Billing code 65820: GoniotomyMedicare rate & RVUs in Alaska
An ophthalmic surgeon incises the trabecular meshwork from inside the eye to improve aqueous outflow in selected glaucoma cases.
CMS doesn’t publish an office rate for 65820 in Alaska.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
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.
65820 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $885.07 |
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
Swap in your local Medicare rate.
Work 8.69Practice expense 12.29Malpractice 0.68
All indexes start 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 65820
Goniotomy
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.
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
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).
65820 compared with similar codes
Compare codes
65820 vs 65850 vs 65855 vs 65800: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65850Trabeculotomy
- Choose 65820 for an internal, gonioscopically viewed angle incision; 65850 describes an external approach to opening the outflow pathway.
- 65855Laser trabeculoplasty
- 65855 is laser treatment of the trabecular meshwork. Use 65820 for the surgical incision performed under direct gonioscopic visualization.
- 65800Eye paracentesis
- 65800 describes drainage of the anterior chamber, not an operation to improve glaucoma outflow by incising the trabecular meshwork.
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
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