CPT code 65815: Eye drainage, with chamber replacement2026 Medicare rate & RVUs in North Carolina
Ophthalmologists report this procedure when they drain aqueous from the eye’s anterior chamber and refill it with air, gas, or liquid.
In North Carolina, Medicare pays $607.84 for 65815 in the office and $392.50 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 65815 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 65815 covers
This procedure is an anterior chamber paracentesis that removes aqueous and replaces it with air, another gas, or fluid. An ophthalmologist may perform it as an anterior chamber washout, including for a significant hyphema requiring evacuation and chamber replacement. It is a surgical service, commonly furnished in an operating room or other procedural setting; the operative note should identify the chamber drainage and the replacement material.
Select this code when both drainage and replacement are performed. A diagnostic aspiration or medication injection alone, or drainage without replacement, points to a different code in the family. Documentation should describe the reason for the procedure, the fluid or material removed, and what was used to refill the chamber. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 North Carolina compares for 65815
Across 109 of 109 payment localities, the office rate for 65815 runs from $574.00 in Arkansas to $847.40 in San Benito County, CA. North Carolina pays $607.84. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$607.84
- Los Angeles, CA · California$724.12+$116.28
- Washington, DC area · District of Columbia$731.40+$123.56
- Miami, FL · Florida$683.48+$75.64
- Chicago, IL · Illinois$665.72+$57.88
- Manhattan, NY · New York$733.72+$125.88
- Alaska · Alaska$761.15+$153.31
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $581.69 | $379.74 |
| ArkansasArkansas | $574.00 | $375.74 |
| ArizonaArizona | $626.71 | $403.06 |
| Bakersfield, CACalifornia | $681.43 | $428.48 |
| Chico, CACalifornia | $679.92 | $426.96 |
| El Centro, CACalifornia | $680.00 | $427.04 |
| Fresno, CACalifornia | $679.92 | $426.96 |
| Hanford, CACalifornia | $679.92 | $426.96 |
| Madera, CACalifornia | $679.92 | $426.96 |
| Merced, CACalifornia | $679.92 | $426.96 |
| Modesto, CACalifornia | $679.92 | $426.96 |
| Napa, CACalifornia | $784.28 | $480.08 |
| Oxnard, CACalifornia | $720.52 | $447.71 |
| Redding, CACalifornia | $679.92 | $426.96 |
| Rest of CaliforniaCalifornia | $679.92 | $426.96 |
| Riverside, CACalifornia | $684.99 | $432.03 |
| Sacramento, CACalifornia | $712.55 | $444.12 |
| Salinas, CACalifornia | $709.84 | $442.34 |
| San Diego, CACalifornia | $725.71 | $449.67 |
| Marin County, CACalifornia | $829.48 | $504.05 |
| San Francisco, CACalifornia | $828.96 | $503.53 |
| San Benito County, CACalifornia | $847.40 | $514.59 |
| Santa Clara County, CACalifornia | $845.27 | $512.45 |
| San Luis Obispo, CACalifornia | $698.48 | $435.59 |
| Santa Cruz, CACalifornia | $732.05 | $451.63 |
| Santa Maria, CACalifornia | $712.28 | $443.16 |
| Santa Rosa, CACalifornia | $739.42 | $456.00 |
| Stockton, CACalifornia | $679.92 | $426.96 |
| Vallejo, CACalifornia | $783.53 | $479.33 |
| Visalia, CACalifornia | $679.92 | $426.96 |
| Yuba City, CACalifornia | $679.92 | $426.96 |
| ColoradoColorado | $668.90 | $423.33 |
| ConnecticutConnecticut | $682.66 | $434.09 |
| DelawareDelaware | $636.55 | $408.52 |
| Fort Lauderdale, FLFlorida | $660.32 | $426.52 |
| Rest of FloridaFlorida | $631.04 | $410.39 |
| Atlanta, GAGeorgia | $652.88 | $418.39 |
| Rest of GeorgiaGeorgia | $598.64 | $392.77 |
| Hawaii, Guam, HIHawaii | $694.95 | $432.53 |
| IowaIowa | $596.35 | $385.17 |
| IdahoIdaho | $599.68 | $387.34 |
| East St. Louis, ILIllinois | $623.36 | $411.02 |
| Rest of IllinoisIllinois | $613.41 | $402.68 |
| Suburban Chicago, ILIllinois | $667.18 | $430.15 |
| IndianaIndiana | $602.90 | $388.95 |
| KansasKansas | $593.25 | $384.61 |
