65865 Eye adhesion lysis Medicare reimbursement rates in Washington

An ophthalmologist uses an incision and surgical instruments to divide adhesions in the anterior segment of the eye. These adhesions, or synechiae, may involve the iris and restrict normal separation or movement of anterior-segment structures. The service is typically performed in an operating room or other surgical setting when the surgeon documents that incisional lysis is needed; it is distinct from laser treatment of adhesions.

Choose this code based on the incisional technique and the documented operative work, rather than diagnosis alone. The operative note should identify the treated eye, the adhesions addressed, and the technique used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.