Billing code 65778: Amniotic membraneMedicare rate & RVUs
Reports placement of an amniotic membrane on the ocular surface without sutures, often to support healing of a persistent epithelial defect or other surface injury.
Medicare pays $1,274.24 for 65778 nationally in the office and $35.74 in a hospital or facility. Local office rates run $1,097.98–$1,827.16.
Medicare rate · 65778
Amniotic membrane
Swap in your local Medicare rate.
- Work RVUs
- 0.82
- Total RVUs
- 38.15
- Global days
- 000
National rate · 2026
$1,274.24
Office setting, before claim adjustments.
See every locality for 65778 → · 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 65778 covers
An ophthalmologist places an amniotic membrane over the ocular surface without suturing it in place. The service may be used for a persistent corneal epithelial defect, a nonhealing corneal ulcer, or ocular surface damage after injury. It is commonly performed in an office or ambulatory surgical setting when the clinician determines that membrane coverage is appropriate to support surface healing.
Report this code when the membrane is placed on the ocular surface without sutures; documentation should identify the clinical indication, treated eye, and placement method. The service has a 0-day global period, so same-day preoperative and postoperative care is included. If 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. For bilateral reporting with modifier 50, CMS payment is 150%. Assistant-at-surgery payment requires documentation of 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 65778 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
$1097.98 to $1827.16
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,117.97 | $34.28 |
| Alaska* | $1,368.30 | $49.29 |
| Arizona | $1,235.44 | $35.33 |
| Arkansas | $1,097.98 | $34.10 |
| Atlanta | $1,294.52 | $36.20 |
| Austin | $1,346.39 | $36.05 |
| Bakersfield | $1,393.81 | $36.41 |
| Baltimore/Surr. Cntys | $1,365.92 | $37.01 |
| Beaumont | $1,162.05 | $35.01 |
| Brazoria | $1,262.96 | $35.60 |
| Chicago | $1,282.39 | $37.70 |
| Chico | $1,393.66 | $36.26 |
| Colorado | $1,353.99 | $36.22 |
| Connecticut | $1,370.98 | $37.11 |
| Dallas | $1,269.32 | $35.77 |
| Dc + Md/Va Suburbs | $1,497.58 | $38.62 |
| Delaware | $1,259.30 | $35.66 |
| Detroit | $1,231.57 | $36.41 |
| East St. Louis | $1,175.96 | $36.53 |
| El Centro | $1,393.67 | $36.26 |
| Fort Lauderdale | $1,291.52 | $36.91 |
| Fort Worth | $1,256.88 | $35.71 |
| Fresno | $1,393.66 | $36.26 |
| Galveston | $1,265.52 | $35.68 |
| Hanford-Corcoran | $1,393.66 | $36.26 |
| Hawaii, Guam | $1,444.32 | $36.14 |
| Houston | $1,266.25 | $36.41 |
| Idaho | $1,173.90 | $34.47 |
| Indiana | $1,182.63 | $34.54 |
| Iowa | $1,167.57 | $34.34 |
| Kansas | $1,154.01 | $34.40 |
| Kentucky | $1,135.88 | $34.85 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $1,502.85 | $37.70 |
| Madera | $1,393.66 | $36.26 |
| Manhattan | $1,478.55 | $39.41 |
| Merced | $1,393.66 | $36.26 |
| Metropolitan Boston | $1,516.85 | $38.08 |
