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See a sample rate comparisonCPT 68899 Fee Schedule
Last Verified: October 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.
Unlisted Procedure Lacrimal System
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 11 - Office |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 68899 |
| Medicaid Fee Schedule | View Medicaid rates for 68899 |
National average reimbursement for CPT 68899 by major payers:
$841.12
$91.34
$1,907.38
$699.33
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CPT 68899
5 of 25 sample ratesHigher to lower in this preview
Atlantic Gastro Surgicenter, LLC, T/A Access
Atlantic Gastroenterology Associates, P.A.
$1,708.00Published rateFlorida Orthopaedic Institute Surgery Center LLC
$688.00Published rateCarondelet St. Mary'S Northwest, LLC, Carondelet Foothills Surgery Center
Camp Lowell Surgery Center
$531.00Published rateNatraj Surgery Center Inc.
Natraj Surgery Center Inc
$187.00Published rateCataract And Refractive Surgery Center, LLC, Novamed Surgery Center Of Richmond, LLC
Cataract And Refractive Surgery Center LLC
$80.00Published rate
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See a sample payer proposalCPT 68899 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 68899 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 68899 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 68899. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 68899 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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