How much does Medicare pay for CPT 65778?

Medicare allowed an average of $1085.85 per service and paid $859.32 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2332.46, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 65778?

Placement of amniotic membrane on eye surface for wound healing. It was billed 49,493 times to 27,468 Medicare beneficiaries by 720 providers in 2024.

Does 65778 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1086.46 in an office setting and $45.03 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 65778 most?

Optometry, with 26,669 services from 361 clinicians. Next are Ophthalmology, General Surgery, Neurology.

CPT 65778

Placement of amniotic membrane on eye surface for wound healing

$1085.85Medicare-allowed amount per service, averaged across 49,493 services

Providers submitted

$2332.46

Asking price, not received

Medicare allowed

$1085.85

The fee schedule figure

Medicare paid

$859.32

Balance is patient coinsurance

Providers submitted an average of $2332.46 for this code and Medicare allowed $1085.85 — 2.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $859.32 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1086.46
Hospital / facility: $45.03

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 49,464 services were billed in an office setting and 29 in a facility.

Services: 49,493
Beneficiaries: 27,468
Providers billing it: 720
Total allowed: $53,741,974

What Medicare pays for CPT 65778

Across 49,493 services billed by 720 providers to 27,468 beneficiaries, Medicare allowed an average of $1085.85 per service. That is 1.8 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 65778

Specialty	Services	Beneficiaries	Avg allowed	Providers
Optometry	26,669	14,614	$1047.48	361
Ophthalmology	22,281	12,656	$1132.79	356
General Surgery	480	163	$1050.16	1
Neurology	46	24	$1038.73	1
Physician Assistant	17	11	$872.42	1

65778 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	9,725	$1224.31	$844.13	96
Texas	7,639	$1038.40	$859.60	120
New York	3,483	$1220.35	$852.57	49
Florida	2,906	$1044.67	$851.76	50
Tennessee	2,717	$957.10	$845.99	14
Arizona	2,584	$1042.39	$852.47	28
Pennsylvania	2,363	$1010.01	$846.91	38
New Jersey	1,480	$1223.74	$850.17	26
Nevada	1,335	$1065.59	$857.39	11
Ohio	1,334	$984.19	$845.01	25
Illinois	1,254	$1085.42	$849.33	24
Oklahoma	1,128	$958.42	$843.31	13
Michigan	1,108	$1011.90	$845.43	18
Virginia	987	$1046.59	$841.46	11
Maryland	842	$1257.63	$846.68	14
Georgia	839	$1005.35	$844.97	17
Alabama	755	$929.92	$852.60	8
Louisiana	657	$942.65	$847.29	15
Missouri	653	$998.05	$845.36	12
Kentucky	649	$972.66	$846.62	11
North Carolina	630	$1020.02	$870.86	14
Indiana	606	$1001.85	$845.32	10
South Carolina	564	$971.93	$841.42	12
Kansas	418	$975.72	$839.28	11
Washington	352	$1137.90	$855.07	11
Connecticut	318	$1283.97	$853.07	3
Hawaii	261	$1218.39	$838.72	2
Mississippi	250	$906.38	$840.83	9
Utah	238	$951.38	$842.34	5
Colorado	235	$931.27	$732.95	6
Wisconsin	211	$997.53	$852.43	5
Massachusetts	196	$1230.80	$860.21	8
Delaware	139	$1057.59	$847.66	2
Arkansas	118	$970.16	$841.49	2
Nebraska	65	$1149.42	$940.82	3
South Dakota	60	$1067.74	$836.57	1
New Hampshire	56	$1109.81	$840.40	2
Rhode Island	46	$1122.52	$846.14	2
Minnesota	46	$1105.96	$849.14	2
Iowa	44	$975.53	$841.12	2
Alaska	35	$1220.36	$843.10	1
Oregon	34	$1315.21	$853.92	1
Wyoming	31	$1065.71	$834.12	1
West Virginia	26	$947.73	$858.94	1
New Mexico	23	$979.09	$842.81	1
Montana	19	$1074.44	$846.43	1
Idaho	17	$969.90	$849.37	1
ZZ	17	$1038.78	$869.00	1

Related codes

65756Transplantation of outer layer of corneal tissue$1421.30

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.