$262.19
Choose 65273 when conjunctival advancement or resection is part of the repair. Code 65270 describes the related conjunctival repair without that distinction.
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CMS RVU26D · Effective 2026-10-01
65273 Eye wound repair Medicare reimbursement rates in Idaho
Repair of a conjunctival laceration with advancement or resection is reported when closure requires mobilizing or removing conjunctival tissue over a nonperforating scleral injury. Compare 65273 office and facility rates across CMS payment localities in Idaho.
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 65273 in Idaho?
Idaho 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
$302.77
1 of 1 localities have a supported rate.
Payment area: Idaho
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 65273: Conjunctival wound repair with advancement
Repair of a conjunctival laceration with advancement or resection is reported when closure requires mobilizing or removing conjunctival tissue over a nonperforating scleral injury.
This code describes surgical repair of a conjunctival laceration when the surgeon advances or removes conjunctival tissue to close the wound. It may be used for a conjunctival injury accompanied by a nonperforating scleral laceration. An ophthalmologist typically performs the repair in an operating room or other surgical setting, often after eye trauma. The operative report should identify the injured tissue and explain the advancement or resection performed.
Select this code based on the repair method and the structures involved, rather than wound size alone. Document whether the sclera is lacerated and whether the injury is nonperforating; a penetrating corneal or scleral wound belongs to a different repair category. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 identifies bilateral services, 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 65273
- 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 RVU5.03 · 52%
- Practice expense (office) RVU4.18 · 43%
- Malpractice RVU0.40 · 4%
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.
65273 compared with similar codes
Office rates for Idaho, from the same CMS release.
$490.94
Code 65272 is distinguished by repositioning or resection of uveal tissue; 65273 is identified by conjunctival advancement or resection.
$552.81
Code 65275 is for a nonperforating corneal laceration. Use 65273 for the conjunctival repair involving advancement or resection.
No office rate
Code 65280 addresses a perforating corneal or scleral wound. The 65273 repair is associated with conjunctival tissue and a nonperforating scleral injury.
Compare 65273 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
Idaho →
Office / nonfacility
Unavailable
Facility
$302.77
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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 65273 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
7,312
- Code
- 65273
- Physician work
- 5.03
- Practice expense
- 4.18
- Malpractice
- 0.40
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.03 | × 1.000 | 5.0300 |
| Practice expense | 4.18 | × 0.920 | 3.8456 |
| Malpractice | 0.40 | × 0.473 | 0.1892 |
| Total RVUs | 9.0648 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$302.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.03 | 1 |
| Practice expense | 4.18 | 0.92 |
| Malpractice | 0.4 | 0.473 |
(5.03 × 1 + 4.18 × 0.92 + 0.4 × 0.473) × $33.4009 = $302.77
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.
65273 billing questions
When is 65273 a better fit than 65270?
Use 65273 when the repair includes conjunctival advancement or resection. Code 65270 is the related repair without that tissue advancement or resection.
How does 65273 differ from 65272?
The distinction is the repair performed: 65273 involves conjunctival advancement or resection, while 65272 addresses repositioning or resection of uveal tissue.
What documentation supports 65273?
The operative report should describe the conjunctival wound, any associated scleral injury and whether it is nonperforating, and the advancement or resection used to complete the repair.
How is modifier 50 handled for bilateral repairs?
When the service is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.
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.
7,30965265,,Remove foreign body from eye,A,,13.98,13.10,NA,13.10,,1.12,28.20,28.20,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31065270,,Repair of eye wound,A,,1.90,6.39,,1.50,,0.15,8.44,3.55,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31165272,,Repair of eye wound,A,,4.50,10.90,,4.11,,0.36,15.76,8.97,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31265273,,Repair of eye wound,A,,5.03,4.18,NA,4.18,,0.40,9.61,9.61,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31365275,,Repair of eye wound,A,,6.13,11.08,,5.03,,0.48,17.69,11.64,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31465280,,Repair of eye wound,A,,8.87,7.37,NA,7.37,,0.70,16.94,16.94,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31565285,,Repair of eye wound,A,,14.98,11.63,NA,11.63,,1.21,27.82,27.82,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772