Billing code 65930: Eye clot removalMedicare rate & RVUs in Ohio
Reports surgical removal of a blood clot from the eye’s anterior segment, such as an organized clot associated with hyphema.
CMS doesn’t publish an office rate for 65930 in Ohio.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 65930 covers
An ophthalmologist reports this service when surgically removing a blood clot from the anterior segment of the eye. A typical clinical context is a persistent or organized hyphema after trauma; the documented target is the clot in the front portion of the eye, not blood in the vitreous cavity. The procedure is generally performed in an operating room or other surgical setting when the clot requires operative removal rather than simple observation or a fluid tap.
Select this code based on the documented location and removal of the clot. The operative report should identify the anterior-segment clot and describe its removal and clinical rationale. The service has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 identifies bilateral performance and is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
65930 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $525.92 |
How the 65930 rate is calculated
Each of 65930’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 65930
RVUs × geographic indexes × conversion factor
Work8.18
8.18 RVUs× 1.000 GPCI
Practice expense7.58
7.58 RVUs× 1.000 GPCI
Malpractice0.64
0.64 RVUs× 1.000 GPCI
Adjusted RVUs
16.4000
Conversion factor
$33.4009
Medicare rate
$547.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 65930
65930 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65930
Eye clot removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 65930
Eye clot removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
65930 without 50 · national facility
$547.77
Eye clot removal
65930-50 · Bilateral: 150%
$821.66
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
65930 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 65800Eye paracentesis
- 65800 describes an anterior chamber paracentesis. Choose 65930 when the operative service removes a clot rather than performing a chamber tap.
- 65900Eye lesion removal
- 65900 concerns removal of an eye lesion; 65930 is selected for removal of a blood clot from the anterior segment.
- 65920Implant removal
- 65920 concerns removal of implanted material from the eye. It is not the clot-removal code.
- 67010Anterior vitrectomy
- 67010 addresses vitreous removal by an anterior approach. Use 65930 for a clot in the anterior segment, not blood or material in the vitreous cavity.
65930 billing questions
When should 65930 be selected instead of an anterior chamber paracentesis?
Use 65930 when the documented service is surgical removal of a blood clot from the anterior segment. A paracentesis describes an anterior chamber tap or fluid removal, not clot extraction.
Does this code describe removal of vitreous blood?
No. The target for 65930 is a clot in the anterior segment; blood in the vitreous cavity involves a different anatomical site and procedure.
What documentation supports reporting 65930?
Document the clot’s anterior-segment location, the operative removal performed, and the clinical reason for intervention, such as a persistent or organized hyphema.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are bilateral procedures and multiple procedures handled?
Modifier 50 identifies bilateral performance and is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only with supporting documentation; team surgery is 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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