Billing code 65273: Eye wound repairMedicare rate & RVUs in Washington
Repair of a conjunctival laceration with advancement or resection is reported when closure requires mobilizing or removing conjunctival tissue over a nonperforating scleral injury.
CMS doesn’t publish an office rate for 65273 in Washington.
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 65273 covers
This code describes surgical repair of a conjunctival laceration when the surgeon advances or removes conjunctival tissue to close the wound. It may be used for a conjunctival injury accompanied by a nonperforating scleral laceration. An ophthalmologist typically performs the repair in an operating room or other surgical setting, often after eye trauma. The operative report should identify the injured tissue and explain the advancement or resection performed.
Select this code based on the repair method and the structures involved, rather than wound size alone. Document whether the sclera is lacerated and whether the injury is nonperforating; a penetrating corneal or scleral wound belongs to a different repair category. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 identifies bilateral services, 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.
Where 65273 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $327.37 |
| Seattle (King Cnty) | Unavailable | $358.63 |
How the 65273 rate is calculated
Each of 65273’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 · 65273
RVUs × geographic indexes × conversion factor
Work5.03
5.03 RVUs× 1.000 GPCI
Practice expense4.18
4.18 RVUs× 1.000 GPCI
Malpractice0.40
0.40 RVUs× 1.000 GPCI
Adjusted RVUs
9.6100
Conversion factor
$33.4009
Medicare rate
$320.98
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 65273
65273 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65273
Eye wound repair
| 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 · 65273
Eye wound repair
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
65273 without 50 · national facility
$320.98
Eye wound repair
65273-50 · Bilateral: 150%
$481.47
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).
65273 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 65270Eye wound repair
- Choose 65273 when conjunctival advancement or resection is part of the repair. Code 65270 describes the related conjunctival repair without that distinction.
- 65272Corneal wound repair
- Code 65272 is distinguished by repositioning or resection of uveal tissue; 65273 is identified by conjunctival advancement or resection.
- 65275Corneal wound repair
- Code 65275 is for a nonperforating corneal laceration. Use 65273 for the conjunctival repair involving advancement or resection.
- 65280Eye wound repair
- Code 65280 addresses a perforating corneal or scleral wound. The 65273 repair is associated with conjunctival tissue and a nonperforating scleral injury.
65273 billing questions
When is 65273 a better fit than 65270?
Use 65273 when the repair includes conjunctival advancement or resection. Code 65270 is the related repair without that tissue advancement or resection.
How does 65273 differ from 65272?
The distinction is the repair performed: 65273 involves conjunctival advancement or resection, while 65272 addresses repositioning or resection of uveal tissue.
What documentation supports 65273?
The operative report should describe the conjunctival wound, any associated scleral injury and whether it is nonperforating, and the advancement or resection used to complete the repair.
How is modifier 50 handled for bilateral repairs?
When the service is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.
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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