65860 Severing ads ant sgm laser
What 65860 is
CMS fee schedule short descriptor: Severing ads ant sgm laser.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 65860 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 3.50 | 5.51 | 0.27 | 9.28 | $309.96 |
| Facility (hospital, ASC) | 3.50 | 2.49 | 0.27 | 6.26 | $209.09 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.
Medically Unlikely Edit (MUE)
Medicare caps 65860 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 65860? These codes are bundled into it
65860 is a Column 1 code in 227 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0621T | Trabeculostomy interno laser | 1 - modifier may bypass | Check pair |
0622T | Trabeculostomy int lsr w/scp | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0730T | Trabeculotomy lsr w/oct gdn | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
12014 | Rpr f/e/e/n/l/m 5.1-7.5 cm | 1 - modifier may bypass | Check pair |
12015 | Rpr f/e/e/n/l/m 7.6-12.5 cm | 1 - modifier may bypass | Check pair |
12016 | Rpr fe/e/en/l/m 12.6-20.0 cm | 1 - modifier may bypass | Check pair |
12017 | Rpr fe/e/en/l/m 20.1-30.0 cm | 1 - modifier may bypass | Check pair |
12018 | Rpr f/e/e/n/l/m >30.0 cm | 1 - modifier may bypass | Check pair |
12020 | Tx supfc wnd dehsn smpl clsr | 1 - modifier may bypass | Check pair |
12021 | Tx supfc wnd dehsn w/packing | 1 - modifier may bypass | Check pair |
12031 | Intmd rpr s/a/t/ext 2.5 cm/< | 1 - modifier may bypass | Check pair |
12032 | Intmd rpr s/a/t/ext 2.6-7.5 | 1 - modifier may bypass | Check pair |
12034 | Intmd rpr s/tr/ext 7.6-12.5 | 1 - modifier may bypass | Check pair |
Showing 30 of 227 column 2 codes. Use the pair checker for any specific combination.
65860 is bundled into these codes
65860 appears as a Column 2 code in 14 active edits. Reported with one of these Column 1 codes on the same date of service, 65860 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0308T | Insj ocular telescope prosth | 1 | Check pair |
65865 | Incise inner eye adhesions | 1 | Check pair |
65870 | Incise inner eye adhesions | 1 | Check pair |
65875 | Incise inner eye adhesions | 1 | Check pair |
65880 | Incise inner eye adhesions | 1 | Check pair |
66174 | Trluml dil aq o/f can w/o st | 1 | Check pair |
66175 | Trluml dil aq o/f can w/st | 1 | Check pair |
66711 | Ecp ciliary body destruction | 1 | Check pair |
66982 | Xcapsl ctrc rmvl cplx wo ecp | 1 | Check pair |
66984 | Xcapsl ctrc rmvl w/o ecp | 1 | Check pair |
66987 | Xcapsl ctrc rmvl cplx w/ecp | 1 | Check pair |
66988 | Xcapsl ctrc rmvl w/ecp | 1 | Check pair |
66989 | Xcpsl ctrc rmvl cplx insj 1+ | 1 | Check pair |
66991 | Xcapsl ctrc rmvl insj 1+ | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.