No office rate
Use 65781 for donor limbal stem cells; use 65782 when the graft is autologous.
On this page
CMS RVU26D · Effective 2026-10-01
65781 Ocular reconstruction Medicare reimbursement rates in Pennsylvania
Reports ocular surface reconstruction using donor limbal stem cells for limbal stem cell deficiency, such as after severe chemical injury. Compare 65781 office and facility rates across CMS payment localities in Pennsylvania.
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 65781 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1080.58–$1162.55
2 of 2 localities have a supported rate.
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.
Ophthalmic surgery
About 65781: Ocular surface limbal allograft reconstruction
Reports ocular surface reconstruction using donor limbal stem cells for limbal stem cell deficiency, such as after severe chemical injury.
An ophthalmic surgeon uses donor limbal tissue containing stem cells to rebuild the ocular surface when the patient’s limbal stem cell function is inadequate. The donor tissue may come from a cadaveric or living donor. This operation is used for significant limbal stem cell deficiency, including cases following severe chemical or thermal injury, and is generally performed in a surgical facility.
Report 65781 when the reconstruction uses an allogeneic limbal stem cell graft; document the donor tissue and the surgical work performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple procedure reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 65781
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.69 · 53%
- Practice expense (office) RVU14.52 · 43%
- Malpractice RVU1.41 · 4%
28
Medicare services in 2024 · #5716 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.
65781 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
65780 represents reconstruction with a multilayer amniotic membrane approach, rather than a limbal stem cell allograft.
$1,051.30–$1,186.11
65779 covers sutured amniotic membrane placement for ocular surface coverage. It does not describe transplantation of donor limbal stem cells.
Compare 65781 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1162.55
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1080.58
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65781 billing questions
How is 65781 different from 65782?
65781 is for limbal stem cells from a donor. 65782 is for an autologous graft using the patient’s own tissue.
When would 65780 be reported instead?
65780 describes ocular surface reconstruction using a multilayer amniotic membrane approach. Choose based on the graft and reconstruction performed, not just the diagnosis.
Does 65781 have a global period?
Yes. Its 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days.
How is bilateral 65781 paid?
CMS lists bilateral reporting with modifier 50 at 150%. The operative documentation should support surgery on both eyes.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
What documentation supports reporting 65781?
Document the limbal stem cell deficiency, the donor source of the graft, and the operative reconstruction performed.
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.
7,34065778,,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
7,34465782,,Ocular reconst transplant,A,,15.04,12.90,NA,12.90,,1.21,29.15,29.15,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,34565785,,Impltj ntrstrml crnl rng seg,A,,5.26,57.15,,5.88,,0.42,62.83,11.56,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,34665800,,Drainage of eye,A,,1.49,2.00,,0.52,,0.12,3.61,2.13,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00