$484.96
This code is for a penetrating corneal or scleral wound. Code 65272 concerns a conjunctival wound, with or without nonperforating scleral involvement.
On this page
CMS RVU26D · Effective 2026-10-01
65270 Eye wound repair Medicare reimbursement rates in Kentucky
Reports surgical closure of a penetrating corneal or scleral wound, including open-globe injuries with or without protruding uveal tissue. Compare 65270 office and facility rates across CMS payment localities in Kentucky.
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 65270 in Kentucky?
Kentucky 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
$257.79
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$112.59
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Ophthalmology surgery
About 65270: Perforating corneal or scleral wound repair
Reports surgical closure of a penetrating corneal or scleral wound, including open-globe injuries with or without protruding uveal tissue.
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.
CMS billing rules for 65270
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.90 · 23%
- Practice expense (office) RVU6.39 · 76%
- Malpractice RVU0.15 · 2%
88
Medicare services in 2024 · #4976 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.
65270 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$548.42
Choose 65275 for a nonperforating corneal laceration. Choose 65270 when the wound penetrates the cornea or sclera.
No office rate
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.
Compare 65270 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
Kentucky →
Office / nonfacility
$257.79
Facility
$112.59
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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 65270 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,310
- Code
- 65270
- Physician work
- 1.90
- Practice expense
- 6.39
- Malpractice
- 0.15
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.90 | × 1.000 | 1.9000 |
| Practice expense | 6.39 | × 0.889 | 5.6807 |
| Malpractice | 0.15 | × 0.915 | 0.1373 |
| Total RVUs | 7.7180 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$257.79
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.9 | 1 |
| Practice expense | 6.39 | 0.889 |
| Malpractice | 0.15 | 0.915 |
(1.9 × 1 + 6.39 × 0.889 + 0.15 × 0.915) × $33.4009 = $257.79
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.9 | 1 |
| Practice expense | 1.5 | 0.889 |
| Malpractice | 0.15 | 0.915 |
(1.9 × 1 + 1.5 × 0.889 + 0.15 × 0.915) × $33.4009 = $112.59
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.
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 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.
7,30765235,,Remove foreign body from eye,A,,8.78,9.54,NA,9.54,,0.71,19.03,19.03,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30865260,,Remove foreign body from eye,A,,12.23,11.93,NA,11.93,,0.99,25.15,25.15,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631