Billing code 65400: Corneal excisionMedicare rate & RVUs
Ophthalmologists report this procedure to excise a superficial corneal lesion when the target is removed rather than sampled, scraped, or destroyed.
Medicare pays $698.41 for 65400 nationally in the office and $523.39 in a hospital or facility. Local office rates run $627.47–$907.89.
Medicare rate · 65400
Corneal excision
Swap in your local Medicare rate.
- Work RVUs
- 7.31
- Total RVUs
- 20.91
- Global days
- 090
National rate · 2026
$698.41
Office setting, before claim adjustments.
See every locality for 65400 → · 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 65400 covers
An ophthalmologist uses magnification and microsurgical instruments to excise a focal lesion from the corneal surface. This code is for superficial corneal lesions other than pterygium; removed tissue may be sent for pathology when clinically indicated. It describes removal of the lesion itself, not a diagnostic corneal biopsy alone, epithelial scraping for recurrent erosion, or destruction by a method such as freezing or photocoagulation. The service may be performed in an office procedure setting or an outpatient surgical facility, depending on the lesion and clinical circumstances.
Report 65400 when documentation identifies a superficial corneal lesion and supports excision, including its location, extent, and the work performed. Distinguish it from biopsy, epithelial removal for recurrent erosion, and pterygium surgery. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, CMS pays the highest-valued procedure in full and reduces other procedures to 50%. Bilateral reporting with modifier 50 is paid at 150%. CMS 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 65400 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
$627.47 to $907.89
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $635.44 | $482.30 |
| Alaska* | $839.72 | $653.32 |
| Arizona | $682.07 | $512.47 |
| Arkansas | $627.47 | $477.13 |
| Atlanta | $710.12 | $532.30 |
| Austin | $721.80 | $536.63 |
| Bakersfield | $736.90 | $545.08 |
| Baltimore/Surr. Cntys | $738.77 | $550.97 |
| Beaumont | $657.91 | $498.64 |
| Brazoria | $692.05 | $518.60 |
| Chicago | $728.25 | $552.35 |
| Chico | $734.95 | $543.13 |
| Colorado | $724.74 | $538.52 |
| Connecticut | $740.94 | $552.44 |
| Dallas | $696.03 | $521.71 |
| Dc + Md/Va Suburbs | $791.15 | $584.98 |
| Delaware | $692.40 | $519.48 |
| Detroit | $696.96 | $528.07 |
| East St. Louis | $684.00 | $522.98 |
| El Centro | $735.05 | $543.23 |
| Fort Lauderdale | $720.25 | $542.95 |
| Fort Worth | $691.95 | $519.38 |
| Fresno | $734.95 | $543.13 |
| Galveston | $693.88 | $520.08 |
| Hanford-Corcoran | $734.95 | $543.13 |
| Hawaii, Guam | $749.46 | $550.46 |
| Houston | $704.86 | $531.07 |
| Idaho | $653.11 | $492.10 |
| Indiana | $656.41 | $494.17 |
| Iowa | $649.42 | $489.28 |
| Kansas | $646.79 | $488.57 |
| Kentucky | $648.51 | $492.92 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $781.15 | $574.10 |
| Madera | $734.95 | $543.13 |
| Manhattan | $796.13 | $592.75 |
| Merced | $734.95 | $543.13 |
| Metropolitan Boston | $790.46 | $581.48 |
| Metropolitan Kansas City | $671.46 | $507.12 |
| Metropolitan Philadelphia | $724.48 | $542.28 |
| Metropolitan St. Louis | $677.61 | $510.99 |
| Miami | $746.86 | $564.66 |
| Minnesota | $696.90 | $516.80 |
| Mississippi | $632.83 | $482.13 |
| Modesto | $734.95 | $543.13 |
| Montana** | $698.37 | $523.35 |
| Napa | $842.01 | $611.34 |
| Nebraska | $652.51 | $490.97 |
| Nevada** | $695.50 | $520.30 |
| New Hampshire | $713.71 | $531.51 |
| New Mexico | $666.40 | $505.91 |
| New Orleans | $675.52 | $510.83 |
| North Carolina | $662.09 | $498.79 |
| North Dakota** | $686.51 | $511.49 |
| Northern Nj | $784.63 | $581.61 |
| Nyc Suburbs/Long Island | $813.28 | $605.18 |
| Ohio | $660.80 | $501.00 |
| Oklahoma | $647.48 | $491.19 |
| Oxnard-Thousand Oaks-Ventura | $776.72 | $569.85 |
| Portland | $745.39 | $550.94 |
| Poughkpsie/N Nyc Suburbs | $754.86 | $563.21 |
| Puerto Rico | $702.89 | $525.94 |
| Queens | $801.92 | $595.05 |
| Redding | $734.95 | $543.13 |
| Rest Of California | $734.95 | $543.13 |
| Rest Of Florida | $689.39 | $522.07 |
| Rest Of Georgia | $655.37 | $499.25 |
| Rest Of Illinois | $671.92 | $512.13 |
| Rest Of Louisiana | $647.64 | $492.74 |
| Rest Of Maine | $656.10 | $495.08 |
| Rest Of Maryland | $704.42 | $527.30 |
| Rest Of Massachusetts | $721.26 | $536.97 |
| Rest Of Michigan | $663.22 | $503.43 |
| Rest Of Missouri | $637.97 | $487.10 |
| Rest Of New Jersey | $750.07 | $558.95 |
| Rest Of New York | $670.75 | $504.48 |
| Rest Of Oregon | $690.72 | $516.40 |
| Rest Of Pennsylvania | $661.71 | $501.04 |
| Rest Of Texas | $674.32 | $508.23 |
| Rest Of Washington | $719.81 | $535.51 |
| Rhode Island | $715.22 | $534.42 |
| Riverside-San Bernardino-Ontario | $741.55 | $549.72 |
| Sacramento-Roseville-Folsom | $768.68 | $565.13 |
| Salinas | $765.72 | $562.87 |
| San Diego-Chula Vista-Carlsbad | $781.66 | $572.34 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $888.79 | $642.01 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $888.11 | $641.33 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $907.89 | $655.51 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $905.11 | $652.73 |
| San Luis Obispo-Paso Robles | $753.62 | $554.27 |
| Santa Cruz-Watsonville | $787.60 | $574.95 |
| Santa Maria-Santa Barbara | $768.03 | $563.96 |
| Santa Rosa-Petaluma | $795.44 | $580.51 |
| Seattle (King Cnty) | $805.52 | $590.77 |
| South Carolina | $662.41 | $500.69 |
| South Dakota** | $685.11 | $510.09 |
| Southern Maine | $687.11 | $513.66 |
| Stockton | $734.95 | $543.13 |
| Suburban Chicago | $727.32 | $547.57 |
| Tennessee | $649.62 | $490.53 |
| Utah | $670.32 | $505.80 |
| Vallejo | $841.03 | $610.36 |
| Vermont | $684.17 | $510.90 |
| Virgin Islands | $702.89 | $525.94 |
| Virginia | $685.14 | $513.09 |
| Visalia | $734.95 | $543.13 |
| West Virginia | $650.17 | $498.08 |
| Wisconsin | $666.31 | $498.64 |
| Wyoming** | $693.20 | $518.18 |
| Yuba City | $734.95 | $543.13 |
65400 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.
