FeeBase
Log inGet started
Menu

CPT code 65125: Ocular implant revision, with graft2026 Medicare rate & RVUs in King County, WA

Revision of an existing orbital implant with graft material to address implant-related problems in an anophthalmic socket, performed by an ophthalmic surgeon.

CMS RVU26DEffective Oct 1, 2026One payment locality

In King County, WA, Medicare pays $536.72 for 65125 in the office and $297.79 when it’s performed in a hospital or facility.

$536.72Office (non-facility)
$297.79Hospital or facility
+17.8%vs the national office rate ($455.59)

Check a contract rate as a % of Medicare · 65125 nationwide

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

We’ll open 65125 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 65125 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 65125 covers

This service revises an orbital implant already present in an anophthalmic socket, using a graft as part of the reconstruction. An ophthalmic or oculoplastic surgeon may correct an implant-related problem such as exposure or poor fit. The operation addresses the existing implant rather than placing a new implant during eye removal, and is typically performed in an operating-room setting.

Report 65125 when the operative work revises the existing implant and includes grafting. The operative report should identify the implant problem, the revision performed, and the graft used. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral reporting with modifier 50, CMS pays 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment is restricted; co-surgeon payment requires 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.

How King County, WA compares for 65125

Across 109 of 109 payment localities, the office rate for 65125 runs from $403.50 in Arkansas to $614.02 in San Benito County, CA. King County, WA pays $536.72. The RVUs are the same everywhere; the geographic indexes change the dollars.

65125 in King County, WA vs other payment areas
  1. King County, WA · this page$536.72
  2. Rest of Washington · Washington$473.03−$63.69
  3. Los Angeles, CA · California$519.50−$17.22
  4. Washington, DC area · District of Columbia$522.93−$13.79
  5. Miami, FL · Florida$482.32−$54.40
  6. Chicago, IL · Illinois$468.85−$67.87
  7. Manhattan, NY · New York$522.49−$14.23

Other areas in Washington first, then benchmark localities. Bars start at $0.

Every other payment area

65125 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$527.26$319.87
AlabamaAlabama$409.38$238.99
ArkansasArkansas$403.50$236.23
ArizonaArizona$443.82$255.13
Bakersfield, CACalifornia$487.05$273.63
Chico, CACalifornia$486.23$272.81
El Centro, CACalifornia$486.27$272.85
Fresno, CACalifornia$486.23$272.81

65125 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$403.50

$550.13

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
65125 office rate range by state
State / territoryOffice rate rangeLocalities
AK$527.261
AL$409.381
AR$403.501
AZ$443.821
CA$486.23–$614.0229
CO$476.841
CT$485.711
DC$522.931
DE$451.191
FL$444.80–$482.323
GA$420.40–$463.042
GU$498.751
HI$498.751
IA$421.591
ID$423.931
IL$430.65–$471.984
IN$426.431
KS$418.741
KY$417.061
LA$416.06–$436.622
MA$473.65–$525.132
MD$460.06–$522.933
ME$425.18–$449.442
MI$427.03–$449.392
MN$459.591
MO$408.36–$439.253
MS$406.051
MT$455.571
NC$429.751
ND$450.631
NE$424.161
NH$468.511
NJ$492.00–$517.382
NM$428.991
NV$454.531
NY$436.07–$533.955
OH$426.021
OK$417.271
OR$451.75–$492.972
PA$427.19–$473.092
PR$459.211
RI$467.951
SC$428.441
SD$450.041
TN$420.721
TX$424.33–$474.618
UT$434.301
VA$447.34–$522.932
VI$459.211
VT$448.061
WA$473.03–$536.722
WI$435.501
WV$414.561
WY$453.421

See 65125 in every payment locality

How the 65125 rate is calculated

Each of 65125’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.

How the rate is built · 65125

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.19

3.19 RVUs× 1.000 GPCI

Practice expense10.20

10.20 RVUs× 1.000 GPCI

Malpractice0.25

0.25 RVUs× 1.000 GPCI

Adjusted RVUs

13.6400

Conversion factor

$33.4009

Medicare rate

$455.59

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,296

Code
65125
Physician work
3.19
Practice expense
10.20
Malpractice
0.25

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 65125 in King County, WA
ComponentRVULocality factorAdjusted
Physician work3.19× 1.0503.3495
Practice expense10.20× 1.22712.5154
Malpractice0.25× 0.8170.2042
Total RVUs16.0691
Conversion factor× 33.4009

Office rate, King County, WA$536.72

Office: (3.19 × 1.05 + 10.2 × 1.227 + 0.25 × 0.817) × $33.4009 = $536.72

Facility: (3.19 × 1.05 + 4.37 × 1.227 + 0.25 × 0.817) × $33.4009 = $297.79

Open 65125 in the RVU calculator

Payment rules and modifiers for 65125

65125 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 65125

Ocular implant revision, with graft

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.70/0.20Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 65125

Ocular implant revision, with graft

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

65125 without 50 · national office

$455.59

Ocular implant revision, with graft

65125-50 · Bilateral: 150%

$683.39

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 65125

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

Codes related to 65125
CodeHow it relatesOffice range, King County, WA
Same family
65150Ocular implant revision, with graftAnother ocular implant revision code; distinguish the reported procedure and whether grafting is performed.No office rate
Used instead
65155Ocular implant, reinsertionUsed for reinsertion of an ocular implant rather than revision with grafting.No office rate
65175Ocular implant removal, implant removal aloneRemoval of an ocular implant is reported when the implant is removed rather than revised.No office rate
65130Ocular implant insertion, extraocular muscles attachedDescribes insertion of a new implant with muscles attached, not revision of an existing implant.No office rate
65135Ocular implant, extraocular muscles attachedDescribes insertion of a new implant with muscles not attached, rather than implant revision.No office rate

