Billing code 65410: Corneal biopsyMedicare rate & RVUs
An ophthalmologist samples corneal tissue for diagnostic evaluation, such as investigating a deep or atypical corneal lesion or infection.
Medicare pays $143.96 for 65410 nationally in the office and $86.51 in a hospital or facility. Local office rates run $129.13–$188.40.
Medicare rate · 65410
Corneal biopsy
- Work RVUs
- 1.43
- Total RVUs
- 4.31
- Global days
- 000
National rate · 2026
$143.96
Office setting, before claim adjustments.
See every locality for 65410 →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 65410 covers
An ophthalmologist, often a cornea specialist, removes a small piece of corneal tissue when examination or less invasive sampling has not resolved a diagnostic question. This may be done in an office or operating-room setting for a deep or atypical corneal infection, a nonhealing ulcer, or a lesion requiring tissue evaluation. The specimen may be sent for histopathology or microbiologic testing, depending on the clinical concern.
Report 65410 when corneal tissue is obtained by biopsy, rather than when the clinician takes a surface smear or treats a corneal lesion. Documentation should identify the eye and biopsy site, the reason tissue sampling was needed, the method used, and the specimen’s disposition. The code has a 0-day global period, so same-day preoperative and postoperative care is included. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; 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 65410 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
$129.13 to $188.40
109 of 109 payment localities
65410 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.
$129.13
$172.20
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 | $172.20 | 1 |
| AL | $130.80 | 1 |
| AR | $129.13 | 1 |
| AZ | $140.56 | 1 |
| CA | $151.95–$188.40 | 29 |
| CO | $149.65 | 1 |
| CT | $152.81 | 1 |
| DC | $163.42 | 1 |
| DE | $142.72 | 1 |
| FL | $141.74–$153.37 | 3 |
| GA | $134.67–$146.32 | 2 |
| GU | $155.09 | 1 |
| HI | $155.09 | 1 |
| IA | $133.88 | 1 |
| ID | $134.62 | 1 |
| IL | $137.98–$149.63 | 4 |
| IN | $135.32 | 1 |
| KS | $133.25 | 1 |
| KY | $133.38 | 1 |
| LA | $133.16–$139.00 | 2 |
| MA | $148.88–$163.46 | 2 |
| MD | $145.24–$163.42 | 3 |
| ME | $135.17–$141.77 | 2 |
| MI | $136.38–$143.24 | 2 |
| MN | $144.05 | 1 |
| MO | $131.09–$139.52 | 3 |
| MS | $130.14 | 1 |
| MT | $143.95 | 1 |
| NC | $136.43 | 1 |
| ND | $141.78 | 1 |
| NE | $134.55 | 1 |
| NH | $147.29 | 1 |
| NJ | $154.74–$162.02 | 2 |
| NM | $137.02 | 1 |
| NV | $143.44 | 1 |
| NY | $138.24–$167.65 | 5 |
| OH | $135.94 | 1 |
| OK | $133.24 | 1 |
| OR | $142.50–$154.05 | 2 |
| PA | $136.17–$149.32 | 2 |
| PR | $144.92 | 1 |
| RI | $147.52 | 1 |
| SC | $136.38 | 1 |
| SD | $141.52 | 1 |
| TN | $133.84 | 1 |
| TX | $135.37–$149.00 | 8 |
| UT | $138.03 | 1 |
| VA | $141.30–$163.42 | 2 |
| VI | $144.92 | 1 |
| VT | $141.22 | 1 |
| WA | $148.60–$166.68 | 2 |
| WI | $137.53 | 1 |
| WV | $133.42 | 1 |
| WY | $143.00 | 1 |
How the 65410 rate is calculated
Each of 65410’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 · 65410
RVUs × geographic indexes × conversion factor
Work1.43
1.43 RVUs× 1.000 GPCI
Practice expense2.77
2.77 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
4.3100
Conversion factor
$33.4009
Medicare rate
$143.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 65410
The CMS indicators that decide how 65410 is paid alongside other services.
CMS payment indicators · 65410
Corneal biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
65410 without 50 · national office
$143.96
Corneal biopsy
65410-50 · Bilateral: 150%
$215.94
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).
65410 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 65430Corneal scraping
- 65430 is for obtaining a corneal smear from the surface. Choose 65410 when the service removes corneal tissue for diagnostic evaluation.
- 65400Corneal excision
- 65400 describes excision of a corneal lesion. Use 65410 when the intent is to obtain tissue for diagnosis rather than excise the lesion as treatment.
- 65435Corneal treatment
- 65435 is a corneal epithelial treatment or removal procedure. It is not the code for obtaining a corneal tissue biopsy.
65410 billing questions
When should 65410 be used instead of 65430?
Use 65410 when corneal tissue is removed for biopsy. Code 65430 describes corneal smear sampling, which collects surface material rather than a tissue specimen.
Is removal of a corneal lesion reported as a biopsy?
Not when the service is excision or treatment of the lesion rather than tissue sampling for diagnosis. For example, 65400 describes excision of a corneal lesion.
What documentation supports 65410?
Document the eye and biopsy site, the diagnostic reason for obtaining tissue, the sampling method, and where the specimen was sent.
How is bilateral corneal biopsy reported?
Report the bilateral procedure with modifier 50. CMS pays bilateral procedures at 150% under the stated rule.
Does the biopsy include same-day care?
Yes. Its 0-day global period includes same-day preoperative and postoperative care.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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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