CPT 65820 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 65820 by major payers:
$1,037.44
$983.75
$1,079.95
$1,308.63
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 65820 | ||||||
United | 65820 | $1344.51 | 1942576871 - SHALONDA NEWCOMB | 350593390 - DEACONESS HOSPITAL INC | IN | Family Medicine Physician (207Q00000X) |
United | 65820 | $2353.00 | 1841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER | 383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $900.00 | 1164662912 - SPACE COAST SURGERY CENTER LLC | 263184352 - (FL) SPACE COAST SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $2918.00 | 1124083878 - THREE GABLES SURGERY CENTER LLC | 870648900 - (OH) THREE GABLES SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $3008.00 | 1275071789 - KADLEC REGIONAL MEDICAL CENTER | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $2300.00 | 1437794625 - VANCE THOMPSON VISION SURGERY CENTER BILLINGS, LLC | 843362063 | MT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $817.00 | 1871174706 - AMBULATORY CARDIOVASCULAR CENTER OF MISSISSIPPI | 861979907 - (MS) AMBULATORY CARDIOVASCULAR CENTER OF MISSISSIPPI | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1921.00 | 1891186987 - FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTER,LLC | 464426708 - (CO) FUNCTIONAL NEUROSURGICAL AMBULATORY SURGERY CENTERLLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $2388.00 | 1851710735 - SURGCENTER TUCSON, LLC | 462350774 - (AZ) SURGCENTER TUCSON, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $3120.00 | 1295790327 - ENDOSCOPY OF PLANO, LP, GASTROINTESTINAL ENDOSCOPY CENTER OF PLANO | 201477775 - (TX) ENDOSCOPY OF PLANO LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1350.00 | 1346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP | 934728316 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $600.00 | 1053417402 - KEYSTONE KIDNEY ASSOCIATES, PC | 232470181 - (PA) KEYSTONE KIDNEY ASSOCIATES PC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1223.00 | 1770911463 - SALUBRIOUS ASC, LLC | 463866454 - (GA) SALUBRIOUS ASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1420.00 | 1396700753 - HALCYON LASER & SURGERY CENTER, INC. | 770410936 - (CA) HALCYON LASER SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1629.00 | 1497201867 - ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY, L.L.C. | 813619502 - (TX) ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 65820 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65820 code is part of the Surgery services used for Surgical Procedures on the Eye and Ocular Adnexa. 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 CPT 65820 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 |
|---|---|---|
| 65800 | Low | Paracentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Aqueous (Rvsd 1/1/13) |
| 65810 | Moderate | Paracentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Vitreous And/Or Discission Of Anterior Hyaloid Membrane, With Or Without Air Injection |
| 65815 | Moderate | Paracentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Blood, With Or Without Irrigation And/Or Air Injection |
| 65820 | High | Goniotomy Wo Goniopuncture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65820 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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