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CPT code 65778: Amniotic membrane, without sutures2026 Medicare rate & RVUs in Idaho

Reports placement of an amniotic membrane on the ocular surface without sutures, often to support healing of a persistent epithelial defect or other surface injury.

CMS RVU26DEffective Oct 1, 2026One payment locality71.8K Medicare services in 2024

In Idaho, Medicare pays $1,173.90 for 65778 in the office and $34.47 when it’s performed in a hospital or facility.

$1,173.90Office (non-facility)
$34.47Hospital or facility
−7.9%vs the national office rate ($1,274.24)

Check a contract rate as a % of Medicare · 65778 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 65778 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Idaho
  2. What 65778 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 65778 covers

An ophthalmologist places an amniotic membrane over the ocular surface without suturing it in place. The service may be used for a persistent corneal epithelial defect, a nonhealing corneal ulcer, or ocular surface damage after injury. It is commonly performed in an office or ambulatory surgical setting when the clinician determines that membrane coverage is appropriate to support surface healing.

Report this code when the membrane is placed on the ocular surface without sutures; documentation should identify the clinical indication, treated eye, and placement method. The service has a 0-day global period, so same-day preoperative and postoperative care is included. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral reporting with modifier 50, CMS payment is 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Idaho compares for 65778

Across 109 of 109 payment localities, the office rate for 65778 runs from $1,097.98 in Arkansas to $1,827.16 in San Benito County, CA. Idaho pays $1,173.90. The RVUs are the same everywhere; the geographic indexes change the dollars.

65778 in Idaho vs other payment areas
  1. Idaho · this page$1,173.90
  2. Los Angeles, CA · California$1,502.85+$328.95
  3. Washington, DC area · District of Columbia$1,497.58+$323.68
  4. Miami, FL · Florida$1,327.35+$153.45
  5. Chicago, IL · Illinois$1,282.39+$108.49
  6. Manhattan, NY · New York$1,478.55+$304.65
  7. Alaska · Alaska$1,368.30+$194.40

Other areas in Idaho first, then benchmark localities. Bars start at $0.

Every other payment area

65778 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,117.97$34.28
ArkansasArkansas$1,097.98$34.10
ArizonaArizona$1,235.44$35.33
Bakersfield, CACalifornia$1,393.81$36.41
Chico, CACalifornia$1,393.66$36.26
El Centro, CACalifornia$1,393.67$36.26
Fresno, CACalifornia$1,393.66$36.26
Hanford, CACalifornia$1,393.66$36.26

65778 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$1,097.98

$1,610.41

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
65778 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,368.301
AL$1,117.971
AR$1,097.981
AZ$1,235.441
CA$1,393.66–$1,827.1629
CO$1,353.991
CT$1,370.981
DC$1,497.581
DE$1,259.301
FL$1,220.11–$1,327.353
GA$1,139.98–$1,294.522
GU$1,444.321
HI$1,444.321
IA$1,167.571
ID$1,173.901
IL$1,166.64–$1,309.104
IN$1,182.631
KS$1,154.011
KY$1,135.881
LA$1,130.95–$1,200.942
MA$1,340.42–$1,516.852
MD$1,289.35–$1,497.583
ME$1,174.10–$1,262.542
MI$1,166.06–$1,231.572
MN$1,309.421
MO$1,102.33–$1,214.463
MS$1,100.771
MT$1,274.241
NC$1,190.311
ND$1,273.451
NE$1,177.511
NH$1,325.141
NJ$1,390.06–$1,475.342
NM$1,171.131
NV$1,275.271
NY$1,211.57–$1,512.555
OH$1,165.891
OK$1,140.681
OR$1,268.87–$1,412.592
PA$1,172.04–$1,326.062
PR$1,287.931
RI$1,315.721
SC$1,179.381
SD$1,273.361
TN$1,160.281
TX$1,162.05–$1,346.398
UT$1,199.381
VA$1,252.68–$1,497.582
VI$1,287.931
VT$1,261.131
WA$1,340.29–$1,558.102
WI$1,221.011
WV$1,111.661
WY$1,273.901

