$260.16
This code addresses a leaking glaucoma filtering bleb. Code 65270 is for repair of a superficial conjunctival wound.
On this page
CMS RVU26D · Effective 2026-10-01
65286 Bleb repair Medicare reimbursement rates in Tennessee
Reports transconjunctival repair of a leaking glaucoma filtering bleb, often after trabeculectomy, rather than repair of a traumatic eye laceration. Compare 65286 office and facility rates across CMS payment localities in Tennessee.
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 65286 in Tennessee?
Tennessee 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
$648.58
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
Facility setting
$395.07
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 surgery
About 65286: Transconjunctival leaking bleb repair
Reports transconjunctival repair of a leaking glaucoma filtering bleb, often after trabeculectomy, rather than repair of a traumatic eye laceration.
An ophthalmologist uses a transconjunctival approach to close a leaking glaucoma filtering bleb, commonly after trabeculectomy. The service treats leakage from the bleb, not a traumatic corneal or scleral laceration. It may be performed in an office procedure area or operating room, depending on the clinical circumstances. Documentation should identify the leaking bleb and the transconjunctival repair performed.
Report this code for repair of a leaking bleb by this approach, rather than for general revision of an anterior-segment operative wound. Medicare assigns 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 treatment, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 65286
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.46 · 31%
- Practice expense (office) RVU13.96 · 67%
- Malpractice RVU0.50 · 2%
579
Medicare services in 2024 · #3430 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.
65286 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
Use this code for transconjunctival leaking bleb repair; 65285 describes repair of a perforating corneal or scleral laceration with multiple sutures.
$697.33
This code is specific to transconjunctival repair of a leaking bleb. Code 66250 describes revision or repair of an anterior-segment operative wound more generally.
Compare 65286 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
Tennessee →
Office / nonfacility
$648.58
Facility
$395.07
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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 65286 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
7,316
- Code
- 65286
- Physician work
- 6.46
- Practice expense
- 13.96
- Malpractice
- 0.50
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.46 | × 1.000 | 6.4600 |
| Practice expense | 13.96 | × 0.909 | 12.6896 |
| Malpractice | 0.50 | × 0.537 | 0.2685 |
| Total RVUs | 19.4181 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Tennessee$648.58
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.46 | 1 |
| Practice expense | 13.96 | 0.909 |
| Malpractice | 0.5 | 0.537 |
(6.46 × 1 + 13.96 × 0.909 + 0.5 × 0.537) × $33.4009 = $648.58
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.46 | 1 |
| Practice expense | 5.61 | 0.909 |
| Malpractice | 0.5 | 0.537 |
(6.46 × 1 + 5.61 × 0.909 + 0.5 × 0.537) × $33.4009 = $395.07
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.
65286 billing questions
When is this code appropriate instead of a traumatic eye-wound repair code?
Use it for transconjunctival repair of a leaking glaucoma filtering bleb. Codes for traumatic wounds describe repair of injuries such as conjunctival, corneal, or scleral lacerations.
What should the operative note document?
Document the leaking filtering bleb, the repair performed, and that the approach was transconjunctival. Include the treated eye and the clinical findings supporting repair.
Does the code include postoperative visits?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How is bilateral repair reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service. 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.
7,31365275,,Repair of eye wound,A,,6.13,11.08,,5.03,,0.48,17.69,11.64,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31465280,,Repair of eye wound,A,,8.87,7.37,NA,7.37,,0.70,16.94,16.94,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31565285,,Repair of eye wound,A,,14.98,11.63,NA,11.63,,1.21,27.82,27.82,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31665286,,Repair of eye wound,A,,6.46,13.96,,5.61,,0.50,20.92,12.57,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31765290,,Repair of eye socket wound,A,,6.37,5.57,NA,5.57,,0.49,12.43,12.43,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31865400,,Removal of eye lesion,A,,7.31,13.00,,7.76,,0.60,20.91,15.67,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,31965410,,Biopsy of cornea,A,,1.43,2.77,,1.05,,0.11,4.31,2.59,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780