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Billing code 65781: Ocular reconstructionMedicare rate & RVUs

Reports ocular surface reconstruction using donor limbal stem cells for limbal stem cell deficiency, such as after severe chemical injury.

CMS RVU26DEffective Oct 1, 2026109 payment localities28 Medicare services in 2024

Medicare pays $1,122.94 for 65781 nationally in a facility.

Medicare rate · 65781

Ocular reconstruction

Swap in your local Medicare rate.

Work RVUs
17.69
Total RVUs
33.62
Global days
090

National rate · 2026

$1,122.94

Facility setting, before claim adjustments.

See every locality for 65781 → · 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
  1. Medicare rate
  2. What 65781 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 65781 covers

An ophthalmic surgeon uses donor limbal tissue containing stem cells to rebuild the ocular surface when the patient’s limbal stem cell function is inadequate. The donor tissue may come from a cadaveric or living donor. This operation is used for significant limbal stem cell deficiency, including cases following severe chemical or thermal injury, and is generally performed in a surgical facility.

Report 65781 when the reconstruction uses an allogeneic limbal stem cell graft; document the donor tissue and the surgical work performed. The code has 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 reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be available; co-surgeons require 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.

Where 65781 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

65781 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,041.88
Alaska*Unavailable$1,428.75
ArizonaUnavailable$1,101.12
ArkansasUnavailable$1,031.71
AtlantaUnavailable$1,141.94
AustinUnavailable$1,146.88
BakersfieldUnavailable$1,162.31
Baltimore/Surr. CntysUnavailable$1,178.96
BeaumontUnavailable$1,075.95
BrazoriaUnavailable$1,112.94

65781 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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.

View every state and territory as a table
65781 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 65781 rate is calculated

Each of 65781’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 · 65781

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.69Practice expense 14.52Malpractice 1.41

33.6200 adjusted RVUs×$33.4009 conversion factor=$1,122.94

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 65781

65781 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 65781

Ocular reconstruction

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 65781

Ocular reconstruction

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

65781 without 50 · national facility

$1,122.94

Ocular reconstruction

65781-50 · Bilateral: 150%

$1,684.41

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).

When to use modifier 50

65781 compared with similar codes

Compare codes

65781 vs 65782 vs 65780 vs 65779: national Medicare rates

Swap in your local Medicare rate.

  • 65781
    Ocular reconstruction · 17.69 wRVU
    —
  • 65782
    Ocular reconstruction · 15.04 wRVU
    —
  • 65780
    Amniotic membrane graft · 6.85 wRVU
    —
  • 65779
    Amniotic membrane · 1.71 wRVU
    $1,139.97

How to choose

65782Ocular reconstruction
Use 65781 for donor limbal stem cells; use 65782 when the graft is autologous.
65780Amniotic membrane graft
65780 represents reconstruction with a multilayer amniotic membrane approach, rather than a limbal stem cell allograft.
65779Amniotic membrane
65779 covers sutured amniotic membrane placement for ocular surface coverage. It does not describe transplantation of donor limbal stem cells.

Codes related to 65781

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

Codes related to 65781
CodeHow it relatesNational office range
Same family
65780Amniotic membrane graftOcular surface reconstruction using a multilayer amniotic membrane approach.No office rate
65782Ocular reconstructionOcular surface reconstruction using the patient’s own limbal stem cells.No office rate
Used instead
65778Amniotic membraneAmniotic membrane coverage may be used for surface treatment without limbal stem cell transplantation.$1,097.98–$1,827.16
65779Amniotic membraneSutured amniotic membrane coverage is a surface-treatment approach, not donor limbal cell replacement.$985.68–$1,620.64

65781 billing questions

How is 65781 different from 65782?

65781 is for limbal stem cells from a donor. 65782 is for an autologous graft using the patient’s own tissue.

When would 65780 be reported instead?

65780 describes ocular surface reconstruction using a multilayer amniotic membrane approach. Choose based on the graft and reconstruction performed, not just the diagnosis.

Does 65781 have a global period?

Yes. Its 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days.

How is bilateral 65781 paid?

CMS lists bilateral reporting with modifier 50 at 150%. The operative documentation should support surgery on both eyes.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

What documentation supports reporting 65781?

Document the limbal stem cell deficiency, the donor source of the graft, and the operative reconstruction performed.

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
RVUs for 65781PPRRVU2026_Oct_nonQPP.csv, line 7,343 (RVU26D)

Open CMS sourceHow we calculate rates

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