Summary & Overview
CPT 65855: Laser Trabeculoplasty for Glaucoma
CPT code 65855 identifies a laser trabeculoplasty procedure used to treat glaucoma by applying laser energy to the trabecular meshwork to improve aqueous humor outflow and lower intraocular pressure. Nationally, this code represents a commonly used ophthalmic therapeutic procedure important for managing open-angle glaucoma and preventing progressive vision loss. Its utilization impacts outpatient ophthalmology practice patterns, resource use in ambulatory surgery centers, and payer coverage policies for glaucoma interventions.
Key payers included in the coverage and benchmark discussion are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical sites of service, plus coverage and billing context across major payers. The publication summarizes common modifiers and service-line considerations, outlines typical clinical indications for laser trabeculoplasty, and highlights benchmarking metrics and policy updates relevant to reimbursement and utilization management.
This analysis is intended for national audiences including clinicians, coding and billing staff, and policy analysts seeking a clear, practical reference to support accurate coding, payer engagement, and operational planning for ophthalmic laser procedures.
Billing Code Overview
CPT code 65855 describes a laser trabeculoplasty procedure in which a provider uses a laser to treat the trabecular meshwork—the tissue at the junction of the iris and sclera—to improve drainage of aqueous humor from the anterior chamber and treat glaucoma. This procedure is a targeted ophthalmic intervention to lower intraocular pressure by increasing outflow through the trabecular meshwork.
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Service type: Ophthalmic laser procedure (glaucoma treatment)
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Typical site of service: Outpatient ophthalmology clinic or ambulatory surgery center where laser procedures are performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of primary open-angle glaucoma presents to the ophthalmology clinic with progressive elevation of intraocular pressure (IOP) despite maximally tolerated topical medical therapy. The patient reports gradual peripheral vision loss and an IOP of 26 mm Hg on exam. After a comprehensive ophthalmic evaluation including slit-lamp exam, gonioscopy demonstrating an accessible trabecular meshwork, and discussion of risks and benefits, the ophthalmologist schedules a laser trabeculoplasty procedure.
On the day of service the patient arrives at an ambulatory surgery center or hospital outpatient department. The workflow includes pre-procedure consent and topical anesthesia in clinic or ASC, administration of pilocarpine and topical anesthetic, placement at the slit lamp or procedural laser unit, delivery of laser burns to the trabecular meshwork under gonioscopic visualization, post-procedure IOP check, and brief observation before discharge with follow-up arranged in 4–6 weeks.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician’s professional service separate from the facility or technical component. |
50 |