No office rate
Choose 65820 for an internal, gonioscopically viewed angle incision; 65850 describes an external approach to opening the outflow pathway.
On this page
CMS RVU26D · Effective 2026-10-01
65820 Goniotomy Medicare reimbursement rates in Missouri
An ophthalmic surgeon incises the trabecular meshwork from inside the eye to improve aqueous outflow in selected glaucoma cases. Compare 65820 office and facility rates across CMS payment localities in Missouri.
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 65820 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$666.22–$703.81
3 of 3 localities have a 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 65820 pays more and less in Missouri
Glaucoma surgery
About 65820: Goniotomy for glaucoma
An ophthalmic surgeon incises the trabecular meshwork from inside the eye to improve aqueous outflow in selected glaucoma cases.
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.
CMS billing rules for 65820
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.69 · 40%
- Practice expense (office) RVU12.29 · 57%
- Malpractice RVU0.68 · 3%
70.8K
Medicare services in 2024 · #668 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.
65820 compared with similar codes
Office rates for Missouri, from the same CMS release.
$225.95–$238.78
65855 is laser treatment of the trabecular meshwork. Use 65820 for the surgical incision performed under direct gonioscopic visualization.
$111.25–$117.38
65800 describes drainage of the anterior chamber, not an operation to improve glaucoma outflow by incising the trabecular meshwork.
Compare 65820 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$697.90
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$703.81
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$666.22
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 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.
7,34665800,,Drainage of eye,A,,1.49,2.00,,0.52,,0.12,3.61,2.13,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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