When a medically appropriate ocular-surface case has failed conservative therapy, amniotic membrane placement can create meaningful patient benefit and meaningful practice economics without a capital equipment purchase.
Amniotic membrane placement is not a routine dry-eye add-on. Coverage and case selection depend on documented medical necessity, payer policy, and conservative-therapy failure when required.
Important: This is not a routine dry-eye add-on. Coverage and case selection depend on documented medical necessity, payer policy, and conservative-therapy failure when required.
| CPT 65778 | Placement of amniotic membrane on the ocular surface, without sutures |
| CPT 65779 | Placement of amniotic membrane on the ocular surface, single layer, sutured |
| CPT 65780 | Ocular surface reconstruction, amniotic membrane transplantation, multiple layers |
| V2790 | Amniotic membrane for surgical reconstruction, per procedure |
For the common office-use sutureless placement code (65778), the membrane supply cost is bundled into the procedure payment. V2790 should not be billed separately with 65778 or 65779. Coverage is driven by medical necessity, documentation, and local claims processing rules rather than a blanket diagnosis label.
One of the biggest barriers to adopting amniotic membrane is the assumption that patients will resist the out-of-pocket cost. In practice, the majority of Medicare beneficiaries have supplemental coverage that significantly reduces or eliminates their cost-sharing responsibility.
Blue Cross Blue Shield supplemental plans are among the most common in Virginia, North Carolina, and South Carolina. These plans often cover most or all of the Medicare Part B coinsurance, significantly reducing the patient’s out-of-pocket cost.
Many employer retiree plans function similarly to Medigap and cover most or all of the Medicare cost-sharing, though plan terms vary.
Patients with two commercial plans often have very low or zero out-of-pocket cost after coordination of benefits.
For medically appropriate cases, the economics can be attractive because the practice is not buying a capital device or adding a long treatment protocol. The main variables are the payer’s allowed amount and how consistently the office documents medical necessity.
Want us to walk you through the numbers for your specific payer mix?
Illustrative estimate based on publicly available national averages. Actual reimbursement depends on payer, diagnosis, documentation, place of service, and jurisdiction. Carolina Optics does not guarantee payment.
The reimbursement code is procedure-based, not brand-based. That means the practical economic question is not just whether the procedure gets covered, but which product makes the workflow easiest to adopt and the margin easiest to protect.
SurSight is dehydrated and terminally sterilized. It stores at room temperature with no cold-chain logistics, no freezer space, and no preparation steps before use.
Bi-directional application means either side of the membrane can face the ocular surface. No staining, no flipping, no carrier-paper handling.
Available in eight sizes from 5 to 15 mm diameter, designed specifically for ocular surface applications.
Room-temperature shelf life means your practice can stock SurSight without dedicating freezer space or managing expiration-sensitive cold-chain inventory.
Carolina Optics is an independent distributor serving Virginia, North Carolina, and South Carolina. We work with you through every step of adopting amniotic membrane as a service line.
We walk you through coding basics, documentation requirements, and payer verification so your team submits clean claims from the start.
We help you identify which patients in your existing flow are appropriate candidates based on documented medical necessity.
We handle ordering, inventory planning, and product education so your team is confident from the first case.
Local support across Virginia, North Carolina, and South Carolina. Not a call center — a direct line to our team.
Talk to Carolina Optics about SurSight pricing, reimbursement strategy, and how to identify your first appropriate cases.
Coverage and reimbursement vary by payer, diagnosis, documentation, place of service, and jurisdiction. Carolina Optics does not guarantee payment. Providers are responsible for verifying payer policy and documenting medical necessity. This page is for educational purposes and does not constitute billing, coding, or legal advice.