See 65778 in every payment locality

How the 65778 rate is calculated

Each of 65778’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 65778

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.82

0.82 RVUs× 1.000 GPCI

Practice expense37.29

37.29 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

38.1500

Conversion factor

$33.4009

Medicare rate

$1,274.24

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Idaho inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,340

Code
65778
Physician work
0.82
Practice expense
37.29
Malpractice
0.04

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Office calculation for 65778 in Idaho
ComponentRVULocality factorAdjusted
Physician work0.82× 1.0000.8200
Practice expense37.29× 0.92034.3068
Malpractice0.04× 0.4730.0189
Total RVUs35.1457
Conversion factor× 33.4009

Office rate, Idaho$1173.90

Office: (0.82 × 1 + 37.29 × 0.92 + 0.04 × 0.473) × $33.4009 = $1173.90

Facility: (0.82 × 1 + 0.21 × 0.92 + 0.04 × 0.473) × $33.4009 = $34.47

Open 65778 in the RVU calculator

Payment rules and modifiers for 65778

The CMS indicators that decide how 65778 is paid alongside other services.

CMS payment indicators · 65778

Amniotic membrane, without sutures

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

65778 without 50 · national office

$1,274.24

Amniotic membrane, without sutures

65778-50 · Bilateral: 150%

$1,911.36

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 65778

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 65778
CodeHow it relatesOffice range, Idaho
Same family
65779Amniotic membrane, single layer, suturedAmniotic membrane placement on the ocular surface when sutures are used.$1,051.25
Used instead
65780Amniotic membrane graft, multiple layersOcular surface reconstruction involving amniotic membrane transplantation.No office rate
65781Ocular reconstruction, limbal stem cell allograftOcular surface reconstruction involving limbal stem cell allograft.No office rate
65782Ocular reconstruction, autologous limbal stem cell graftOcular surface reconstruction involving limbal stem cell autograft.No office rate

How 65778 has changed in Idaho

65778 · Office / nonfacility

$1173.90

Effective 2026-10-01

The base rate is $66.47 higher than on 2025-10-01, moving from $1107.43 to $1173.90 (6.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $1107.43changed to$1173.90

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.84 changed to 0.82
    • Practice expense RVU 36.76 changed to 37.29
    • Practice expense GPCI 0.908 changed to 0.920
    • Malpractice GPCI 0.461 changed to 0.473

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $988.52changed to$1107.43

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 31.76 changed to 36.76

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $972.39changed to$988.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1204.69changed to$972.39

    • Conversion factor 33.8872 changed to 32.7442
    • Work RVU 1.00 changed to 0.84
    • Practice expense RVU 38.67 changed to 31.76
    • Practice expense GPCI 0.893 changed to 0.908
    • Malpractice GPCI 0.439 changed to 0.461

  5. January 1, 2023

    RVU23A

    $1242.33changed to$1204.69

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 39.77 changed to 38.67
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.877 changed to 0.893
    • Malpractice GPCI 0.416 changed to 0.439

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1313.83changed to$1242.33

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 41.77 changed to 39.77

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1281.57changed to$1313.83

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 38.75 changed to 41.77
    • Practice expense GPCI 0.890 changed to 0.877
    • Malpractice GPCI 0.464 changed to 0.416

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1305.58changed to$1281.57

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 39.02 changed to 38.75
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.902 changed to 0.890
    • Malpractice GPCI 0.512 changed to 0.464

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1308.37changed to$1305.58

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 39.15 changed to 39.02

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1298.94changed to$1308.37

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 39.07 changed to 39.15
    • Practice expense GPCI 0.900 changed to 0.902
    • Malpractice GPCI 0.510 changed to 0.512

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1306.13changed to$1298.94

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 39.47 changed to 39.07
    • Malpractice RVU 0.07 changed to 0.06
    • Practice expense GPCI 0.898 changed to 0.900
    • Malpractice GPCI 0.508 changed to 0.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1259.26changed to$1306.13

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 1.19 changed to 1.00
    • Practice expense RVU 37.66 changed to 39.47

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1253.00changed to$1259.26

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1246.77changed to$1253.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 37.41 changed to 37.66
    • Malpractice RVU 0.17 changed to 0.07
    • Practice expense GPCI 0.896 changed to 0.898
    • Malpractice GPCI 0.556 changed to 0.508

