Billing code 65270: Eye wound repairMedicare rate & RVUs in Florida
Reports surgical closure of a penetrating corneal or scleral wound, including open-globe injuries with or without protruding uveal tissue.
Medicare pays $275.03–$298.31 for 65270 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 65270 covers
An ophthalmologist uses this service to close a full-thickness wound through the cornea, sclera, or both, such as a penetrating injury that opens the globe. The repair may include managing uveal tissue that has prolapsed through the wound. These urgent procedures commonly occur in an operating room after evaluation in an emergency department; the operative record should identify the injured tissue and establish that the wound penetrates the eye wall.
Report the code for the perforating wound repair, not for a superficial or nonperforating corneal injury. Document wound location and depth, the structures involved, the closure performed, and any repositioning or removal of prolapsed tissue. CMS assigns a 10-day global period, so related postoperative visits during that period are included. 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 50% reduction. For bilateral reporting with modifier 50, CMS pays 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 65270 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$275.03 to $298.31
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $288.73 | $123.27 |
| Miami | $298.31 | $128.29 |
| Rest Of Florida | $275.03 | $118.89 |
How the 65270 rate is calculated
Each of 65270’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 · 65270
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.90Practice expense 6.39Malpractice 0.15
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 65270
65270 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65270
Eye wound repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 65270
Eye wound repair
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
65270 without 50 · national office
$281.90
Eye wound repair
65270-50 · Bilateral: 150%
$422.85
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).
65270 compared with similar codes
Compare codes
65270 vs 65272 vs 65275 vs 65273: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65272Corneal wound repair
- This code is for a penetrating corneal or scleral wound. Code 65272 concerns a conjunctival wound, with or without nonperforating scleral involvement.
- 65275Corneal wound repair
- Choose 65275 for a nonperforating corneal laceration. Choose 65270 when the wound penetrates the cornea or sclera.
- 65273Eye wound repair
- Both are related corneal wound repair codes, but selection depends on the exact wound and operative service. The record should support the specific repair reported.
65270 billing questions
How does this differ from a repair of a nonperforating corneal wound?
Use this code when the corneal or scleral wound is full thickness and penetrates the eye wall. A nonperforating corneal injury is represented by a different repair code.
What documentation supports reporting this repair?
The operative note should establish penetration through the cornea or sclera and describe the wound location, structures involved, and closure. Document any management of prolapsed uveal tissue.
Are postoperative visits separately reported during the global period?
Related postoperative visits for 10 days are included in the global period.
How does CMS handle bilateral repairs and other procedures in the same session?
For bilateral reporting with modifier 50, CMS pays 150%. Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this 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
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