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 | $2000.00 | 1235466863 - AESTHETIC ASSOCIATES INC., P.S, SEATTLE FACIAL PLASTIC SURGERY CENTER | 911650765 - (WA) AESTHETIC ASSOCIATES INC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $5379.00 | 1770252868 - STONESPRINGS SURGICENTER, LLC | 812929320 - (VA) STONESPRINGS SURGICENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1285.00 | 1316919574 - CHEVY CHASE ASC LLC, CHEVY CHASE ENDOSCOPY CENTER | 621666144 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $2353.00 | 1245263292 - CHATTANOOGA PAIN MANAGEMENT CENTER LLC, CHATTANOOGA PAIN SURGERY CENTER | 320121593 - (TN) CHATTANOOGA PAIN MANAGEMENT | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1667.00 | 1093230450 - CENTER FOR UROLOGIC SURGERY LLC | 822344535 - (MO) CENTER FOR UROLOGIC SURGERY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1001.00 | 1316900830 - BAYONET POINT SURGERY CENTER LTD | 200670560 - (FL) BAYONET POINT SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1288.00 | 1447254172 - SURGICENTER OF BALTIMORE LLC, SURGICENTER OF BALTIMORE | 521658841 - (MD) SURGICENTER OF BALTIMORE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $526.00 | 1720833163 - MIDWEST EYE CENTER | 363010536 - (IL) MIDWEST EYE CENTER | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1148.00 | 1164012142 - COMPREHENSIVE DIGESTIVE SURGICENTER, LLC, COMPREHENSIVE DIGESTIVE SURGICAL CENTER | 854015524 - (NV) COMPREHENSIVE DIGESTIVE SURGICENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1387.00 | 1144970112 - SONORAN ENDOSCOPY CENTER LLC | 852760027 - (AZ) SONORAN ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1352.00 | 1528061918 - CATARACT SPECIALTY SURGICAL CENTER, LLC, CATARACT SPECIALTY SURGICAL CENTER | 200225369 - (MI) CATARACT SPECIALTY SURGICAL CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $3348.22 | 1215904131 - NEBRASKA SURGERY CENTER LLC | 470812621 - (NE) NEBRASKA SURGERY CENTER, LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $1148.00 | 1457350449 - BAPTIST AND PHYSICIANS OUTPATIENT SURGERY CENTER OF NORTH MS, LP, OXFORD SURGERY CENTER | 640925692 - (MS) BAPTIST AND PHYSICIANS OUTPATIENT SURGERY CENTER OF NORTH MS LP | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 65820 | $2388.00 | 1588854772 - ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER, LLC | 201243484 - (AL) ALABAMA DIGESTIVE HEALTH | AL | 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 | 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-CPT | Low | Paracentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Aqueous (Rvsd 1/1/13) |
| 65810-CPT | 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-CPT | Moderate | Paracentesis Of Anterior Chamber Of Eye (Separate Procedure); With Removal Of Blood, With Or Without Irrigation And/Or Air Injection |
| 65820-CPT | 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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