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See a sample rate comparisonHealthcare 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 | Low |
| Medicare Fee Schedule | View Medicare rates for 68850 |
| Medicaid Fee Schedule | View Medicaid rates for 68850 |
National average reimbursement for CPT 68850 by major payers:

$85.86

$101.12

$92.36

$104.30
Choose a payer to see a sample of rates for CPT 68850.
Skyway Surgery Center LLC
Icare Center Dba Central Indiana Surgery Center, LLC
Conway Ambulatory Surgery Center LLC
Gurley Surgery Center
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 68810-CPT | Moderate | Probing Of Nasolacrimal Duct, With Or Without Irrigation |
| 68815-CPT | Moderate | Probing Of Nasolacrimal Duct W//W/O Irrigation; W/ Inserti, Probing Of Nasolacrimal Duct With Or Without Irrigation; With Inserti |
| 68816-CPT | Moderate | Probing Of Nasolacrimal Duct, Probing Of Nasolacrimal Duct With Or Without Irrigation With Transluminal Balloon Catheter Dilation |
| 68850-CPT | Low | Injec Contrast Medium-Dacryocystogr |
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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