CPT 68520 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 |
National average reimbursement for CPT 68520 by major payers:

$937.35

$893.23

$979.36

$1,177.74
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 68520 | ||||||
United | 68520 | $4735.00 | 1356878052 - PAVILION SURGERY CENTER LLC | 814376492 - (CA) PAVILION SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $2052.00 | 1891175188 - PHOENIX SPINE GOODYEAR ASC, LLC, PHOENIX SPINE SURGERY CENTER | 853605981 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $1300.00 | 1225497019 - LANGLEY HOLDINGS, LLC | 473550370 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $1250.00 | 1699328146 - ALLIANCE SURGERY CENTER, LLC | 824278461 - (MI) ALLIANCE SURGERY CENTER | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $679.00 | 1881616357 - CINCINNATI HEALTH CARE GROUP PSC | 621719097 | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $5513.00 | 1952364499 - DENTON REGIONAL AMBULATORY SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DENTON | 200270605 - (TX) DENTON REGIONAL AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $3212.00 | 1710945787 - UPLAND OUTPATIENT SURGERY CENTER LP, ONTARIO ADVANCED SURGERY CENTER | 330812827 - (CA) UPLAND OUTPATIENT SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $1402.00 | 1194214510 - SPECIALTY SURGERY & LASER CENTER | 822989454 - (MS) SPECIALTY SURGERY LASER CENTER | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $1397.00 | 1598815110 - EXECUTIVE ENDOSCOPY, INC., ENDOSCOPY CENTER OF SAN JOSE | 770583401 - (CA) EXECUTIVE ENDOSCOPY INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $4192.00 | 1245820042 - ALOE SURGICAL CENTER SCOTTSDALE, LLC | 845112576 - (AZ) ALOE SURGICAL CENTER SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $1792.00 | 1740771708 - EAST FORT LAUDERDALE ASC LLC, FT. LAUDERDALE HEART & RHYTHM SURGERY CENTER | 821945127 - (FL) EAST FORT LAUDERDALE ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $985.00 | 1295708964 - COLUMBIA TN ENDOSCOPY ASC LLC, MID-SOUTH ENDOSCOPY CENTER | 810558898 - (TN) COLUMBIA TN ENDOSCOPY ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $1180.00 | 1770724122 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA | 264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $9098.00 | 1154454460 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68520 | $5329.00 | 1568427151 - PLANO AMBULATORY SURGERY ASSOCIATES, LP | 621560420 | TX | 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 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.
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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