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CPT code 65820: Goniotomy, angle incision2026 Medicare rate & RVUs

An ophthalmic surgeon incises the trabecular meshwork from inside the eye to improve aqueous outflow in selected glaucoma cases.

CMS RVU26DEffective Oct 1, 2026109 payment localities70.8K Medicare services in 2024

Medicare pays $723.46 for 65820 nationally in a facility.

Medicare rate · 65820

Goniotomy, angle incision

Office or facility?

Work RVUs
8.69
Total RVUs
21.66
Global days
090

National rate · 2026

$723.46

Facility setting, before claim adjustments.

See every locality for 65820 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 65820 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 65820 covers

Goniotomy is an angle-based glaucoma operation: the surgeon views the drainage angle with a gonioscopic lens and makes an incision in the trabecular meshwork to improve aqueous outflow. It is classically used for congenital glaucoma when the angle can be visualized, and is performed by an ophthalmologist in an operating room. The procedure may also be performed with another eye operation when both services are indicated and documented.

Report the service for each treated eye and document the glaucoma indication, operative approach, and eye treated. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued is paid in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 65820 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

65820 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$662.29
AlaskaUnavailable$885.07
ArizonaUnavailable$707.47
ArkansasUnavailable$654.57
Atlanta, GAUnavailable$735.47
Austin, TXUnavailable$745.26
Bakersfield, CAUnavailable$759.51
Baltimore area, MDUnavailable$763.46
Beaumont, TXUnavailable$684.91
Brazoria, TXUnavailable$717.09

65820 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
65820 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 65820 rate is calculated

Each of 65820’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 65820

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.69

8.69 RVUs× 1.000 GPCI

Practice expense12.29

12.29 RVUs× 1.000 GPCI

Malpractice0.68

0.68 RVUs× 1.000 GPCI

Adjusted RVUs

21.6600

Conversion factor

$33.4009

Medicare rate

$723.46

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 65820

65820 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 65820

Goniotomy, angle incision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 65820

Goniotomy, angle incision

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

65820 without 50 · national facility

$723.46

Goniotomy, angle incision

65820-50 · Bilateral: 150%

$1,085.19

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

65820 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 65820

    Goniotomy, angle incision8.69 wRVU

    Not priced

  • 65850

    Trabeculotomy, external approach11.11 wRVU

    Not priced

  • 65855

    Laser trabeculoplasty, trabecular meshwork treatment2.93 wRVU

    $245.50

  • 65800

    Eye paracentesis, aqueous removal1.49 wRVU

    $120.58

How to choose

65850TrabeculotomyExternal approach
Choose 65820 for an internal, gonioscopically viewed angle incision; 65850 describes an external approach to opening the outflow pathway.
65855Laser trabeculoplastyTrabecular meshwork treatment
65855 is laser treatment of the trabecular meshwork. Use 65820 for the surgical incision performed under direct gonioscopic visualization.
65800Eye paracentesisAqueous removal
65800 describes drainage of the anterior chamber, not an operation to improve glaucoma outflow by incising the trabecular meshwork.

Codes related to 65820

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 65820
CodeHow it relatesNational office range
Used instead
65850Trabeculotomy, external approachTrabeculotomy approaches the outflow pathway externally rather than through an internal angle incision.No office rate
65855Laser trabeculoplasty, trabecular meshwork treatmentLaser trabeculoplasty treats the drainage angle with laser rather than surgical incision.$222.15–$314.86
Often billed with
66984Cataract surgery, standard, without ECP or drainage deviceCataract extraction with lens implantation may be performed during the same session when separately indicated.No office rate

65820 billing questions

How is goniotomy different from an ab externo trabeculotomy?

Goniotomy reaches the drainage angle from inside the eye under gonioscopic view. Ab externo trabeculotomy approaches the outflow pathway from outside the eye.

Can goniotomy be reported with cataract extraction?

It may be reported with cataract extraction when both procedures are performed and documented. The multiple-procedure reduction applies when the procedures are performed in the same session.

How should bilateral goniotomy be reported?

Use modifier 50 for bilateral surgery; CMS pays the bilateral procedure at 150%. Document that both eyes were treated.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant surgeon be billed?

Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 65820PPRRVU2026_Oct_nonQPP.csv, line 7,349 (RVU26D)

Open CMS sourceHow we calculate rates

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