fee Schedule

Last Verified: January 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.

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$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$2350.001669720397 - PLEASANT VIEW SURGERY CENTER, LLC455254219 - (ID) PLEASANT VIEW SURGERY CENTER, LLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$4192.001033373691 - THE SOUTHEASTERN SPINE INSTITUTE AMBULATORY SURGERY CENTER, LLC208037589 - (SC) THE SOUTHEASTERN SPINE INSTITUTE AMBULATORY SURGERY CENTER LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$4338.001275071789 - KADLEC REGIONAL MEDICAL CENTER910655392 - KADLEC REGIONAL MEDICAL CENTERWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1290.001609931229 - THE SURGERY CENTER OF JACKSONVILLE LLC, CENTERONE SURGERY CENTER320209201 - (FL) CENTER ONE SURGERY CENTERFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$4192.001215548524 - SUMMIT AMBULATORY SURGICAL CENTER, LLC522148280MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1823.001083946149 - METHODIST ENDOSCOPY CENTER LLC263765679 - (NE) METHODIST ENDOSCOPY CENTER, LLCNEAmbulatory 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$1941.001225665292 - ANNAPOLIS ENDOSCOPY CENTER LLC843556524 - (MD) ANNAPOLIS ENDOSCOPY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$2204.001265679674 - GEORGIA UROLOGY FAYETTE ASC550846177GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$779.001073588356 - DIGESTIVE HEALTH SPECIALISTS ENDOSCOPY CENTER ARIZONA, LLC201456252 - (AZ) DIGESTIVE HEALTH SPECIALISTS ENDOSCOPY CENTER ARIZONA LLCAZAmbulatory 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$626.001538113238 - ADVANCED LASER & SURGICENTER OF ARIZONA, PC721546625AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$1376.001134182546 - JACKSONVILLE SURGERY CENTER, LTD621600402 - (FL) JACKSONVILLE SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68520$962.001326202086 - LAKEFOREST AMBULATORY SURGERY CENTER, DISTRICT HEIGHTS AMBULATORY SURGERY CENTER521944179 - (MD) LAKEFOREST AMBULATORY SURGERY CENTERMDAmbulatory 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
68420-CPTModerateI&D Lacrimal Sac
68500-CPTHighExc Lacrimal Gland Ex Tumor Total
68505-CPTHighExc Lacrimal Glnd,Not-Tumor;Partial
68520-CPTModerateExcis 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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