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

In South Dakota, Medicare pays $404.08 for 65865 in a facility. There’s no office rate.

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.

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 South Dakota 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. South Dakota pays $404.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

65865 rates by state

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

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.

Payment rules and modifiers for 65865

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

What modifiers do to the payment

When to use modifier 50

Codes related to 65865

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

How 65865 has changed in South Dakota

Price 65865 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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

Open CMS sourceHow we calculate rates