No office rate
Use 65865 for simple incisional synechiolysis. Use 65870 when the adhesions and release work are extensive.
On this page
CMS RVU26D · Effective 2026-10-01
65870 Synechiolysis Medicare reimbursement rates in Vermont
Report 65870 when an ophthalmologist uses an incisional approach to release extensive adhesions in the eye’s anterior segment, such as iris synechiae. Compare 65870 office and facility rates across CMS payment localities in Vermont.
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 65870 in Vermont?
Vermont 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
No supported rate
Facility setting
$501.10
1 of 1 localities have a supported rate.
Payment area: Vermont
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 65870: Extensive incisional anterior synechiolysis
Report 65870 when an ophthalmologist uses an incisional approach to release extensive adhesions in the eye’s anterior segment, such as iris synechiae.
An ophthalmologist performs this procedure to cut and release extensive adhesions within the anterior segment, commonly involving the iris and adjacent structures. Synechiae may follow inflammation, trauma, or prior eye surgery and can interfere with the pupil, aqueous flow, or other anterior-segment function. The surgeon works inside the eye with an incisional technique, typically in an operating-room setting.
Choose this code when the adhesions and work are extensive, rather than the simple incisional service represented by 65865. Document the affected eye, the location and extent of adhesions, and the incisional work used to release them. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. With modifier 50, bilateral payment is 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 65870
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.21 · 47%
- Practice expense (office) RVU7.58 · 49%
- Malpractice RVU0.57 · 4%
615
Medicare services in 2024 · #3372 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.
65870 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Use 65875 when incisional synechiolysis is performed with concomitant intraocular surgery; 65870 identifies extensive incisional adhesiolysis.
$303.66
65860 represents laser severing of anterior-segment adhesions. 65870 represents extensive release using an incisional approach.
Compare 65870 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
Vermont →
Office / nonfacility
Unavailable
Facility
$501.10
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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 65870 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
7,354
- Code
- 65870
- Physician work
- 7.21
- Practice expense
- 7.58
- Malpractice
- 0.57
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.21 | × 1.000 | 7.2100 |
| Practice expense | 7.58 | × 0.990 | 7.5042 |
| Malpractice | 0.57 | × 0.506 | 0.2884 |
| Total RVUs | 15.0026 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$501.10
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.21 | 1 |
| Practice expense | 7.58 | 0.99 |
| Malpractice | 0.57 | 0.506 |
(7.21 × 1 + 7.58 × 0.99 + 0.57 × 0.506) × $33.4009 = $501.10
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.
65870 billing questions
How does 65870 differ from 65865?
Both describe incisional release of anterior-segment adhesions. Use 65870 for extensive adhesions and 65865 for simple adhesions; document the extent and work supporting the level selected.
When would 65875 be considered instead?
65875 is the related incisional service when synechiolysis is performed with concomitant intraocular surgery. Use 65870 for extensive incisional synechiolysis without that distinguishing circumstance.
Can laser treatment be reported with 65870?
65870 describes an incisional approach. Code 65860 is the laser alternative for severing anterior-segment adhesions, so select the code that matches the technique performed.
What documentation supports 65870?
Record the eye treated, where the adhesions are located, their extent, and the incisional steps used to release them. The record should support why the work was extensive rather than simple.
How is bilateral 65870 paid?
CMS pays a bilateral procedure reported with modifier 50 at 150%. The code also follows the stated multiple-procedure reduction when other procedures are performed in the same session.
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.
7,35165855,,Trabeculoplasty laser surg,A,,2.93,4.20,,1.98,,0.22,7.35,5.13,0,010,0.10,0.80,0.10,2,1,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35265860,,Severing ads ant sgm laser,A,,3.50,5.51,,2.49,,0.27,9.28,6.26,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35365865,,Incise inner eye adhesions,A,,5.63,6.32,NA,6.32,,0.44,12.39,12.39,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35465870,,Incise inner eye adhesions,A,,7.21,7.58,NA,7.58,,0.57,15.36,15.36,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35565875,,Incise inner eye adhesions,A,,7.61,8.20,NA,8.20,,0.60,16.41,16.41,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35665880,,Incise inner eye adhesions,A,,8.15,8.38,NA,8.38,,0.64,17.17,17.17,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35765900,,Remove eye lesion,A,,12.20,12.25,NA,12.25,,0.99,25.44,25.44,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817