$1,046.21
The key distinction is fixation: 65778 is for membrane placement without sutures, while 65779 is for placement with sutures.
On this page
CMS RVU26D · Effective 2026-10-01
65778 Amniotic membrane Medicare reimbursement rates in Ohio
Reports placement of an amniotic membrane on the ocular surface without sutures, often to support healing of a persistent epithelial defect or other surface injury. Compare 65778 office and facility rates across CMS payment localities in Ohio.
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 65778 in Ohio?
Ohio 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
$1165.89
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$35.14
1 of 1 localities have a supported rate.
Payment area: Ohio
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
About 65778: Ocular surface amniotic membrane placement without sutures
Reports placement of an amniotic membrane on the ocular surface without sutures, often to support healing of a persistent epithelial defect or other surface injury.
An ophthalmologist places an amniotic membrane over the ocular surface without suturing it in place. The service may be used for a persistent corneal epithelial defect, a nonhealing corneal ulcer, or ocular surface damage after injury. It is commonly performed in an office or ambulatory surgical setting when the clinician determines that membrane coverage is appropriate to support surface healing.
Report this code when the membrane is placed on the ocular surface without sutures; documentation should identify the clinical indication, treated eye, and placement method. The service has a 0-day global period, so same-day preoperative and postoperative care is included. If 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% multiple-procedure reduction. For bilateral reporting with modifier 50, CMS payment is 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 65778
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU0.82 · 2%
- Practice expense (office) RVU37.29 · 98%
- Malpractice RVU0.04 · 0%
71.8K
Medicare services in 2024 · #662 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.
65778 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
65780 describes ocular surface reconstruction involving amniotic membrane transplantation; 65778 is the more specific service of placing a membrane without sutures.
No office rate
65710 is a corneal transplant procedure. It is not the code for placing an amniotic membrane on the ocular surface without sutures.
Compare 65778 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
Ohio →
Office / nonfacility
$1165.89
Facility
$35.14
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 65778 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
7,340
- Code
- 65778
- Physician work
- 0.82
- Practice expense
- 37.29
- Malpractice
- 0.04
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.82 | × 1.000 | 0.8200 |
| Practice expense | 37.29 | × 0.913 | 34.0458 |
| Malpractice | 0.04 | × 1.008 | 0.0403 |
| Total RVUs | 34.9061 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$1165.89
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.82 | 1 |
| Practice expense | 37.29 | 0.913 |
| Malpractice | 0.04 | 1.008 |
(0.82 × 1 + 37.29 × 0.913 + 0.04 × 1.008) × $33.4009 = $1165.89
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.82 | 1 |
| Practice expense | 0.21 | 0.913 |
| Malpractice | 0.04 | 1.008 |
(0.82 × 1 + 0.21 × 0.913 + 0.04 × 1.008) × $33.4009 = $35.14
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.
65778 billing questions
How does this differ from 65779?
Both codes report amniotic membrane placement on the ocular surface. Use 65778 when the membrane is placed without sutures and 65779 when it is sutured.
What documentation supports 65778?
Document the ocular surface condition being treated, the eye involved, and that the amniotic membrane was placed without sutures.
Is same-day postoperative care separately included?
No. The 0-day global period includes same-day preoperative and postoperative care.
How is bilateral placement reported?
CMS lists this as a bilateral procedure; reporting modifier 50 results in payment at 150%.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the other procedure is paid at 50%.
Can an assistant surgeon be paid for this service?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
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.
7,33765771,,Radial keratotomy,N,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
7,33865772,,Correction of astigmatism,A,,4.96,8.42,,5.15,,0.40,13.78,10.51,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,33965775,,Correction of astigmatism,A,,6.74,7.67,NA,7.67,,0.53,14.94,14.94,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,34065778,,Cover eye w/membrane,A,,0.82,37.29,,0.21,,0.04,38.15,1.07,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,34165779,,Cover eye w/membrane suture,A,,1.71,32.28,,0.69,,0.14,34.13,2.54,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,34265780,,Ocular reconst transplant,A,,6.85,8.06,NA,8.06,,0.54,15.45,15.45,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,34365781,,Ocular reconst transplant,A,,17.69,14.52,NA,14.52,,1.41,33.62,33.62,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703