Billing code 65286: Bleb repairMedicare rate & RVUs
Reports transconjunctival repair of a leaking glaucoma filtering bleb, often after trabeculectomy, rather than repair of a traumatic eye laceration.
Medicare pays $698.75 for 65286 nationally in the office and $419.85 in a hospital or facility. Local office rates run $624.90–$920.83.
Medicare rate · 65286
Bleb repair
Swap in your local Medicare rate.
- Work RVUs
- 6.46
- Total RVUs
- 20.92
- Global days
- 090
National rate · 2026
$698.75
Office setting, before claim adjustments.
See every locality for 65286 → · Billed by an NP, PA or therapist? →
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 10 sections
What 65286 covers
An ophthalmologist uses a transconjunctival approach to close a leaking glaucoma filtering bleb, commonly after trabeculectomy. The service treats leakage from the bleb, not a traumatic corneal or scleral laceration. It may be performed in an office procedure area or operating room, depending on the clinical circumstances. Documentation should identify the leaking bleb and the transconjunctival repair performed.
Report this code for repair of a leaking bleb by this approach, rather than for general revision of an anterior-segment operative wound. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. For bilateral treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; 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.
Where 65286 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$624.90 to $920.83
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $633.21 | $389.18 |
| Alaska* | $829.44 | $532.42 |
| Arizona | $681.89 | $411.64 |
| Arkansas | $624.90 | $385.33 |
| Atlanta | $710.21 | $426.85 |
| Austin | $724.32 | $429.24 |
| Bakersfield | $741.08 | $435.41 |
| Baltimore/Surr. Cntys | $740.20 | $440.94 |
| Beaumont | $655.60 | $401.80 |
| Brazoria | $692.60 | $416.21 |
| Chicago | $724.22 | $443.92 |
| Chico | $739.43 | $433.76 |
| Colorado | $727.52 | $430.77 |
| Connecticut | $742.47 | $442.10 |
| Dallas | $696.45 | $418.67 |
| Dc + Md/Va Suburbs | $795.28 | $466.74 |
| Delaware | $692.54 | $416.99 |
| Detroit | $693.88 | $424.75 |
| East St. Louis | $678.38 | $421.79 |
| El Centro | $739.51 | $433.84 |
| Fort Lauderdale | $718.30 | $435.78 |
| Fort Worth | $692.01 | $417.01 |
| Fresno | $739.43 | $433.76 |
| Galveston | $694.34 | $417.39 |
| Hanford-Corcoran | $739.43 | $433.76 |
| Hawaii, Guam | $755.60 | $438.49 |
| Houston | $703.49 | $426.54 |
| Idaho | $652.64 | $396.06 |
| Indiana | $656.12 | $397.59 |
| Iowa | $649.04 | $393.85 |
| Kansas | $645.70 | $393.58 |
| Kentucky | $645.57 | $397.63 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $787.31 | $457.37 |
| Madera | $739.43 | $433.76 |
| Manhattan | $797.88 | $473.80 |
| Merced | $739.43 | $433.76 |
| Metropolitan Boston | $796.21 | $463.21 |
| Metropolitan Kansas City | $669.92 | $408.04 |
| Metropolitan Philadelphia | $724.97 | $434.64 |
| Metropolitan St. Louis | $676.40 | $410.89 |
| Miami | $743.40 | $453.07 |
| Minnesota | $700.51 | $413.53 |
| Mississippi | $629.58 | $389.44 |
| Modesto | $739.43 | $433.76 |
| Montana** | $698.71 | $419.82 |
| Napa | $852.40 | $484.81 |
| Nebraska | $652.46 | $395.03 |
| Nevada** | $696.42 | $417.25 |
| New Hampshire | $715.78 | $425.44 |
| New Mexico | $663.40 | $407.65 |
| New Orleans | $673.51 | $411.07 |
| North Carolina | $661.48 | $401.27 |
| North Dakota** | $688.83 | $409.93 |
| Northern Nj | $788.08 | $464.56 |
| Nyc Suburbs/Long Island | $814.99 | $483.39 |
| Ohio | $658.31 | $403.68 |
| Oklahoma | $645.13 | $396.08 |
| Oxnard-Thousand Oaks-Ventura | $783.35 | $453.70 |
| Portland | $749.68 | $439.83 |
| Poughkpsie/N Nyc Suburbs | $756.26 | $450.87 |
| Puerto Rico | $703.63 | $421.66 |
| Queens | $804.80 | $475.14 |
| Redding | $739.43 | $433.76 |
| Rest Of California | $739.43 | $433.76 |
| Rest Of Florida | $686.63 | $420.00 |
| Rest Of Georgia | $651.60 | $402.82 |
| Rest Of Illinois | $667.58 | $412.95 |
| Rest Of Louisiana | $644.42 | $397.60 |
| Rest Of Maine | $655.13 | $398.55 |
| Rest Of Maryland | $705.13 | $422.89 |
| Rest Of Massachusetts | $723.52 | $429.84 |
| Rest Of Michigan | $660.34 | $405.70 |
| Rest Of Missouri | $633.97 | $393.56 |
| Rest Of New Jersey | $751.90 | $447.34 |
| Rest Of New York | $670.47 | $405.52 |
| Rest Of Oregon | $691.92 | $414.14 |
| Rest Of Pennsylvania | $659.59 | $403.57 |
| Rest Of Texas | $673.35 | $408.67 |
| Rest Of Washington | $722.27 | $428.59 |
| Rhode Island | $716.43 | $428.33 |
| Riverside-San Bernardino-Ontario | $744.94 | $439.27 |
| Sacramento-Roseville-Folsom | $774.77 | $450.41 |
