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CMS RVU26D · Effective 2026-10-01

65286 Bleb repair Medicare reimbursement rates in Florida

Reports transconjunctival repair of a leaking glaucoma filtering bleb, often after trabeculectomy, rather than repair of a traumatic eye laceration. Compare 65286 office and facility rates across CMS payment localities in Florida.

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 65286 in Florida?

Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.

Office / nonfacility

$686.63–$743.40

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $56.77 per service.

Facility setting

$420.00–$453.07

3 of 3 localities have a supported rate.

Lowest: Rest Of Florida

Highest: Miami

A spread of $33.07 per service.

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.

Find 65286 in your payment locality →

Where 65286 pays more and less in Florida

3 payment localities

$686.63 to $743.40

$686.63$715.01$743.40
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

Ophthalmology surgery

About 65286: Transconjunctival leaking bleb repair

Reports transconjunctival repair of a leaking glaucoma filtering bleb, often after trabeculectomy, rather than repair of a traumatic eye laceration.

An ophthalmologist uses a transconjunctival approach to close a leaking glaucoma filtering bleb, commonly after trabeculectomy. The service treats leakage from the bleb, not a traumatic corneal or scleral laceration. It may be performed in an office procedure area or operating room, depending on the clinical circumstances. Documentation should identify the leaking bleb and the transconjunctival repair performed.

Report this code for repair of a leaking bleb by this approach, rather than for general revision of an anterior-segment operative wound. Medicare assigns 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 treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

CMS billing rules for 65286

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 not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU6.46 · 31%
  • Practice expense (office) RVU13.96 · 67%
  • Malpractice RVU0.50 · 2%

579

Medicare services in 2024 · #3430 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.

65286 compared with similar codes

Office rates for Florida, from the same CMS release.

65270

Eye wound repair

Perforating cornea or sclera

$275.03–$298.31

This code addresses a leaking glaucoma filtering bleb. Code 65270 is for repair of a superficial conjunctival wound.

65285

Eye wound repair

Perforating, with uveal tissue

No office rate

Use this code for transconjunctival leaking bleb repair; 65285 describes repair of a perforating corneal or scleral laceration with multiple sutures.

66250

Eye wound repair

Anterior segment revision

$738.67–$800.19

This code is specific to transconjunctival repair of a leaking bleb. Code 66250 describes revision or repair of an anterior-segment operative wound more generally.

Compare 65286 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.

3 of 3 payment localities

Office and facility base rates · shared scale starting at $0

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65286 billing questions

When is this code appropriate instead of a traumatic eye-wound repair code?

Use it for transconjunctival repair of a leaking glaucoma filtering bleb. Codes for traumatic wounds describe repair of injuries such as conjunctival, corneal, or scleral lacerations.

What should the operative note document?

Document the leaking filtering bleb, the repair performed, and that the approach was transconjunctival. Include the treated eye and the clinical findings supporting repair.

Does the code include postoperative visits?

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

How is bilateral repair reported?

For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.

How does Medicare handle another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service. 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 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.

RVUs for 65286PPRRVU2026_Oct_nonQPP.csv, line 7,316 (RVU26D)