$124.57
65800 describes an anterior chamber paracentesis. Choose 65930 when the operative service removes a clot rather than performing a chamber tap.
On this page
CMS RVU26D · Effective 2026-10-01
65930 Eye clot removal Medicare reimbursement rates in Colorado
Reports surgical removal of a blood clot from the eye’s anterior segment, such as an organized clot associated with hyphema. Compare 65930 office and facility rates across CMS payment localities in Colorado.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 65930 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$562.58
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Ophthalmic surgery
About 65930: Anterior segment blood clot removal
Reports surgical removal of a blood clot from the eye’s anterior segment, such as an organized clot associated with hyphema.
An ophthalmologist reports this service when surgically removing a blood clot from the anterior segment of the eye. A typical clinical context is a persistent or organized hyphema after trauma; the documented target is the clot in the front portion of the eye, not blood in the vitreous cavity. The procedure is generally performed in an operating room or other surgical setting when the clot requires operative removal rather than simple observation or a fluid tap.
Select this code based on the documented location and removal of the clot. The operative report should identify the anterior-segment clot and describe its removal and clinical rationale. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 identifies bilateral performance and is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 65930
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.18 · 50%
- Practice expense (office) RVU7.58 · 46%
- Malpractice RVU0.64 · 4%
461
Medicare services in 2024 · #3633 by national volume
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.
65930 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
65900 concerns removal of an eye lesion; 65930 is selected for removal of a blood clot from the anterior segment.
No office rate
65920 concerns removal of implanted material from the eye. It is not the clot-removal code.
No office rate
67010 addresses vitreous removal by an anterior approach. Use 65930 for a clot in the anterior segment, not blood or material in the vitreous cavity.
Compare 65930 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$562.58
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 65930 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
7,359
- Code
- 65930
- Physician work
- 8.18
- Practice expense
- 7.58
- Malpractice
- 0.64
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.18 | × 1.012 | 8.2782 |
| Practice expense | 7.58 | × 1.064 | 8.0651 |
| Malpractice | 0.64 | × 0.781 | 0.4998 |
| Total RVUs | 16.8431 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$562.58
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.18 | 1.012 |
| Practice expense | 7.58 | 1.064 |
| Malpractice | 0.64 | 0.781 |
(8.18 × 1.012 + 7.58 × 1.064 + 0.64 × 0.781) × $33.4009 = $562.58
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
65930 billing questions
When should 65930 be selected instead of an anterior chamber paracentesis?
Use 65930 when the documented service is surgical removal of a blood clot from the anterior segment. A paracentesis describes an anterior chamber tap or fluid removal, not clot extraction.
Does this code describe removal of vitreous blood?
No. The target for 65930 is a clot in the anterior segment; blood in the vitreous cavity involves a different anatomical site and procedure.
What documentation supports reporting 65930?
Document the clot’s anterior-segment location, the operative removal performed, and the clinical reason for intervention, such as a persistent or organized hyphema.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are bilateral procedures and multiple procedures handled?
Modifier 50 identifies bilateral performance and is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only with supporting documentation; team surgery is 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,35665880,,Incise inner eye adhesions,A,,8.15,8.38,NA,8.38,,0.64,17.17,17.17,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35765900,,Remove eye lesion,A,,12.20,12.25,NA,12.25,,0.99,25.44,25.44,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35865920,,Remove implant of eye,A,,9.74,9.86,NA,9.86,,0.79,20.39,20.39,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35965930,,Remove blood clot from eye,A,,8.18,7.58,NA,7.58,,0.64,16.40,16.40,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36066020,,Injection treatment of eye,A,,1.60,4.16,,1.68,,0.13,5.89,3.41,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36166030,,Injection treatment of eye,A,,1.27,3.93,,1.56,,0.09,5.29,2.92,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36266130,,Remove eye lesion,A,,7.63,12.90,,6.02,,0.62,21.15,14.27,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899