CPT 65820 · professional fee

Goniotomy (CPT 65820): negotiated rates by payer and state

What UnitedHealthcare, Aetna, Cigna and Blue Cross Blue Shield pay for CPT 65820, from their published in-network rate files.

OphthalmologySnapshot Aug 2026Professional fee only

National summary

Commercial in-network, four payers combined, professional fee

Median rate

$955

P10 to P90: $673 to $1,910

vs Medicare

132%

non-facility rate $723.46

Payer spread

1.12×

BCBS $1,017 vs Aetna $910

State spread

5.2×

AK $3,313 to FL $634

4,631 sampled providers6,423 TINs51 statesSample-based · how this is calculated

What the data shows

Generated from this code's own numbers

Blue Cross Blue Shield has the highest median for CPT 65820 in the files analyzed, at $1,017, 12% above Aetna ($910), the lowest of the 4 payers shown.

The state spread is 5.2×: Alaska has the highest median at $3,313 and Florida the lowest at $634, a gap larger than the gap between the highest and lowest payer.

Commercial rates run 132% of the Medicare non-facility rate ($723.46), which ranks 149th of 228 tracked codes by commercial-to-Medicare ratio.

Rates are tightest within Aetna (interquartile range $380) and widest within UnitedHealthcare ($617).

This is a top-21 code for ophthalmology by Medicare allowed dollars, so it carries real revenue weight for that specialty.

Rates by payer

Median of per-provider median rates, with interquartile range

Payer	Median	P25	P75	vs national	Rank	Providers	Position
Blue Cross Blue Shield	$1,017	$835	$1,360	+7%	1	3,471	141% of Medicare
UnitedHealthcare	$965	$760	$1,377	+1%	2	3,834	133% of Medicare
Cigna	$938	$762	$1,331	-2%	3	3,783	130% of Medicare
Aetna	$910	$818	$1,198	-5%	4	2,776	126% of Medicare

Rate distribution

Box = P25 to P75, whiskers = P10 to P90, tick = median, dashed line = Medicare non-facility ($723.46)

Rates by state

Median across payers · 50 states with enough data

Rank	State	Median	vs national	Highest payer	Lowest payer	Providers
1	Alaska	$3,313	+247%	n/a	n/a	23
2	Nebraska	$1,754	+84%	Cigna	BCBS	70
2	South Dakota	$1,754	+84%	BCBS	UHC	39
4	Wisconsin	$1,606	+68%	UHC	Aetna	87
5	Oregon	$1,550	+62%	UHC	BCBS	100
6	Iowa	$1,510	+58%	UHC	Aetna	93
7	North Dakota	$1,500	+57%	BCBS	Aetna	33
8	Massachusetts	$1,364	+43%	Cigna	Aetna	116
9	Georgia	$1,362	+43%	Cigna	Aetna	115
10	Connecticut	$1,311	+37%	BCBS	Cigna	109
11	Idaho	$1,300	+36%	Aetna	UHC	57
12	Montana	$1,290	+35%	UHC	Cigna	36
13	Minnesota	$1,229	+29%	BCBS	Aetna	94
14	Maine	$1,208	+26%	Cigna	UHC	64
15	Illinois	$1,164	+22%	BCBS	Aetna	111
16	Washington	$1,163	+22%	Aetna	Cigna	120
17	New Hampshire	$1,141	+19%	Cigna	Aetna	55
18	Vermont	$1,140	+19%	Cigna	BCBS	33
19	Michigan	$1,098	+15%	BCBS	UHC	112
20	Hawaii	$1,059	+11%	UHC	Cigna	85
21	Mississippi	$1,029	+8%	Aetna	UHC	103
22	Colorado	$1,020	+7%	BCBS	Cigna	104
23	Utah	$989	+4%	BCBS	UHC	115
24	Rhode Island	$970	+2%	Cigna	UHC	62
25	New Mexico	$957	+0%	UHC	BCBS	71
26	Kansas	$939	-2%	BCBS	Cigna	106
27	Louisiana	$933	-2%	Aetna	UHC	109
28	West Virginia	$916	-4%	Cigna	BCBS	76
29	Oklahoma	$905	-5%	BCBS	UHC	111
30	New York	$900	-6%	BCBS	Cigna	109
31	North Carolina	$894	-6%	Cigna	Aetna	118
32	Alabama	$892	-7%	Aetna	UHC	111
33	Tennessee	$892	-7%	Aetna	Cigna	120
34	Missouri	$887	-7%	UHC	Cigna	110
35	Virginia	$868	-9%	Aetna	Cigna	108
36	Indiana	$866	-9%	BCBS	Aetna	115
37	Texas	$866	-9%	Aetna	UHC	122
38	Arkansas	$864	-10%	Cigna	UHC	91
39	Nevada	$848	-11%	Aetna	Cigna	111
40	South Carolina	$840	-12%	Aetna	Cigna	102
41	Kentucky	$834	-13%	Cigna	BCBS	112
42	Ohio	$819	-14%	UHC	BCBS	108
43	District of Columbia	$817	-14%	Aetna	BCBS	52
44	Maryland	$806	-16%	Aetna	BCBS	105
45	Arizona	$797	-17%	Aetna	BCBS	109
46	Pennsylvania	$797	-17%	UHC	Cigna	116
47	New Jersey	$766	-20%	BCBS	UHC	117
48	Delaware	$766	-20%	Aetna	Cigna	47
49	California	$719	-25%	UHC	Aetna	121
50	Florida	$634	-34%	UHC	Aetna	111

Frequently asked questions

Answers use this page's data

Which payer has the highest median rate for CPT 65820?

In the files we analyzed, Blue Cross Blue Shield, at a median of $1,017 across 3,471 sampled providers. Aetna is lowest at $910, 12% lower than the highest.

How does the commercial rate compare with Medicare?

The national median is 132% of the 2026 Medicare non-facility rate of $723.46.

Which state has the highest median for CPT 65820?

Alaska has the highest median at $3,313; Florida has the lowest at $634.

Is this the surgeon, physician or facility payment?

These are professional (physician) fees only. Facility, device and implant payments are priced separately and are not included.

How current is this data?

It is the August 2026 snapshot of each payer's in-network rate file. Sources and filters are listed in the methodology below.

Methodology

How these numbers are calculated

Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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