No office rate
Choose 65850 for the external approach to the trabecular meshwork; 65820 describes an internal goniotomy approach.
On this page
CMS RVU26D · Effective 2026-10-01
65850 Trabeculotomy Medicare reimbursement rates
Reports glaucoma surgery that opens the trabecular drainage pathway through an external approach to improve aqueous outflow from the eye. Compare 65850 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 65850?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 65850 pays more and less
Glaucoma surgery
About 65850: Ab externo trabeculotomy for glaucoma
Reports glaucoma surgery that opens the trabecular drainage pathway through an external approach to improve aqueous outflow from the eye.
An ophthalmologist performs an ab externo trabeculotomy by approaching the drainage angle from outside the eye and opening the trabecular meshwork to improve aqueous humor outflow. The procedure is used for glaucoma, including congenital or developmental glaucoma, and is performed in a surgical setting. It differs from an internal angle incision because the surgeon reaches the trabecular meshwork through an external approach.
Report 65850 when the operative documentation supports this external approach and the trabecular incision. Record the treated eye and any other procedures performed during the session. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 65850
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.11 · 52%
- Practice expense (office) RVU9.39 · 44%
- Malpractice RVU0.88 · 4%
285
Medicare services in 2024 · #4032 by national volume
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.
65850 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$222.15–$314.86
65855 is laser treatment of the trabecular drainage angle. It does not describe the external incision reported with 65850.
No office rate
66170 describes trabeculectomy, which creates a filtration pathway; 65850 opens the trabecular meshwork through an external approach.
See how rates vary across the country
65850 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 65850 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $662.15 |
| Alaska* | Office Unavailable | Facility $906.84 |
| Arizona | Office Unavailable | Facility $700.16 |
| Arkansas | Office Unavailable | Facility $655.63 |
| Atlanta | Office Unavailable | Facility $726.15 |
| Austin | Office Unavailable | Facility $729.69 |
| Bakersfield | Office Unavailable | Facility $739.78 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $749.91 |
| Beaumont | Office Unavailable | Facility $683.80 |
| Brazoria | Office Unavailable | Facility $707.79 |
| Chicago | Office Unavailable | Facility $756.34 |
| Chico | Office Unavailable | Facility $736.89 |
| Colorado | Office Unavailable | Facility $732.20 |
| Connecticut | Office Unavailable | Facility $751.86 |
| Dallas | Office Unavailable | Facility $712.02 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $793.30 |
| Delaware | Office Unavailable | Facility $709.23 |
| Detroit | Office Unavailable | Facility $723.30 |
| East St. Louis | Office Unavailable | Facility $718.82 |
| El Centro | Office Unavailable | Facility $737.04 |
| Fort Lauderdale | Office Unavailable | Facility $741.94 |
| Fort Worth | Office Unavailable | Facility $709.27 |
| Fresno | Office Unavailable | Facility $736.89 |
| Galveston | Office Unavailable | Facility $709.83 |
| Hanford-Corcoran | Office Unavailable | Facility $736.89 |
| Hawaii, Guam | Office Unavailable | Facility $744.70 |
| Houston | Office Unavailable | Facility $725.94 |
| Idaho | Office Unavailable | Facility $673.53 |
| Indiana | Office Unavailable | Facility $676.11 |
| Iowa | Office Unavailable | Facility $669.73 |
| Kansas | Office Unavailable | Facility $669.42 |
| Kentucky | Office Unavailable | Facility $676.80 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $776.84 |
| Madera | Office Unavailable | Facility $736.89 |
| Manhattan | Office Unavailable | Facility $805.89 |
| Merced | Office Unavailable | Facility $736.89 |
| Metropolitan Boston | Office Unavailable | Facility $786.94 |
| Metropolitan Kansas City | Office Unavailable | Facility $694.30 |
| Metropolitan Philadelphia | Office Unavailable | Facility $739.32 |
| Metropolitan St. Louis | Office Unavailable | Facility $699.12 |
| Miami | Office Unavailable | Facility $771.91 |
| Minnesota | Office Unavailable | Facility $702.51 |
| Mississippi | Office Unavailable | Facility $662.84 |
| Modesto | Office Unavailable | Facility $736.89 |
| Montana** | Office Unavailable | Facility $714.05 |
| Napa | Office Unavailable | Facility $822.76 |
| Nebraska | Office Unavailable | Facility $671.68 |
| Nevada** | Office Unavailable | Facility $709.52 |
| New Hampshire | Office Unavailable | Facility $723.30 |
| New Mexico | Office Unavailable | Facility $693.99 |