| Metropolitan Kansas City | $1,198.24 | $35.28 |
| Metropolitan Philadelphia | $1,326.06 | $36.78 |
| Metropolitan St. Louis | $1,214.46 | $35.40 |
| Miami | $1,327.35 | $38.07 |
| Minnesota | $1,309.42 | $35.00 |
| Mississippi | $1,100.77 | $34.42 |
| Modesto | $1,393.66 | $36.26 |
| Montana** | $1,274.24 | $35.74 |
| Napa | $1,671.39 | $39.04 |
| Nebraska | $1,177.51 | $34.37 |
| Nevada** | $1,275.27 | $35.52 |
| New Hampshire | $1,325.14 | $35.86 |
| New Mexico | $1,171.13 | $35.43 |
| New Orleans | $1,200.94 | $35.51 |
| North Carolina | $1,190.31 | $34.79 |
| North Dakota** | $1,273.45 | $34.95 |
| Northern Nj | $1,475.34 | $38.68 |
| Nyc Suburbs/Long Island | $1,512.55 | $39.96 |
| Ohio | $1,165.89 | $35.14 |
| Oklahoma | $1,140.68 | $34.69 |
| Oxnard-Thousand Oaks-Ventura | $1,501.19 | $37.28 |
| Portland | $1,412.59 | $36.61 |
| Poughkpsie/N Nyc Suburbs | $1,394.08 | $37.92 |
| Puerto Rico | $1,287.93 | $35.80 |
| Queens | $1,503.27 | $39.36 |
| Redding | $1,393.66 | $36.26 |
| Rest Of California | $1,393.66 | $36.26 |
| Rest Of Florida | $1,220.11 | $36.10 |
| Rest Of Georgia | $1,139.98 | $35.24 |
| Rest Of Illinois | $1,166.64 | $35.88 |
| Rest Of Louisiana | $1,130.95 | $34.88 |
| Rest Of Maine | $1,174.10 | $34.67 |
| Rest Of Maryland | $1,289.35 | $35.99 |
| Rest Of Massachusetts | $1,340.42 | $36.28 |
| Rest Of Michigan | $1,166.06 | $35.30 |
| Rest Of Missouri | $1,102.33 | $34.74 |
| Rest Of New Jersey | $1,390.06 | $37.61 |
| Rest Of New York | $1,211.57 | $34.99 |
| Rest Of Oregon | $1,268.87 | $35.31 |
| Rest Of Pennsylvania | $1,172.04 | $35.09 |
| Rest Of Texas | $1,210.59 | $35.25 |
| Rest Of Washington | $1,340.29 | $36.15 |
| Rhode Island | $1,315.72 | $36.35 |
| Riverside-San Bernardino-Ontario | $1,394.11 | $36.71 |
| Sacramento-Roseville-Folsom | $1,477.63 | $37.25 |
| Salinas | $1,472.51 | $37.08 |
| San Diego-Chula Vista-Carlsbad | $1,518.58 | $37.32 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,786.79 | $40.49 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,786.74 | $40.45 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,827.16 | $41.23 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,826.97 | $41.05 |
| San Luis Obispo-Paso Robles | $1,447.22 | $36.56 |
| Santa Cruz-Watsonville | $1,541.99 | $37.20 |
| Santa Maria-Santa Barbara | $1,481.15 | $37.05 |
| Santa Rosa-Petaluma | $1,558.42 | $37.54 |
| Seattle (King Cnty) | $1,558.10 | $38.46 |
| South Carolina | $1,179.38 | $35.01 |
| South Dakota** | $1,273.36 | $34.85 |
| Southern Maine | $1,262.54 | $35.18 |
| Stockton | $1,393.66 | $36.26 |
| Suburban Chicago | $1,309.10 | $37.15 |
| Tennessee | $1,160.28 | $34.48 |
| Utah | $1,199.38 | $35.18 |
| Vallejo | $1,671.32 | $38.97 |
| Vermont | $1,261.13 | $35.01 |
| Virgin Islands | $1,287.93 | $35.80 |
| Virginia | $1,252.68 | $35.23 |
| Visalia | $1,393.66 | $36.26 |
| West Virginia | $1,111.66 | $35.40 |
| Wisconsin | $1,221.01 | $34.52 |
| Wyoming** | $1,273.90 | $35.39 |
| Yuba City | $1,393.66 | $36.26 |
65778 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.
