Use 65778 for single-layer amniotic membrane treatment with a self-retaining technique; use 65780 when multiple layers are placed.
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CMS RVU26D · Effective 2026-10-01
65780 Amniotic membrane graft Medicare reimbursement rates in Wisconsin
Ophthalmologists use this surgery to rebuild a damaged ocular surface with multiple layers of amniotic membrane, such as for a persistent epithelial defect. Compare 65780 office and facility rates across CMS payment localities in Wisconsin.
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 65780 in Wisconsin?
Wisconsin 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
$492.26
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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.
Ophthalmic surgery
About 65780: Multilayer amniotic membrane reconstruction
Ophthalmologists use this surgery to rebuild a damaged ocular surface with multiple layers of amniotic membrane, such as for a persistent epithelial defect.
An ophthalmologist, often a cornea specialist, places multiple layers of amniotic membrane on the ocular surface to support reconstruction and healing. This approach may be used for severe surface damage, including a persistent epithelial defect or injury from a chemical or thermal burn. The service is typically performed in an operating room or other surgical setting when the extent of the ocular surface problem calls for multilayer reconstruction.
Report this code when the operative record supports amniotic membrane reconstruction using multiple layers. The documentation should identify the treated eye, the ocular surface condition, and the multilayer technique; do not report separate units for each layer. Medicare assigns a 90-day global period, which includes 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 50% reduction. Modifier 50 applies to bilateral procedures, paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 65780
- 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 RVU6.85 · 44%
- Practice expense (office) RVU8.06 · 52%
- Malpractice RVU0.54 · 3%
1.8K
Medicare services in 2024 · #2530 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.
65780 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
Use 65779 for a single sutured layer. The multilayer reconstruction described by 65780 is a different service.
65781 involves limbal stem cell allograft reconstruction, rather than multilayer amniotic membrane placement.
65782 uses the patient's own limbal stem cells for reconstruction; 65780 represents multilayer amniotic membrane reconstruction.
Compare 65780 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$492.26
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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 65780 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
7,342
- Code
- 65780
- Physician work
- 6.85
- Practice expense
- 8.06
- Malpractice
- 0.54
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.85 | × 1.000 | 6.8500 |
| Practice expense | 8.06 | × 0.958 | 7.7215 |
| Malpractice | 0.54 | × 0.308 | 0.1663 |
| Total RVUs | 14.7378 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$492.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.85 | 1 |
| Practice expense | 8.06 | 0.958 |
| Malpractice | 0.54 | 0.308 |
(6.85 × 1 + 8.06 × 0.958 + 0.54 × 0.308) × $33.4009 = $492.26
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.
65780 billing questions
How do I distinguish this from 65778 or 65779?
This code is for multilayer amniotic membrane reconstruction. Codes 65778 and 65779 describe single-layer techniques, distinguished by whether the membrane is self-retaining or sutured.
Can I report multiple units for multiple membrane layers?
No. The multiple-layer technique is represented by this code; do not count each layer as a separate unit.
What documentation supports the code?
Document the ocular surface condition, the treated eye, and that the reconstruction used multiple layers of amniotic membrane.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care for 90 days are included in the global period.
Can this be billed bilaterally?
For bilateral performance, CMS pays the procedure with modifier 50 at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons are paid only with supporting documentation; team surgery is 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.
