Billing code 65436: Corneal treatmentMedicare rate & RVUs in Texas
An ophthalmologist removes corneal surface epithelium and applies a chemical agent to treat recurrent corneal erosion.
Medicare pays $371.20–$403.90 for 65436 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
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 65436 covers
An ophthalmologist removes unstable corneal surface epithelium and applies a chemical agent, such as alcohol, to treat recurrent corneal erosion. The procedure is generally performed in an eye-care office or an outpatient surgical setting. It is intended for epithelial breakdown that repeatedly recurs, rather than for collecting tissue to establish a diagnosis or destroying a discrete corneal lesion by another method.
Select this code when the documented treatment includes chemical application for recurrent erosion; routine epithelial removal or curettage without that treatment points to 65435. Record the affected eye, recurrent-erosion indication, and the epithelial removal and chemical application performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care. For bilateral reporting with modifier 50, CMS pays 150%; when multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are 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.
Where 65436 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$371.20 to $403.90
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $403.90 | $325.45 |
| Beaumont | $371.20 | $303.73 |
| Brazoria | $388.59 | $315.11 |
| Dallas | $390.85 | $316.99 |
| Fort Worth | $388.79 | $315.68 |
| Galveston | $389.64 | $316.01 |
| Houston | $396.60 | $322.97 |
| Rest Of Texas | $379.55 | $309.18 |
How the 65436 rate is calculated
Each of 65436’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 · 65436
RVUs × geographic indexes × conversion factor
Work4.70
4.70 RVUs× 1.000 GPCI
Practice expense6.66
6.66 RVUs× 1.000 GPCI
Malpractice0.38
0.38 RVUs× 1.000 GPCI
Adjusted RVUs
11.7400
Conversion factor
$33.4009
Medicare rate
$392.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 65436
65436 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65436
Corneal treatment
| 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) | 0 | Not permitted. |
| 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 · 65436
Corneal treatment
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
65436 without 50 · national office
$392.13
Corneal treatment
65436-50 · Bilateral: 150%
$588.20
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).
65436 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 65435Corneal treatment
- 65436 includes chemical application for recurrent corneal erosion. 65435 describes epithelial removal or curettage without that treatment.
- 65450Corneal treatment
- 65450 destroys a corneal lesion; 65436 removes epithelium and applies a chemical agent for recurrent erosion.
- 65410Corneal biopsy
- 65410 is for corneal biopsy when tissue is sampled for diagnosis. 65436 is therapeutic treatment of recurrent epithelial breakdown.
65436 billing questions
How does this differ from 65435?
Use 65436 for recurrent corneal erosion treated with epithelial removal and chemical application. Use 65435 for epithelial removal or curettage without that chemical treatment.
What documentation supports the code?
Document recurrent corneal erosion, the eye treated, epithelial removal, and application of the chemical agent. The record should make clear that the chemical treatment was part of the procedure.
Can the procedure be reported for both eyes?
Yes. CMS identifies it as bilateral with modifier 50 paid at 150%; document treatment of each eye and follow applicable claim reporting instructions.
How does the 90-day global period affect follow-up?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be billed?
CMS restricts assistant-at-surgery payment for this procedure. 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 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
Fee sheets
Put 65436 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →