CPT code 65103: Eye removal, implant with muscle attachment2026 Medicare rate & RVUs

Medicare pays $780.58 for 65103 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 65103 covers

An ophthalmic surgeon removes the globe intact and places an implant in the orbit, attaching the extraocular muscles to the implant. This enucleation may be performed for an intraocular malignancy or a severely damaged, blind, painful eye. The service is generally performed in a hospital or ambulatory surgical setting; Medicare recorded facility services for this code in 2024.

Select this code when the operative report supports enucleation, implant placement, and muscle attachment. Documentation should identify the eye, the reason for removal, and the implant and muscle work performed; use a different code when no implant is placed or when the procedure is evisceration rather than enucleation. The procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.

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.

Where 65103 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

65103 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 65103 rate is calculated

Each of 65103’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 65103

65103 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

65103 compared with similar codes

How to choose

65101Eye removalWithout implant

Use 65101 for enucleation without an implant. Code 65103 includes implant placement and attachment of the extraocular muscles.

65105Eye removalImplant with muscles attached

Both describe implant-and-muscle enucleation, but 65105 also includes a temporary tarsorrhaphy.

65112Eye eviscerationWith implant

65112 is evisceration with an implant, removing the eye's contents while retaining the scleral shell; 65103 removes the globe intact.

Codes related to 65103

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates