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CPT 65865 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Severing Adhesions Of Anterior Segment Of Eye, Incisional Technique (With Or Without Injection Of Air Or Liquid) (Separate Procedure); Goniosynechiae
Key FactDetail
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

LT - Left side of body

RT - Right side of body

Complexity LevelModerate

National average reimbursement for CPT 65865 by major payers:

bcbs

$652.31

uhc

$608.56

aetna

$645.88

cigna

$784.32

Preview provider-level rates for...
For billing codeCPT 65865
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 65865

United
65865$695.001669720439 - OCALA SURGICAL CENTER, OCALA SURGICAL CENTER, LLC842579958FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1000.001174615702 - I CARE CENTER LLC, CENTRAL INDIANA SURGERY CENTER351937200 - (IN) ICARE CENTER DBA CENTRAL INDIANA SURGERY CENTER, LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$5048.001598096802 - MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC, MEMORIAL HERMANN MEMORIAL VILLAGE SURGERY CENTER264276930TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1595.001003909789 - OREGON TRAIL EYE SURGERY CENTER, INC200121578 - (NE) OREGON TRAIL EYE SURGERY CENTER INCNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$2762.001629559208 - ORTHOARIZONA SURGERY CENTER GILBERT, LLC, ORTHOARIZONA SURGERY CENTER GILBERT823624585 - (AZ) ORTHOARIZONA SURGERY CENTER GILBERT LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$4000.001386624815 - QUALITY SURGICENTER LLC421480973 - (IA) QUALITY SURGICENTER LLCIAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1533.001528021573 - SUMMIT SURGERY CENTER LP621777535 - (TN) SUMMIT SURGERY CENTER LPTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1650.001538722699 - R & R SURGICAL CENTERS820815470 - (CA) RR SURGICAL INSTITUTECAAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1144.001942267893 - GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, PA223345724 - (NJ) GASTROENTEROLOGY DIAGNOSTICS OF NORTHERN NEW JERSEY, P.A.NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1335.001588756621 - HIGHLINE SOUTH AMBULATORY SURGERY CENTER, LLC, HIGHLINE SOUTH AMBULATORY SURGERY CENTER205001199 - (CO) HIGHLINE SOUTH AMBULATORY SURGERY CENTER LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1155.001346596566 - SCP INDIANAPOLIS LLC460639908INAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$840.001922011501 - LOWERY A. WOODALL OUTPATIENT SURGERY FACILITY, LLC640897321MSAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$3348.221508213810 - ALEGENT CREIGHTON HEALTH, CHI HEALTH AMBULATORY SURGERY CENTER AT MIDLANDS470757164 - ALEGENT CREIGHTON HEALTHNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1380.001396266441 - EYE SURGERY CENTER OF EAST TEXAS LLC811881035 - (TX) EYE SURGERY CENTER OF EAST TEXAS LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
65865$1200.001538159728 - TENAYA SURGICAL CENTER, LLC880423641 - (NV) TENAYA SURGICAL CENTER LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 65865 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes

The CPT 65865 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 65865 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.

CodeComplexityDescription
65860ModerateSever Adhesions Ant Seg Laser Tech
65865ModerateSevering Adhesions Of Anterior Segment Of Eye, Incisional Technique (With Or Without Injection Of Air Or Liquid) (Separate Procedure); Goniosynechiae
65870ModerateSevering Adhesions Of Anterior Segment Of Eye, Incisional Technique (With Or Without Injection Of Air Or Liquid) (Separate Procedure); Anterior Synechiae, Except Goniosynechiae
65875ModerateSevering Adhesions Of Anterior Segment Of Eye, Incisional Technique (With Or Without Injection Of Air Or Liquid) (Separate Procedure); Posterior Synechiae

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65865. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 65865 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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