CPT 68850 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 | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 50 - Bilateral Procedure • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 68850 by major payers:
$85.86
$101.12
$92.36
$109.44
| 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 68850 | ||||||
United | 68850 | $45.00 | 1346308962 - PODIATRY ASSOCIATES AMBULATORY SURGICAL CENTERS LLC | 522210174 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $1446.00 | 1578530226 - PHYSICIANS SURGICAL CENTER OF FT. WORTH LLP, BAYLOR SCOTT & WHITE SURGICARE FORT WORTH | 208303422 - (TX) PHYSICIANS SURGICAL CENTER OF FT WORTH LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $190.00 | 1780764829 - NOVAMED SURGERY CENTER OF ST PETERS LLC, ST PETERS AMBULATORY SURGERY CENTER | 205579933 - (MO) NOVAMED SURGERY CENTER OF ST PETERS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $56.00 | 1477542520 - THE EYE SURGERY CENTER, LTD. | 263915695 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $128.00 | 1083051346 - INTERVENTIONAL PAIN MANAGEMENT LLC | 452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $531.00 | 1891298089 - MICHIGAN OUTPATIENT SURGICAL SOLUTIONS, LLC | 821706937 - (MI) MICHIGAN OUTPATIENT SURGICAL SOLUTIONS LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $300.00 | 1629256961 - BELMONT/HARLEM SURGERY CENTER, LLC | 412237612 - (IL) BELMONT/HARLEM SURGERY CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $199.00 | 1841256302 - NEW ENGLAND PAIN CARE | 760718172 | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $122.00 | 1528099207 - DEER CREEK SURGERY CENTER, LLC | 202255269 - (KS) DEER CREEK SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $143.00 | 1619036381 - WILMINGTON AMBULATORY SURGICAL CENTER, LLC, AMERICAN SURGERY CENTER | 510385184 - (DE) WILMINGTON AMBULATORY SURGICAL CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $90.00 | 1467089599 - CONWAY AMBULATORY SURGERY CENTER, LLC | 832516939 - (AR) CONWAY AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $150.00 | 1275178444 - KENOSHA DIGESTIVE HEALTH CENTER LLC | 842167873 - (WI) KENOSHA DIGESTIVE HEALTH CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $383.00 | 1821276353 - PEND OREILLE SURGERY CENTER LLC | 300430739 - (ID) PEND OREILLE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $601.00 | 1912090432 - MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE, LLC | 812557673 - (DC) MEDSTAR SURGERY CENTER AT LAFAYETTE CENTRE LLC | DC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 68850 | $555.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | 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 68850 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68850 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 68850 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 68850. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68850 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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