| New Orleans | Office Unavailable | Facility $699.60 |
| North Carolina | Office Unavailable | Facility $682.49 |
| North Dakota** | Office Unavailable | Facility $696.65 |
| Northern Nj | Office Unavailable | Facility $789.67 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $822.33 |
| Ohio | Office Unavailable | Facility $687.06 |
| Oklahoma | Office Unavailable | Facility $674.00 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $770.50 |
| Portland | Office Unavailable | Facility $747.34 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $766.78 |
| Puerto Rico | Office Unavailable | Facility $717.12 |
| Queens | Office Unavailable | Facility $807.93 |
| Redding | Office Unavailable | Facility $736.89 |
| Rest Of California | Office Unavailable | Facility $736.89 |
| Rest Of Florida | Office Unavailable | Facility $715.10 |
| Rest Of Georgia | Office Unavailable | Facility $685.88 |
| Rest Of Illinois | Office Unavailable | Facility $703.37 |
| Rest Of Louisiana | Office Unavailable | Facility $676.81 |
| Rest Of Maine | Office Unavailable | Facility $677.91 |
| Rest Of Maryland | Office Unavailable | Facility $719.18 |
| Rest Of Massachusetts | Office Unavailable | Facility $730.70 |
| Rest Of Michigan | Office Unavailable | Facility $690.62 |
| Rest Of Missouri | Office Unavailable | Facility $670.07 |
| Rest Of New Jersey | Office Unavailable | Facility $760.66 |
| Rest Of New York | Office Unavailable | Facility $689.70 |
| Rest Of Oregon | Office Unavailable | Facility $704.13 |
| Rest Of Pennsylvania | Office Unavailable | Facility $686.78 |
| Rest Of Texas | Office Unavailable | Facility $695.26 |
| Rest Of Washington | Office Unavailable | Facility $728.53 |
| Rhode Island | Office Unavailable | Facility $728.34 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $746.58 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $764.95 |
| Salinas | Office Unavailable | Facility $761.84 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $773.25 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $862.05 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $861.05 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $879.92 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $875.83 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $750.38 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $775.70 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $762.93 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $783.11 |
| Seattle (King Cnty) | Office Unavailable | Facility $798.48 |
| South Carolina | Office Unavailable | Facility $685.87 |
| South Dakota** | Office Unavailable | Facility $694.59 |
| Southern Maine | Office Unavailable | Facility $700.44 |
| Stockton | Office Unavailable | Facility $736.89 |
| Suburban Chicago | Office Unavailable | Facility $747.87 |
| Tennessee | Office Unavailable | Facility $671.96 |
| Utah | Office Unavailable | Facility $692.30 |
| Vallejo | Office Unavailable | Facility $821.32 |
| Vermont | Office Unavailable | Facility $696.45 |
| Virgin Islands | Office Unavailable | Facility $717.12 |
| Virginia | Office Unavailable | Facility $700.14 |
| Visalia | Office Unavailable | Facility $736.89 |
| West Virginia | Office Unavailable | Facility $685.69 |
| Wisconsin | Office Unavailable | Facility $680.60 |
| Wyoming** | Office Unavailable | Facility $706.47 |
| Yuba City | Office Unavailable | Facility $736.89 |
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65850 billing questions
How is 65850 different from goniotomy 65820?
65850 describes an external approach to the trabecular meshwork. Goniotomy 65820 approaches and incises the angle internally.
Are related postoperative visits separately reported?
The 90-day global period includes related postoperative care and the day-before preoperative visit.
How should bilateral trabeculotomy be reported?
When the procedure is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,34765810,,Drainage of eye,A,,5.67,5.89,NA,5.89,,0.44,12.00,12.00,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,34865815,,Drainage of eye,A,,5.85,12.92,,6.01,,0.46,19.23,12.32,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,34965820,,Goniotomy,A,,8.69,12.29,NA,12.29,,0.68,21.66,21.66,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35065850,,Trabeculotomy ab externo,A,,11.11,9.39,NA,9.39,,0.88,21.38,21.38,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35165855,,Trabeculoplasty laser surg,A,,2.93,4.20,,1.98,,0.22,7.35,5.13,0,010,0.10,0.80,0.10,2,1,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35265860,,Severing ads ant sgm laser,A,,3.50,5.51,,2.49,,0.27,9.28,6.26,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35365865,,Incise inner eye adhesions,A,,5.63,6.32,NA,6.32,,0.44,12.39,12.39,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00