$627.47
$839.72
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 | $839.72 | 1 |
| AL | $635.44 | 1 |
| AR | $627.47 | 1 |
| AZ | $682.07 | 1 |
| CA | $734.95–$907.89 | 29 |
| CO | $724.74 | 1 |
| CT | $740.94 | 1 |
| DC | $791.15 | 1 |
| DE | $692.40 | 1 |
| FL | $689.39–$746.86 | 3 |
| GA | $655.37–$710.12 | 2 |
| GU | $749.46 | 1 |
| HI | $749.46 | 1 |
| IA | $649.42 | 1 |
| ID | $653.11 | 1 |
| IL | $671.92–$728.25 | 4 |
| IN | $656.41 | 1 |
| KS | $646.79 | 1 |
| KY | $648.51 | 1 |
| LA | $647.64–$675.52 | 2 |
| MA | $721.26–$790.46 | 2 |
| MD | $704.42–$791.15 | 3 |
| ME | $656.10–$687.11 | 2 |
| MI | $663.22–$696.96 | 2 |
| MN | $696.90 | 1 |
| MO | $637.97–$677.61 | 3 |
| MS | $632.83 | 1 |
| MT | $698.37 | 1 |
| NC | $662.09 | 1 |
| ND | $686.51 | 1 |
| NE | $652.51 | 1 |
| NH | $713.71 | 1 |
| NJ | $750.07–$784.63 | 2 |
| NM | $666.40 | 1 |
| NV | $695.50 | 1 |
| NY | $670.75–$813.28 | 5 |
| OH | $660.80 | 1 |
| OK | $647.48 | 1 |
| OR | $690.72–$745.39 | 2 |
| PA | $661.71–$724.48 | 2 |
| PR | $702.89 | 1 |
| RI | $715.22 | 1 |
| SC | $662.41 | 1 |
| SD | $685.11 | 1 |
| TN | $649.62 | 1 |
| TX | $657.91–$721.80 | 8 |
| UT | $670.32 | 1 |
| VA | $685.14–$791.15 | 2 |
| VI | $702.89 | 1 |
| VT | $684.17 | 1 |
| WA | $719.81–$805.52 | 2 |
| WI | $666.31 | 1 |
| WV | $650.17 | 1 |
| WY | $693.20 | 1 |
How the 65400 rate is calculated
Each of 65400’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 · 65400
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.31Practice expense 13.00Malpractice 0.60
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 65400
65400 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65400
Corneal excision
| 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 · 65400
Corneal excision
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
65400 without 50 · national office
$698.41
Corneal excision
65400-50 · Bilateral: 150%
$1,047.62
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).
65400 compared with similar codes
Compare codes
65400 vs 65410 vs 65420 vs 65435 vs 65450: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65410Corneal biopsy
- 65400 excises a superficial lesion; 65410 obtains a corneal tissue sample by biopsy for diagnosis.
- 65420Pterygium removal
- 65420 is for pterygium excision or transposition without a graft. 65400 is for a superficial corneal lesion other than pterygium.
- 65435Corneal treatment
- 65435 removes corneal epithelium to treat recurrent erosion; 65400 excises a focal superficial corneal lesion.
- 65450Corneal treatment
- 65450 destroys a corneal lesion by a destructive method; 65400 removes the lesion by excision.
65400 billing questions
How does 65400 differ from a corneal biopsy?
Use 65400 when the superficial lesion is excised. Use 65410 when the service is a corneal biopsy to obtain tissue for diagnosis rather than excision of the lesion.
Does the 90-day global period include postoperative visits?
Related postoperative care during the 90-day period is included, as is the day-before preoperative visit.
When is modifier 50 used?
For bilateral performance, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for 65400. Co-surgeons and team surgery are not permitted.
How are other procedures performed in the same session paid?
CMS pays the highest-valued procedure in full and reduces the other procedures to 50% under the standard multiple procedure rule.
When should 65400 be distinguished from 65435?
65400 is for excision of a superficial corneal lesion. 65435 is for corneal epithelial removal to treat recurrent corneal erosion.
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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