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Billing code 65900: Eye lesion removalMedicare rate & RVUs

Report 65900 for operative removal of a lesion involving the eye’s anterior segment, with the operative documentation identifying the site and work performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $849.72 for 65900 nationally in a facility.

Medicare rate · 65900

Eye lesion removal

Work RVUs
12.2
Total RVUs
25.44
Global days
090

National rate · 2026

$849.72

Facility setting, before claim adjustments.

See every locality for 65900 →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 65900 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 65900 covers

Code 65900 represents operative removal of a lesion involving the anterior segment of the eye. An ophthalmologist typically performs the procedure as surgical treatment, rather than as an examination or observation alone. The operative report should identify the involved structure and describe the removal performed. Select the code based on the lesion’s location and the procedure actually carried out; a lesion of a specifically coded structure, such as the cornea or conjunctiva, may call for that structure’s excision code instead.

Document the lesion site, laterality, and operative work. CMS classifies 65900 as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 65900 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

65900 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$784.22
Alaska*Unavailable$1,065.21
ArizonaUnavailable$832.27
ArkansasUnavailable$775.99
AtlantaUnavailable$864.13
AustinUnavailable$870.50
BakersfieldUnavailable$883.81
Baltimore/Surr. CntysUnavailable$893.94
BeaumontUnavailable$810.55
BrazoriaUnavailable$842.02

65900 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.

View every state and territory as a table
65900 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 65900 rate is calculated

Each of 65900’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 · 65900

RVUs × geographic indexes × conversion factor

Work12.20

12.20 RVUs× 1.000 GPCI

Practice expense12.25

12.25 RVUs× 1.000 GPCI

Malpractice0.99

0.99 RVUs× 1.000 GPCI

Adjusted RVUs

25.4400

Conversion factor

$33.4009

Medicare rate

$849.72

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 65900

65900 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 65900

Eye lesion removal

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)0Not permitted.
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 · 65900

Eye lesion removal

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

65900 without 50 · national facility

$849.72

Eye lesion removal

65900-50 · Bilateral: 150%

$1,274.58

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

65900 compared with similar codes

Compare codes · National

5 codes, side by side

  • 65900

    Eye lesion removal12.2 wRVU

    Not priced

  • 65400

    Corneal excision7.31 wRVU

    $698.41

  • 68110

    Conjunctival excision1.77 wRVU

    $237.48

  • 65920

    Implant removal9.74 wRVU

    Not priced

  • 65930

    Eye clot removal8.18 wRVU

    Not priced

How to choose

65400Corneal excision
65400 is specific to excision of a corneal lesion. Use 65900 when the removed lesion involves the anterior segment and is not being reported under a more specific structure-based code.
68110Conjunctival excision
68110 describes excision of a conjunctival lesion up to the size specified by that code. Choose by the lesion’s actual site and the procedure performed.
65920Implant removal
65920 is for removal of an eye implant, not removal of a lesion.
65930Eye clot removal
65930 is for removal of a blood clot from the eye; 65900 is for removal of a lesion.

Codes related to 65900

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

Codes related to 65900
CodeHow it relatesNational office range
Used instead
65400Corneal excisionUse for excision when the lesion being removed is on the cornea.$627.47–$907.89
68110Conjunctival excisionUse for conjunctival lesion excision when the service and lesion size fit this code.$210.72–$318.58
68115Conjunctival excisionUse for a larger conjunctival lesion when the service meets this code’s criteria.$293.22–$445.50

65900 billing questions

How is 65900 different from corneal lesion excision?

Use 65900 for a lesion involving the anterior segment when a more specific structure-based code does not describe the procedure. For a lesion excised from the cornea, consider 65400.

When should a conjunctival lesion code be used instead?

When the lesion being excised is on the conjunctiva, use the applicable conjunctival excision code, such as 68110 or 68115, based on the service and lesion size.

How does 65900 differ from 65920 and 65930?

65900 is for lesion removal. 65920 describes removal of an eye implant, while 65930 describes removal of a blood clot from the eye.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral 65900 reported?

Report bilateral performance with modifier 50; CMS pays the bilateral procedure at 150%.

What should the operative report support?

Document the lesion’s exact site, laterality, and the removal performed so the record supports choosing 65900 over a structure-specific code.

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 65900PPRRVU2026_Oct_nonQPP.csv, line 7,357 (RVU26D)

Open CMS sourceHow we calculate rates

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