Billing code 65285: Eye wound repairMedicare rate & RVUs in Guam
Repair a full-thickness corneal or scleral wound when uveal tissue must be repositioned or resected, typically after a penetrating eye injury.
CMS doesn’t publish an office rate for 65285 in Guam.
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 65285 covers
An ophthalmologist uses this code to repair a perforating wound through the cornea, sclera, or both when uveal tissue, such as iris or ciliary tissue, has prolapsed into the wound and must be repositioned or removed. This is typically urgent surgery for an open-globe injury, performed in an operating room. The operative report should identify the wound site and full-thickness nature, describe the uveal tissue involvement, and document whether tissue was repositioned or resected.
Choose this level based on the perforating wound and the operative management of uveal tissue, rather than wound size alone. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral procedures reported with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery for this service; 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.
65285 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $965.42 |
How the 65285 rate is calculated
Each of 65285’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 · 65285
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.98Practice expense 11.63Malpractice 1.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 65285
65285 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65285
Eye wound repair
| 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 65285
Eye wound repair
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
65285 without 50 · national facility
$929.21
Eye wound repair
65285-50 · Bilateral: 150%
$1,393.82
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).
65285 compared with similar codes
Compare codes
65285 vs 65280 vs 65275 vs 65273: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65280Eye wound repair
- Both address perforating corneal or scleral wounds. Report 65285 when uveal tissue is repositioned or resected; 65280 describes a wound without uveal tissue involvement.
- 65275Corneal wound repair
- 65275 is for a perforating corneal laceration that does not involve the iris or lens. Use 65285 when uveal tissue involvement requires repositioning or resection.
- 65273Eye wound repair
- 65273 addresses a nonperforating corneal laceration. A full-thickness corneal or scleral wound with uveal tissue management supports 65285.
65285 billing questions
How does this differ from 65280?
Use 65285 when the perforating corneal or scleral wound involves uveal tissue that is repositioned or resected. Code 65280 is for a perforating wound without uveal tissue involvement.
Can a nonperforating corneal wound be reported with 65285?
No. This code describes repair of a perforating wound with uveal tissue management; a nonperforating corneal laceration belongs to a different repair level.
What documentation supports the code?
Document the corneal or scleral wound as perforating, describe the uveal tissue involvement, and state whether that tissue was repositioned or resected.
Is related postoperative care separately reported?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
How is bilateral repair handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS 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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