| KentuckyKentucky | $593.09 | $387.91 |
| New Orleans, LALouisiana | $618.93 | $401.75 |
| Rest of LouisianaLouisiana | $592.03 | $387.77 |
| Metropolitan Boston, MAMassachusetts | $732.34 | $456.76 |
| Rest of MassachusettsMassachusetts | $665.18 | $422.15 |
| Baltimore area, MDMaryland | $680.57 | $432.92 |
| Rest of MarylandMaryland | $648.17 | $414.60 |
| Rest of MaineMaine | $601.97 | $389.63 |
| Southern Maine, MEMaine | $632.75 | $404.02 |
| Detroit, MIMichigan | $637.74 | $415.01 |
| Rest of MichiganMichigan | $606.74 | $396.02 |
| MinnesotaMinnesota | $644.00 | $406.50 |
| Metropolitan Kansas City, MOMissouri | $615.62 | $398.90 |
| Metropolitan St. Louis, MOMissouri | $621.62 | $401.89 |
| Rest of MissouriMissouri | $582.35 | $383.40 |
| MississippiMississippi | $578.31 | $379.59 |
| MontanaMontana | $642.27 | $411.47 |
| North DakotaNorth Dakota | $633.17 | $402.37 |
| NebraskaNebraska | $599.51 | $386.49 |
| New HampshireNew Hampshire | $658.07 | $417.81 |
| Northern New JerseyNew Jersey | $724.70 | $456.97 |
| Rest of New JerseyNew Jersey | $691.31 | $439.27 |
| New MexicoNew Mexico | $609.57 | $397.93 |
| NevadaNevada | $640.16 | $409.13 |
| NYC suburbs and Long Island, NYNew York | $749.53 | $475.11 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $695.31 | $442.59 |
| Queens, NYNew York | $740.14 | $467.33 |
| Rest of New YorkNew York | $616.16 | $396.90 |
| OhioOhio | $604.88 | $394.16 |
| OklahomaOklahoma | $592.70 | $386.59 |
| Portland, OROregon | $689.39 | $432.97 |
| Rest of OregonOregon | $636.01 | $406.13 |
| Metropolitan Philadelphia, PAPennsylvania | $666.47 | $426.21 |
| Rest of PennsylvaniaPennsylvania | $606.07 | $394.19 |
| Puerto RicoPuerto Rico | $646.82 | $413.48 |
| Rhode IslandRhode Island | $658.59 | $420.18 |
| South CarolinaSouth Carolina | $607.20 | $393.94 |
| South DakotaSouth Dakota | $632.10 | $401.30 |
| TennesseeTennessee | $595.92 | $386.12 |
| Austin, TXTexas | $665.97 | $421.78 |
| Beaumont, TXTexas | $602.37 | $392.34 |
| Brazoria, TXTexas | $636.60 | $407.88 |
| Dallas, TXTexas | $640.15 | $410.27 |
| Fort Worth, TXTexas | $636.03 | $408.47 |
| Galveston, TXTexas | $638.20 | $409.01 |
| Houston, TXTexas | $646.62 | $417.43 |
| Rest of TexasTexas | $618.80 | $399.77 |
| UtahUtah | $614.84 | $397.89 |
| VirginiaVirginia | $630.45 | $403.57 |
| Virgin Islands, VIUnited States Virgin Islands | $646.82 | $413.48 |
| VermontVermont | $630.39 | $401.90 |
| Rest of WashingtonWashington | $664.04 | $421.01 |
| King County, WAWashington | $747.22 | $464.03 |
| WisconsinWisconsin | $613.54 | $392.44 |
| West VirginiaWest Virginia | $592.39 | $391.82 |
| WyomingWyoming | $638.30 | $407.50 |
65815 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$574.00
$763.66
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $761.15 | 1 |
| AL | $581.69 | 1 |
| AR | $574.00 | 1 |
| AZ | $626.71 | 1 |
| CA | $679.92–$847.40 | 29 |
| CO | $668.90 | 1 |
| CT | $682.66 | 1 |
| DC | $731.40 | 1 |
| DE | $636.55 | 1 |
| FL | $631.04–$683.48 | 3 |
| GA | $598.64–$652.88 | 2 |
| GU | $694.95 | 1 |
| HI | $694.95 | 1 |
| IA | $596.35 | 1 |
| ID | $599.68 | 1 |
| IL | $613.41–$667.18 | 4 |
| IN | $602.90 | 1 |
| KS | $593.25 | 1 |
| KY | $593.09 | 1 |
| LA | $592.03–$618.93 | 2 |
| MA | $665.18–$732.34 | 2 |
| MD | $648.17–$731.40 | 3 |
| ME | $601.97–$632.75 | 2 |
| MI | $606.74–$637.74 | 2 |
| MN | $644.00 | 1 |
| MO | $582.35–$621.62 | 3 |
| MS | $578.31 | 1 |
| MT | $642.27 | 1 |
| NC | $607.84 | 1 |
| ND | $633.17 | 1 |
| NE | $599.51 | 1 |
| NH | $658.07 | 1 |
| NJ | $691.31–$724.70 | 2 |
| NM | $609.57 | 1 |
| NV | $640.16 | 1 |
| NY | $616.16–$749.53 | 5 |
| OH | $604.88 | 1 |
| OK | $592.70 | 1 |
| OR | $636.01–$689.39 | 2 |
| PA | $606.07–$666.47 | 2 |
| PR | $646.82 | 1 |
| RI | $658.59 | 1 |
| SC | $607.20 | 1 |
| SD | $632.10 | 1 |
| TN | $595.92 | 1 |
| TX | $602.37–$665.97 | 8 |
| UT | $614.84 | 1 |
| VA | $630.45–$731.40 | 2 |
