65430 Corneal scraping Medicare reimbursement rates in New Jersey

An ophthalmologist uses a sterile instrument to collect superficial material from the corneal surface when an ulcer or infiltrate raises concern for infectious keratitis. The sample is placed on slides and/or submitted for culture, allowing microbiology testing to identify an organism and guide treatment. The service is typically performed in an eye clinic or hospital setting; it is diagnostic sampling, not removal of diseased tissue or therapeutic epithelial debridement.

Report 65430 for the corneal scraping itself when the record identifies the eye, the suspicious corneal finding, and specimen collection for smear, culture, or both. Laboratory microscopy and culture are distinct testing services and may be separately reported by the laboratory when performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% multiple-procedure reduction. For bilateral scraping, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.