CPT code 65865: Eye adhesion lysis, incisional technique2026 Medicare rate & RVUs in Connecticut

Reports incisional division of adhesions within the eye’s anterior segment, such as iris synechiae, when the surgeon performs surgical rather than laser lysis.

CMS RVU26DEffective Oct 1, 2026One payment locality768 Medicare services in 2024

In Connecticut, Medicare pays $436.94 for 65865 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$436.94Hospital or facility

Check a contract rate as a % of Medicare · 65865 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 65865 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 65865 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 65865 covers

An ophthalmologist uses an incision and surgical instruments to divide adhesions in the anterior segment of the eye. These adhesions, or synechiae, may involve the iris and restrict normal separation or movement of anterior-segment structures. The service is typically performed in an operating room or other surgical setting when the surgeon documents that incisional lysis is needed; it is distinct from laser treatment of adhesions.

Choose this code based on the incisional technique and the documented operative work, rather than diagnosis alone. The operative note should identify the treated eye, the adhesions addressed, and the technique used. CMS 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 the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with supporting documentation, and team surgery is 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 Connecticut compares for 65865

Across 109 of 109 payment localities, the facility rate for 65865 runs from $376.95 in Arkansas to $521.01 in San Benito County, CA. Connecticut pays $436.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

65865 in Connecticut vs other payment areas
  1. Connecticut · this page$436.94
  2. Los Angeles, CA · California$455.24+$18.30
  3. Washington, DC area · District of Columbia$463.23+$26.29
  4. Miami, FL · Florida$444.96+$8.02
  5. Chicago, IL · Illinois$435.24−$1.70
  6. Manhattan, NY · New York$468.68+$31.74
  7. Alaska · Alaska$514.98+$78.04

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

Every other payment area

65865 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$381.07
ArkansasArkansas—$376.95
ArizonaArizona—$405.18
Bakersfield, CACalifornia—$431.93
Chico, CACalifornia—$430.48
El Centro, CACalifornia—$430.55
Fresno, CACalifornia—$430.48
Hanford, CACalifornia—$430.48

65865 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
65865 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 65865 in every payment locality

How the 65865 rate is calculated

Each of 65865’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 · 65865

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.63

5.63 RVUs× 1.000 GPCI

Practice expense6.32

6.32 RVUs× 1.000 GPCI

Malpractice0.44

0.44 RVUs× 1.000 GPCI

Adjusted RVUs

12.3900

Conversion factor

$33.4009

Medicare rate

$413.84

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,353

Code
65865
Physician work
5.63
Practice expense
6.32
Malpractice
0.44

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Facility calculation for 65865 in Connecticut
ComponentRVULocality factorAdjusted
Physician work5.63× 1.0205.7426
Practice expense6.32× 1.0776.8066
Malpractice0.44× 1.2100.5324
Total RVUs13.0816
Conversion factor× 33.4009

Facility rate, Connecticut$436.94

Facility: (5.63 × 1.02 + 6.32 × 1.077 + 0.44 × 1.21) × $33.4009 = $436.94

Open 65865 in the RVU calculator

Payment rules and modifiers for 65865

65865 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 65865

Eye adhesion lysis, incisional technique

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 65865

Eye adhesion lysis, incisional technique

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

65865 without 50 · national facility

$413.84

Eye adhesion lysis, incisional technique

65865-50 · Bilateral: 150%

$620.76

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

How 65865 has changed in Connecticut

65865 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$436.94RVU26D
2026-07-01Not available in this setting$436.94RVU26C
2026-04-01Not available in this setting$436.94RVU26B
2026-01-01Not available in this setting$436.94RVU26A
2025-10-01Not available in this setting$489.30RVU25D
2025-07-01Not available in this setting$489.30RVU25C
2025-04-01Not available in this setting$489.30RVU25B
2025-01-01Not available in this setting$489.30RVU25A
2024-10-01Not available in this setting$506.00RVU24D
2024-07-01Not available in this setting$506.00RVU24C
2024-04-01Not available in this setting$506.00RVU24B
2024-03-09Not available in this setting$506.00RVU24AR
2024-01-01Not available in this setting$497.74RVU24A
2023-10-01Not available in this setting$512.36RVU23D
2023-07-01Not available in this setting$512.36RVU23C
2023-04-01Not available in this setting$512.36RVU23B
2023-01-01Not available in this setting$512.36RVU23A
2022-10-01Not available in this setting$517.42RVU22D
2022-07-01Not available in this setting$517.42RVU22C
2022-04-01Not available in this setting$517.42RVU22B
2022-01-01Not available in this setting$517.42RVU22A
2021-10-01Not available in this setting$519.32RVU21D
2021-07-01Not available in this setting$519.32RVU21C
2021-04-01Not available in this setting$519.32RVU21B
2021-01-01Not available in this setting$519.32RVU21A
2020-10-01Not available in this setting$522.47RVU20D
2020-07-01Not available in this setting$522.47RVU20C
2020-04-01Not available in this setting$522.47RVU20B
2020-01-01Not available in this setting$522.47RVU20A
2019-10-01Not available in this setting$522.66RVU19D
2019-07-01Not available in this setting$522.66RVU19C
2019-04-01Not available in this setting$522.66RVU19B
2019-01-01Not available in this setting$522.66RVU19A
2018-10-01Not available in this setting$522.83RVU18D
2018-07-01Not available in this setting$522.83RVU18C
2018-04-01Not available in this setting$522.83RVU18B
2018-01-01Not available in this setting$522.83RVU18AR1
2017-10-01Not available in this setting$519.62RVU17D
2017-07-01Not available in this setting$519.62RVU17C
2017-04-01Not available in this setting$519.62RVU17B
2017-01-01Not available in this setting$519.62RVU17A
2016-10-01Not available in this setting$519.06RVU16D
2016-07-01Not available in this setting$519.06RVU16C
2016-04-01Not available in this setting$519.06RVU16B
2016-01-01Not available in this setting$519.06RVU16A
2015-10-01Not available in this setting$520.57RVU15D
2015-07-01Not available in this setting$520.57RVU15C
2015-04-01Not available in this setting$517.98RVU15B
2015-01-01Not available in this setting$517.98RVU15A
2014-10-01Not available in this setting$515.46RVU14D
2014-07-01Not available in this setting$515.46RVU14C
2014-04-01Not available in this setting$515.46RVU14B
2014-01-01Not available in this setting$515.46RVU14A
2013-10-01Not available in this setting$513.49RVU13D
2013-07-01Not available in this setting$513.49RVU13C
2013-04-01Not available in this setting$513.49RVU13B
2013-01-01Not available in this setting$513.49RVU13AR

Price 65865 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

65865 billing questions

How does this differ from 65860?

65865 describes incisional division of anterior-segment adhesions. Code 65860 is the laser-technique option, so the documented method is central to the distinction.

How should the operative note support 65865?

Document the treated eye, the anterior-segment adhesions divided, and the incisional technique performed. The note should support the actual operative work, not just the diagnosis.

Can modifier 50 be used for bilateral treatment?

CMS identifies this as a bilateral procedure. With modifier 50, payment is at 150%.

How does the multiple-procedure reduction affect same-session surgery?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% reduction.

What is included in the global period?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 65865PPRRVU2026_Oct_nonQPP.csv, line 7,353 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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