| VI | $646.82 | 1 |
| VT | $630.39 | 1 |
| WA | $664.04–$747.22 | 2 |
| WI | $613.54 | 1 |
| WV | $592.39 | 1 |
| WY | $638.30 | 1 |
How the 65815 rate is calculated
Each of 65815’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 · 65815
RVUs × geographic indexes × conversion factor
Work5.85
5.85 RVUs× 1.000 GPCI
Practice expense12.92
12.92 RVUs× 1.000 GPCI
Malpractice0.46
0.46 RVUs× 1.000 GPCI
Adjusted RVUs
19.2300
Conversion factor
$33.4009
Medicare rate
$642.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,348
- Code
- 65815
- Physician work
- 5.85
- Practice expense
- 12.92
- Malpractice
- 0.46
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.85 | × 1.000 | 5.8500 |
| Practice expense | 12.92 | × 0.933 | 12.0544 |
| Malpractice | 0.46 | × 0.639 | 0.2939 |
| Total RVUs | 18.1983 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$607.84
Office: (5.85 × 1 + 12.92 × 0.933 + 0.46 × 0.639) × $33.4009 = $607.84
Facility: (5.85 × 1 + 6.01 × 0.933 + 0.46 × 0.639) × $33.4009 = $392.50
Payment rules and modifiers for 65815
65815 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65815
Eye drainage, with chamber replacement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 65815
Eye drainage, with chamber replacement
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
65815 without 50 · national office
$642.30
Eye drainage, with chamber replacement
65815-50 · Bilateral: 150%
$963.45
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).
How 65815 has changed in North Carolina
65815 · Office / nonfacility
$607.84
Effective 2026-10-01
The base rate is $30.31 higher than on 2025-10-01, moving from $577.53 to $607.84 (5.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$577.53changed to$607.84
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 6.00 changed to 5.85
- Practice expense RVU 12.45 changed to 12.92
- Malpractice RVU 0.49 changed to 0.46
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$601.68changed to$577.53
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 12.71 changed to 12.45
- Malpractice RVU 0.46 changed to 0.49
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$591.86changed to$601.68
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$611.45changed to$591.86
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 12.64 changed to 12.71
- Malpractice RVU 0.44 changed to 0.46
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$621.22changed to$611.45
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 12.49 changed to 12.64
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$631.19changed to$621.22
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 12.63 changed to 12.49
- Malpractice RVU 0.45 changed to 0.44
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$623.93changed to$631.19
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 11.78 changed to 12.63
- Malpractice RVU 0.44 changed to 0.45
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$623.93changed to$623.93
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 11.83 changed to 11.78
- Malpractice RVU 0.43 changed to 0.44
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$622.16changed to$623.93
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 11.79 changed to 11.83
- Malpractice RVU 0.44 changed to 0.43
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$613.81changed to$622.16
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 11.58 changed to 11.79
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$612.52changed to$613.81
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$614.39changed to$612.52
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 11.57 changed to 11.58
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$611.33changed to$614.39
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$625.47changed to$611.33
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 11.54 changed to 11.57
- Malpractice RVU 1.01 changed to 0.44
