65755 Corneal transplant Medicare reimbursement rates in Michigan

An ophthalmic surgeon performs penetrating keratoplasty to replace diseased or damaged full-thickness corneal tissue with donor cornea. The procedure may be used for problems such as corneal scarring, opacity, dystrophy, or a failed prior graft. Code 65755 identifies the penetrating transplant in a pseudophakic eye, where an intraocular lens is already present. These operations are generally performed in a surgical facility, though CMS records services in both office and facility settings.

Select the code from the operative report’s description of the transplant and the eye’s lens status; documentation should establish the full-thickness transplant and pseudophakia. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 identifies bilateral surgery, paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.