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CPT 68525 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.

Biopsy Lacrimal Sac
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 68525 by major payers:

bcbs

$341.45

uhc

$343.56

aetna

$355.73

cigna

$427.27

Preview provider-level rates for...
For billing codeCPT 68525
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 68525

United
68525$1288.001447254172 - SURGICENTER OF BALTIMORE LLC, SURGICENTER OF BALTIMORE521658841 - (MD) SURGICENTER OF BALTIMORE LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$1100.001275836645 - BROOKSTONE AMBULATORY SURGERY CENTER263097292 - (GA) BROOKSTONE AMBULATORY SURGERY CENTERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$1733.001477886406 - BILTMORE SURGICAL PARTNERS, LLC, DEER VALLEY SURGICAL AND ENDOSCOPY CENTER264509307 - (AZ) BILTMORE SURGICAL PARTNERS LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$811.001043375702 - HAZLETON ENDOSCOPY CENTER, INC.233074102 - (PA) HAZLETON ENDOSCOPY CENTER INCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$950.001588839609 - RIVERWALK AMBULATORY SURGERY CENTER LLC260594903 - (FL) RIVERWALK AMBULATORY SURGERY CENTER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$1490.001053634030 - DALLAS NEPHROLOGY ASSOCIATES, DALLAS NEPHROLOGY ASSOCIATES VASCULAR CENTER DALLAS751366650 - (TX) DALLAS NEPHROLOGY ASSOCIATES, P.A.TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$640.001265542849 - GREAT LAKES EYE SURGERY CENTER LLC205428461MIAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$1500.001902850571 - SDM ASC LLC, DAYTIME OUTPATIENT SURGERY CENTER752816595 - (TX) SDM ASC LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$750.001639237092 - MUSCULOSKELETAL AMBULATORY SURGERY CENTER INC, THE SURGERY CENTER AT POINTE WEST650829385 - (FL) MUSCULOSKELETAL AMBULATORY SURGERY CENTERFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$1850.001629256961 - BELMONT/HARLEM SURGERY CENTER, LLC412237612 - (IL) BELMONT/HARLEM SURGERY CENTERILAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$1268.001629461934 - NORTHERN EC LLC464211412NYAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$846.001710151063 - HENDI AMBULATORY SURGERY CENTER, PC262238944 - (MD) HENDI AMBULATORY SURGERY CENTER PCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$598.001275501512 - NORTHWEST KANSAS SURGERY CENTER, LLC481209668 - (KS) NORTHWEST KANSAS SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$1329.001568864452 - CARPUS SURGERY CENTER LLC471128977 - (GA) CARPUS SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
68525$1400.001730514027 - KY ADVANCED SURGICAL CENTER INC901005366 - (CA) KY ADVANCED SURGICAL CENTER INCCAAmbulatory 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 68525 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 68525 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 68525 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
68525-CPTModerateBiopsy Lacrimal Sac

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 68525. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 68525 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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