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$629.44changed to$625.47
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 12.69 changed to 11.54
- Malpractice RVU 1.06 changed to 1.01
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $629.44
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $607.84 | $392.50 | RVU26D |
| 2026-07-01 | $607.84 | $392.50 | RVU26C |
| 2026-04-01 | $607.84 | $392.50 | RVU26B |
| 2026-01-01 | $607.84 | $392.50 | RVU26A |
| 2025-10-01 | $577.53 | $435.56 | RVU25D |
| 2025-07-01 | $577.53 | $435.56 | RVU25C |
| 2025-04-01 | $577.53 | $435.56 | RVU25B |
| 2025-01-01 | $577.53 | $435.56 | RVU25A |
| 2024-10-01 | $601.68 | $447.87 | RVU24D |
| 2024-07-01 | $601.68 | $447.87 | RVU24C |
| 2024-04-01 | $601.68 | $447.87 | RVU24B |
| 2024-03-09 | $601.68 | $447.87 | RVU24AR |
| 2024-01-01 | $591.86 | $440.56 | RVU24A |
| 2023-10-01 | $611.45 | $452.19 | RVU23D |
| 2023-07-01 | $611.45 | $452.19 | RVU23C |
| 2023-04-01 | $611.45 | $452.19 | RVU23B |
| 2023-01-01 | $611.45 | $452.19 | RVU23A |
| 2022-10-01 | $621.22 | $455.51 | RVU22D |
| 2022-07-01 | $621.22 | $455.51 | RVU22C |
| 2022-04-01 | $621.22 | $455.51 | RVU22B |
| 2022-01-01 | $621.22 | $455.51 | RVU22A |
| 2021-10-01 | $631.19 | $458.60 | RVU21D |
| 2021-07-01 | $631.19 | $458.60 | RVU21C |
| 2021-04-01 | $631.19 | $458.60 | RVU21B |
| 2021-01-01 | $631.19 | $458.60 | RVU21A |
| 2020-10-01 | $623.93 | $464.84 | RVU20D |
| 2020-07-01 | $623.93 | $464.84 | RVU20C |
| 2020-04-01 | $623.93 | $464.84 | RVU20B |
| 2020-01-01 | $623.93 | $464.84 | RVU20A |
| 2019-10-01 | $623.93 | $466.57 | RVU19D |
| 2019-07-01 | $623.93 | $466.57 | RVU19C |
| 2019-04-01 | $623.93 | $466.57 | RVU19B |
| 2019-01-01 | $623.93 | $466.57 | RVU19A |
| 2018-10-01 | $622.16 | $467.98 | RVU18D |
| 2018-07-01 | $622.16 | $467.98 | RVU18C |
| 2018-04-01 | $622.16 | $467.98 | RVU18B |
| 2018-01-01 | $622.16 | $467.98 | RVU18AR1 |
| 2017-10-01 | $613.81 | $464.12 | RVU17D |
| 2017-07-01 | $613.81 | $464.12 | RVU17C |
| 2017-04-01 | $613.81 | $464.12 | RVU17B |
| 2017-01-01 | $613.81 | $464.12 | RVU17A |
| 2016-10-01 | $612.52 | $463.01 | RVU16D |
| 2016-07-01 | $612.52 | $463.01 | RVU16C |
| 2016-04-01 | $612.52 | $463.01 | RVU16B |
| 2016-01-01 | $612.52 | $463.01 | RVU16A |
| 2015-10-01 | $614.39 | $464.01 | RVU15D |
| 2015-07-01 | $614.39 | $464.01 | RVU15C |
| 2015-04-01 | $611.33 | $461.70 | RVU15B |
| 2015-01-01 | $611.33 | $461.70 | RVU15A |
| 2014-10-01 | $625.47 | $477.37 | RVU14D |
| 2014-07-01 | $625.47 | $477.37 | RVU14C |
| 2014-04-01 | $625.47 | $477.37 | RVU14B |
| 2014-01-01 | $625.47 | $477.37 | RVU14A |
| 2013-10-01 | $629.44 | $472.69 | RVU13D |
| 2013-07-01 | $629.44 | $472.69 | RVU13C |
| 2013-04-01 | $629.44 | $472.69 | RVU13B |
| 2013-01-01 | $629.44 | $472.69 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
65815 billing questions
How does this differ from 65810?
Use 65815 when aqueous is drained and the chamber is replaced with air, gas, or liquid. Code 65810 describes drainage without that replacement.
Can 65815 be used for a diagnostic tap or medication injection?
No. A diagnostic aspiration or medication injection without the drainage-and-replacement service belongs to the distinct service described by 65800.
What documentation supports 65815?
The operative note should establish anterior chamber drainage and identify the replacement material. Include the clinical reason, such as a hyphema requiring chamber washout, when applicable.
Does the code have a global period?
Yes. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral reporting handled?
When the procedure is performed bilaterally, modifier 50 is paid at 150% under the CMS rule for this code.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons and team surgery are not permitted for this code.
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
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