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    v1.0.30
    OpenPayerBilling CodesOphthalmological Examination and Evaluation ProceduresCPT cpt-92020-gonioscopy-anterior-chamber-angle-examination
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    CPT 92020: Goniometry of Anterior Chamber Angle

    Medicare pays $28 and commercial payers pay $77 on average nationally for this procedure.

    CPT code 92020 describes a separate goniometry procedure in which the provider examines the anterior chamber angle of the eye using a goniolens with a slit lamp or operating microscope to diagnose and monitor glaucoma-related conditions; service type: diagnostic ophthalmic examination, typical site of service: ophthalmology clinic or outpatient eye surgery setting.

    For related coverage guidance, see recent payer policy updates: Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mapping, Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mapping, Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mapping.

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    National Reimbursement Benchmarks

    Medicare’s mean allowed amount is $27.70, notably lower than BUCA’s commercial average of $77.00, indicating Medicare reimburses roughly one-third of this commercial benchmark for CPT 92020. That gap highlights the split between government and commercial purchasing power for this ophthalmology evaluation code, with BUCA sitting well above Medicare on a national mean basis.

    Examining dispersion (P75 minus P25) highlights variability by payer: Blue Cross Blue Shield has the widest interquartile spread at $43.20 ($131.70 - $89.50), followed by Aetna at $17.20 ($30.00 - $12.80). UnitedHealth Group and Cigna show similar mid-level spreads of $20.90 ($45.80 - $24.70) and $23.30 ($48.00 - $24.70) respectively, while BUCA’s spread is $32.90 ($92.90 - $60.00). Medicare’s interquartile spread is narrow at $2.00 ($28.00 - $26.00).

    National Payer Mean Reimbursement Rates

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    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 64-year-old patient with progressively worsening peripheral vision and a prior diagnosis of primary open-angle glaucoma (H40.11X0) presents for targeted evaluation of the anterior chamber angle. The patient is seen in an ophthalmology clinic by a glaucoma specialist for assessment of angle anatomy, risk of angle-closure, and to guide management decisions. The workflow includes history review, visual acuity, intraocular pressure measurement, slit-lamp biomicroscopy, and then gonioscopy performed with a goniolens at the slit-lamp or operating microscope. Findings are documented (angle grade, synechiae, pigmentation, neovascularization) and compared with prior exams. If indicated, ancillary testing (such as optical coherence tomography of the optic nerve or retina 92133/92134) or medication changes are scheduled. The procedure is billed as a separate, distinct service when gonioscopy is performed independently of other contemporaneous ocular procedures.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    92004Comprehensive eye exam, new patientPerformed when a new patient requires a full diagnostic evaluation; gonioscopy () may follow if angle assessment is indicated.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207W00000X
    207WX0009X
    152W00000X
    2471C1106X
    213E00000X
    2080P0202X
    163WP0809X
    367A00000X

    Related ICD-10-CM Codes

    22 rows

    ICD-10-CM CodeDescription
    H26.9Unspecified cataract
    H27.9Unspecified disorder of lens
    H40.10X0Unspecified open-angle glaucoma, stage unspecified
    H40.10X1Unspecified open-angle glaucoma, mild stage
    H40.10X2Unspecified open-angle glaucoma, moderate stage
    H40.1110Primary open-angle glaucoma, right eye, stage unspecified
    H40.1111Primary open-angle glaucoma, right eye, mild stage
    H40.1120Primary open-angle glaucoma, left eye, stage unspecified
    H40.1121Primary open-angle glaucoma, left eye, mild stage
    H40.11X0

    Showing 1–10 of 22

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mappingpremerabluecrossofwashington2027-02-05
    Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mappingpremerabluecrossofwashington2027-02-05
    Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mappingpremerabluecrossofwashington2027-02-05
    Calcitonin Gene-Related Peptide (CGRP) Inhibitors: Vyepti (eptinezumab-jjmr)Mass General Brigham Health Plan2027-01-04
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Open Neuroplasty Lumbar PlexusCigna2026-12-15
    Laser Interstitial Thermal TherapyCigna2026-11-15
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Microdiscectomyuniverahealthcare2026-10-15

    Related Codes

    CPT-92015-REFRACTION-VISION-ASSESSMENT-CORRECTIVE-LENSES

    CPT 92015: Subjective Refraction for Corrective Lenses

    CPT-92018-EYE-EXAM-UNDER-GENERAL-ANESTHESIA

    CPT 92018: Eye Examination Under General Anesthesia

    CPT-92019-LIMITED-EYE-EXAM-UNDER-GENERAL-ANESTHESIA

    CPT 92019: Limited Eye Examination Under General Anesthesia

    CPT-92025-CORNEAL-KERATOMETRY-INTERPRETATION-REPORT

    CPT 92025: Keratometry (Corneal Curvature Measurement)

    CPT-92060-COMPREHENSIVE-OCULAR-MOTILITY-AND-BINOCULAR-FUNCTION-EXAM

    CPT 92060: Comprehensive Eye Sensorimotor and Deviation Measurement

    CPT-92065-VISION-THERAPY-PATIENT-TRAINING

    CPT 92065: Vision Therapy Patient Exercise Training

    CPT-92066-VISION-THERAPY-PATIENT-TRAINING

    CPT 92066: Training Patient in Vision Therapy Exercises

    CPT-92071-THERAPEUTIC-SOFT-CONTACT-LENS-APPLICATION-OCULAR-SURFACE-DISEASE

    CPT 92071: Soft Contact Lens Application for Ocular Surface Disease

    CPT-92072-SOFT-CONTACT-LENS-FITTING-KERATOCONUS

    CPT 92072: Initial Soft Contact Lens Fitting for Keratoconus

    CPT-92081-LIMITED-VISUAL-FIELD-EXAMINATION-INTERPRETATION

    CPT 92081: Limited Visual Field Examination

    Showing 1–10 of 19

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    92020
    92014Comprehensive eye exam, established patientPerformed for routine comprehensive follow-up; 92020 may be performed during or separately from the comprehensive exam when angle evaluation is required.
    92133Scanning computerized ophthalmic diagnostic imaging, posterior segment; optic nerveOften ordered adjunctively to document optic nerve status in glaucoma management; performed before or after gonioscopy to guide treatment.
    92134Scanning computerized ophthalmic diagnostic imaging, posterior segment; retinaOrdered when retinal evaluation or correlation with visual field/optic nerve findings is needed alongside angle assessment.