$1,097.98
$1,610.41
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 | $1,368.30 | 1 |
| AL | $1,117.97 | 1 |
| AR | $1,097.98 | 1 |
| AZ | $1,235.44 | 1 |
| CA | $1,393.66–$1,827.16 | 29 |
| CO | $1,353.99 | 1 |
| CT | $1,370.98 | 1 |
| DC | $1,497.58 | 1 |
| DE | $1,259.30 | 1 |
| FL | $1,220.11–$1,327.35 | 3 |
| GA | $1,139.98–$1,294.52 | 2 |
| GU | $1,444.32 | 1 |
| HI | $1,444.32 | 1 |
| IA | $1,167.57 | 1 |
| ID | $1,173.90 | 1 |
| IL | $1,166.64–$1,309.10 | 4 |
| IN | $1,182.63 | 1 |
| KS | $1,154.01 | 1 |
| KY | $1,135.88 | 1 |
| LA | $1,130.95–$1,200.94 | 2 |
| MA | $1,340.42–$1,516.85 | 2 |
| MD | $1,289.35–$1,497.58 | 3 |
| ME | $1,174.10–$1,262.54 | 2 |
| MI | $1,166.06–$1,231.57 | 2 |
| MN | $1,309.42 | 1 |
| MO | $1,102.33–$1,214.46 | 3 |
| MS | $1,100.77 | 1 |
| MT | $1,274.24 | 1 |
| NC | $1,190.31 | 1 |
| ND | $1,273.45 | 1 |
| NE | $1,177.51 | 1 |
| NH | $1,325.14 | 1 |
| NJ | $1,390.06–$1,475.34 | 2 |
| NM | $1,171.13 | 1 |
| NV | $1,275.27 | 1 |
| NY | $1,211.57–$1,512.55 | 5 |
| OH | $1,165.89 | 1 |
| OK | $1,140.68 | 1 |
| OR | $1,268.87–$1,412.59 | 2 |
| PA | $1,172.04–$1,326.06 | 2 |
| PR | $1,287.93 | 1 |
| RI | $1,315.72 | 1 |
| SC | $1,179.38 | 1 |
| SD | $1,273.36 | 1 |
| TN | $1,160.28 | 1 |
| TX | $1,162.05–$1,346.39 | 8 |
| UT | $1,199.38 | 1 |
| VA | $1,252.68–$1,497.58 | 2 |
| VI | $1,287.93 | 1 |
| VT | $1,261.13 | 1 |
| WA | $1,340.29–$1,558.10 | 2 |
| WI | $1,221.01 | 1 |
| WV | $1,111.66 | 1 |
| WY | $1,273.90 | 1 |
How the 65778 rate is calculated
Each of 65778’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 · 65778
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.82Practice expense 37.29Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 65778
The CMS indicators that decide how 65778 is paid alongside other services.
CMS payment indicators · 65778
Amniotic membrane
| 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
65778 without 50 · national office
$1,274.24
Amniotic membrane
65778-50 · Bilateral: 150%
$1,911.36
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).
65778 compared with similar codes
Compare codes
65778 vs 65779 vs 65780 vs 65710: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65779Amniotic membrane
- The key distinction is fixation: 65778 is for membrane placement without sutures, while 65779 is for placement with sutures.
- 65780Amniotic membrane graft
- 65780 describes ocular surface reconstruction involving amniotic membrane transplantation; 65778 is the more specific service of placing a membrane without sutures.
- 65710Corneal transplant
- 65710 is a corneal transplant procedure. It is not the code for placing an amniotic membrane on the ocular surface without sutures.
65778 billing questions
How does this differ from 65779?
Both codes report amniotic membrane placement on the ocular surface. Use 65778 when the membrane is placed without sutures and 65779 when it is sutured.
What documentation supports 65778?
Document the ocular surface condition being treated, the eye involved, and that the amniotic membrane was placed without sutures.
Is same-day postoperative care separately included?
No. The 0-day global period includes same-day preoperative and postoperative care.
How is bilateral placement reported?
CMS lists this as a bilateral procedure; reporting modifier 50 results in payment at 150%.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the other procedure is paid at 50%.
Can an assistant surgeon be paid for this service?
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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