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1316.20changed to$1246.77

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 41.82 changed to 37.41
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.603 changed to 0.556

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1316.20

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,173.90$34.47RVU26D
2026-07-01$1,173.90$34.47RVU26C
2026-04-01$1,173.90$34.47RVU26B
2026-01-01$1,173.90$34.47RVU26A
2025-10-01$1,107.43$40.10RVU25D
2025-07-01$1,107.43$40.10RVU25C
2025-04-01$1,107.43$40.10RVU25B
2025-01-01$1,107.43$40.10RVU25A
2024-10-01$988.52$41.27RVU24D
2024-07-01$988.52$41.27RVU24C
2024-04-01$988.52$41.27RVU24B
2024-03-09$988.52$41.27RVU24AR
2024-01-01$972.39$40.60RVU24A
2023-10-01$1,204.69$49.92RVU23D
2023-07-01$1,204.69$49.92RVU23C
2023-04-01$1,204.69$49.92RVU23B
2023-01-01$1,204.69$49.92RVU23A
2022-10-01$1,242.33$50.50RVU22D
2022-07-01$1,242.33$50.50RVU22C
2022-04-01$1,242.33$50.50RVU22B
2022-01-01$1,242.33$50.50RVU22A
2021-10-01$1,313.83$50.92RVU21D
2021-07-01$1,313.83$50.92RVU21C
2021-04-01$1,313.83$50.92RVU21B
2021-01-01$1,313.83$50.92RVU21A
2020-10-01$1,281.57$52.99RVU20D
2020-07-01$1,281.57$52.99RVU20C
2020-04-01$1,281.57$52.99RVU20B
2020-01-01$1,281.57$52.99RVU20A
2019-10-01$1,305.58$54.05RVU19D
2019-07-01$1,305.58$54.05RVU19C
2019-04-01$1,305.58$54.05RVU19B
2019-01-01$1,305.58$54.05RVU19A
2018-10-01$1,308.37$54.64RVU18D
2018-07-01$1,308.37$54.64RVU18C
2018-04-01$1,308.37$54.64RVU18B
2018-01-01$1,308.37$54.64RVU18AR1
2017-10-01$1,298.94$55.40RVU17D
2017-07-01$1,298.94$55.40RVU17C
2017-04-01$1,298.94$55.40RVU17B
2017-01-01$1,298.94$55.40RVU17A
2016-10-01$1,306.13$56.05RVU16D
2016-07-01$1,306.13$56.05RVU16C
2016-04-01$1,306.13$56.05RVU16B
2016-01-01$1,306.13$56.05RVU16A
2015-10-01$1,259.26$67.59RVU15D
2015-07-01$1,259.26$67.59RVU15C
2015-04-01$1,253.00$67.26RVU15B
2015-01-01$1,253.00$67.26RVU15A
2014-10-01$1,246.77$70.09RVU14D
2014-07-01$1,246.77$70.09RVU14C
2014-04-01$1,246.77$70.09RVU14B
2014-01-01$1,246.77$70.09RVU14A
2013-10-01$1,316.20$68.51RVU13D
2013-07-01$1,316.20$68.51RVU13C
2013-04-01$1,316.20$68.51RVU13B
2013-01-01$1,316.20$68.51RVU13AR

Price 65778 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

65778 billing questions

How does this differ from 65779?

Both codes report amniotic membrane placement on the ocular surface. Use 65778 when the membrane is placed without sutures and 65779 when it is sutured.

What documentation supports 65778?

Document the ocular surface condition being treated, the eye involved, and that the amniotic membrane was placed without sutures.

Is same-day postoperative care separately included?

No. The 0-day global period includes same-day preoperative and postoperative care.

How is bilateral placement reported?

CMS lists this as a bilateral procedure; reporting modifier 50 results in payment at 150%.

What happens when another procedure is performed in the same session?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the other procedure is paid at 50%.

Can an assistant surgeon be paid for this service?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 65778PPRRVU2026_Oct_nonQPP.csv, line 7,340 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)

Open CMS sourceHow we calculate rates

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