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See a sample rate comparisonHCPCS S0621 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.
Routine ophthalmological examination including refraction; established patient
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Screenings and Examinations |
| Common Place of Service | 11 - Office None 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for S0621 |
National average reimbursement for HCPCS S0621 by major payers:
$74.80
$56.66
$42.94
$47.46
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HCPCS S0621
5 of 6 sample ratesHigher to lower in this preview
Bruce Madsen
Bridgeport Eye Physicians LLC
$75.00Published rateBruce Madsen
Eyecare Associates PC
$75.00Published rateBruce Madsen
Eyecare Associates PC
$75.00Published rateMatthew Knecht
Matthew W Knecht LLC
$42.00Published rateMatthew Knecht
Matthew W Knecht LLC
$42.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS S0621 vs. Other Screenings and Examinations Codes
The HCPCS S0621 code is part of the Temporary National Codes (Non-Medicare) services used for Screenings and Examinations. 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 HCPCS S0621 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 |
|---|---|---|
| S0620-HCPCS | Low | Routine ophthalmological examination including refraction; new patient |
| S0621-HCPCS | Low | Routine ophthalmological examination including refraction; established patient |
| S0622-HCPCS | Low | Physical exam for college, new or established patient (list separately in addition to appropriate evaluation and management code) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0621. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S0621 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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