Billing code 65875: Eye adhesiolysisMedicare rate & RVUs in Florida
An ophthalmic surgeon mechanically releases extensive adhesions within the eye’s anterior segment, excluding synechiae, when the operative work meets this service’s scope.
CMS doesn’t publish an office rate for 65875 in Florida.
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 65875 covers
This service involves surgically cutting extensive adhesions within the eye’s anterior segment, excluding synechiae. Adhesions may involve structures such as the iris, cornea, or lens. An ophthalmologist typically performs the procedure in an operating room when adhesions require mechanical release; the operative report should identify the affected structures and describe the extent and technique. This code distinguishes extensive mechanical treatment from less extensive work and laser treatment in the related anterior-segment adhesiolysis codes.
Report the code when the documented procedure supports extensive mechanical adhesiolysis, rather than a different method or extent. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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, payment is at 150%. Assistant-at-surgery payment is restricted; 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 65875 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.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $567.86 |
| Miami | Unavailable | $589.98 |
| Rest Of Florida | Unavailable | $546.14 |
How the 65875 rate is calculated
Each of 65875’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 · 65875
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.61Practice expense 8.20Malpractice 0.60
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 65875
65875 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65875
Eye adhesiolysis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 65875
Eye adhesiolysis
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
65875 without 50 · national facility
$548.11
Eye adhesiolysis
65875-50 · Bilateral: 150%
$822.17
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).
65875 compared with similar codes
Compare codes
65875 vs 65865 vs 65870 vs 65880: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65865Eye adhesion lysis
- Both involve mechanical adhesiolysis in the anterior segment. Use 65875 when the documented work is extensive; 65865 represents less extensive work.
- 65870Synechiolysis
- 65870 uses laser treatment for anterior-segment adhesions, whereas 65875 represents extensive mechanical release.
- 65880Adhesion lysis
- Both represent extensive anterior-segment adhesiolysis; 65880 is the laser approach, while 65875 is the mechanical approach.
65875 billing questions
How does this code differ from 65865?
Both describe mechanical release of anterior-segment adhesions, but 65875 is for extensive work. The operative report should support the greater extent of adhesiolysis.
When would 65870 or 65880 be considered instead?
Those related codes describe laser treatment rather than the mechanical release reported with 65875. The documented method and extent guide selection.
Can 65865 and 65875 both be reported for the same adhesiolysis?
Do not report both for the same work merely to represent its extent. Report the code that matches the documented procedure.
What documentation supports reporting 65875?
Document the adhesions’ location and extent, the structures involved, and the mechanical technique used. The record should support extensive treatment and distinguish the work from synechiae treatment.
What does the 90-day global period include?
It includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment handled?
When the procedure is performed bilaterally and reported with modifier 50, Medicare pays at 150%.
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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