| Salinas | $771.82 | $448.58 |
| San Diego-Chula Vista-Carlsbad | $788.96 | $455.40 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $901.38 | $508.14 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $900.82 | $507.57 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $920.83 | $518.66 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $918.51 | $516.34 |
| San Luis Obispo-Paso Robles | $759.48 | $441.81 |
| Santa Cruz-Watsonville | $795.78 | $456.92 |
| Santa Maria-Santa Barbara | $774.44 | $449.25 |
| Santa Rosa-Petaluma | $803.78 | $461.30 |
| Seattle (King Cnty) | $812.32 | $470.12 |
| South Carolina | $660.80 | $403.10 |
| South Dakota** | $687.66 | $408.76 |
| Southern Maine | $688.39 | $412.00 |
| Stockton | $739.43 | $433.76 |
| Suburban Chicago | $725.74 | $439.31 |
| Tennessee | $648.58 | $395.07 |
| Utah | $669.07 | $406.90 |
| Vallejo | $851.58 | $483.99 |
| Vermont | $685.83 | $409.73 |
| Virgin Islands | $703.63 | $421.66 |
| Virginia | $685.91 | $411.75 |
| Visalia | $739.43 | $433.76 |
| West Virginia | $644.86 | $402.50 |
| Wisconsin | $667.61 | $400.42 |
| Wyoming** | $694.40 | $415.51 |
| Yuba City | $739.43 | $433.76 |
65286 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.
$624.90
$830.13
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 | $829.44 | 1 |
| AL | $633.21 | 1 |
| AR | $624.90 | 1 |
| AZ | $681.89 | 1 |
| CA | $739.43–$920.83 | 29 |
| CO | $727.52 | 1 |
| CT | $742.47 | 1 |
| DC | $795.28 | 1 |
| DE | $692.54 | 1 |
| FL | $686.63–$743.40 | 3 |
| GA | $651.60–$710.21 | 2 |
| GU | $755.60 | 1 |
| HI | $755.60 | 1 |
| IA | $649.04 | 1 |
| ID | $652.64 | 1 |
| IL | $667.58–$725.74 | 4 |
| IN | $656.12 | 1 |
| KS | $645.70 | 1 |
| KY | $645.57 | 1 |
| LA | $644.42–$673.51 | 2 |
| MA | $723.52–$796.21 | 2 |
| MD | $705.13–$795.28 | 3 |
| ME | $655.13–$688.39 | 2 |
| MI | $660.34–$693.88 | 2 |
| MN | $700.51 | 1 |
| MO | $633.97–$676.40 | 3 |
| MS | $629.58 | 1 |
| MT | $698.71 | 1 |
| NC | $661.48 | 1 |
| ND | $688.83 | 1 |
| NE | $652.46 | 1 |
| NH | $715.78 | 1 |
| NJ | $751.90–$788.08 | 2 |
| NM | $663.40 | 1 |
| NV | $696.42 | 1 |
| NY | $670.47–$814.99 | 5 |
| OH | $658.31 | 1 |
| OK | $645.13 | 1 |
| OR | $691.92–$749.68 | 2 |
| PA | $659.59–$724.97 | 2 |
| PR | $703.63 | 1 |
| RI | $716.43 | 1 |
| SC | $660.80 | 1 |
| SD | $687.66 | 1 |
| TN | $648.58 | 1 |
| TX | $655.60–$724.32 | 8 |
| UT | $669.07 | 1 |
| VA | $685.91–$795.28 | 2 |
| VI | $703.63 | 1 |
| VT | $685.83 | 1 |
| WA | $722.27–$812.32 | 2 |
| WI | $667.61 | 1 |
| WV | $644.86 | 1 |
| WY | $694.40 | 1 |
How the 65286 rate is calculated
Each of 65286’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 · 65286
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.46Practice expense 13.96Malpractice 0.50
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 65286
65286 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65286
Bleb repair
| 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 · 65286
Bleb repair
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
65286 without 50 · national office
$698.75
Bleb repair
65286-50 · Bilateral: 150%
$1,048.13
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).
65286 compared with similar codes
Compare codes
65286 vs 65270 vs 65285 vs 66250: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65270Eye wound repair
- This code addresses a leaking glaucoma filtering bleb. Code 65270 is for repair of a superficial conjunctival wound.
- 65285Eye wound repair
- Use this code for transconjunctival leaking bleb repair; 65285 describes repair of a perforating corneal or scleral laceration with multiple sutures.
- 66250Eye wound repair
- This code is specific to transconjunctival repair of a leaking bleb. Code 66250 describes revision or repair of an anterior-segment operative wound more generally.
65286 billing questions
When is this code appropriate instead of a traumatic eye-wound repair code?
Use it for transconjunctival repair of a leaking glaucoma filtering bleb. Codes for traumatic wounds describe repair of injuries such as conjunctival, corneal, or scleral lacerations.
What should the operative note document?
Document the leaking filtering bleb, the repair performed, and that the approach was transconjunctival. Include the treated eye and the clinical findings supporting repair.
Does the code include postoperative visits?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How is bilateral repair reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service. 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
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