How 65125 has changed in King County, WA

65125 · Office / nonfacility

$536.72

Effective 2026-10-01

The base rate is $29.61 higher than on 2025-10-01, moving from $507.11 to $536.72 (5.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $507.11changed to$536.72

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.27 changed to 3.19
    • Practice expense RVU 9.88 changed to 10.20
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $530.39changed to$507.11

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.09 changed to 9.88

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $521.73changed to$530.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $533.51changed to$521.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.06 changed to 10.09
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $536.32changed to$533.51

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.98 changed to 10.06
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $548.68changed to$536.32

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.17 changed to 9.98

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $527.98changed to$548.68

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.44 changed to 10.17
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $522.27changed to$527.98

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.52 changed to 9.44
    • Malpractice RVU 0.24 changed to 0.25
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $523.34changed to$522.27

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.56 changed to 9.52

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $508.12changed to$523.34

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.20 changed to 9.56
    • Malpractice RVU 0.30 changed to 0.24
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $512.28changed to$508.12

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.37 changed to 9.20
    • Malpractice RVU 0.27 changed to 0.30
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $514.01changed to$512.28

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.38 changed to 9.37
    • Malpractice RVU 0.24 changed to 0.27

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $511.45changed to$514.01

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $519.05changed to$511.45

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.32 changed to 9.38
    • Malpractice RVU 0.61 changed to 0.24
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $534.90changed to$519.05

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.32 changed to 9.32
    • Malpractice RVU 0.64 changed to 0.61
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $534.90

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$536.72$297.79RVU26D
2026-07-01$536.72$297.79RVU26C
2026-04-01$536.72$297.79RVU26B
2026-01-01$536.72$297.79RVU26A
2025-10-01$507.11$325.58RVU25D
2025-07-01$507.11$325.58RVU25C
2025-04-01$507.11$325.58RVU25B
2025-01-01$507.11$325.58RVU25A
2024-10-01$530.39$334.65RVU24D
2024-07-01$530.39$334.65RVU24C
2024-04-01$530.39$334.65RVU24B
2024-03-09$530.39$334.65RVU24AR
2024-01-01$521.73$329.19RVU24A
2023-10-01$533.51$332.27RVU23D
2023-07-01$533.51$332.27RVU23C
2023-04-01$533.51$332.27RVU23B
2023-01-01$533.51$332.27RVU23A
2022-10-01$536.32$329.31RVU22D
2022-07-01$536.32$329.31RVU22C
2022-04-01$536.32$329.31RVU22B
2022-01-01$536.32$329.31RVU22A
2021-10-01$548.68$331.21RVU21D
2021-07-01$548.68$331.21RVU21C
2021-04-01$548.68$331.21RVU21B
2021-01-01$548.68$331.21RVU21A
2020-10-01$527.98$329.52RVU20D
2020-07-01$527.98$329.52RVU20C
2020-04-01$527.98$329.52RVU20B
2020-01-01$527.98$329.52RVU20A
2019-10-01$522.27$327.74RVU19D
2019-07-01$522.27$327.74RVU19C
2019-04-01$522.27$327.74RVU19B
2019-01-01$522.27$327.74RVU19A
2018-10-01$523.34$328.62RVU18D
2018-07-01$523.34$328.62RVU18C
2018-04-01$523.34$328.62RVU18B
2018-01-01$523.34$328.62RVU18AR1
2017-10-01$508.12$318.93RVU17D
2017-07-01$508.12$318.93RVU17C
2017-04-01$508.12$318.93RVU17B
2017-01-01$508.12$318.93RVU17A
2016-10-01$512.28$320.81RVU16D
2016-07-01$512.28$320.81RVU16C
2016-04-01$512.28$320.81RVU16B
2016-01-01$512.28$320.81RVU16A
2015-10-01$514.01$321.85RVU15D
2015-07-01$514.01$321.85RVU15C
2015-04-01$511.45$320.25RVU15B
2015-01-01$511.45$320.25RVU15A
2014-10-01$519.05$331.20RVU14D
2014-07-01$519.05$331.20RVU14C
2014-04-01$519.05$331.20RVU14B
2014-01-01$519.05$331.20RVU14A
2013-10-01$534.90$336.01RVU13D
2013-07-01$534.90$336.01RVU13C
2013-04-01$534.90$336.01RVU13B
2013-01-01$534.90$336.01RVU13AR

Price 65125 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 65125 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

65125 billing questions

How does 65125 differ from 65150?

65125 identifies implant revision with grafting. Choose based on the procedure documented; 65150 is another implant-revision code for a different circumstance.

Should 65125 be used for a newly placed implant?

No. It describes revision of an implant already present. Codes such as 65130 or 65135 describe insertion rather than revision.

What documentation supports 65125?

The operative report should establish the existing implant, the problem being corrected, the revision performed, and use of graft material.

How is bilateral 65125 reported?

Use modifier 50 for a bilateral procedure. CMS pays bilateral reporting at 150%.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeon payment requires supporting documentation, and 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 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

Show the CMS file lines behind this rate
RVUs for 65125PPRRVU2026_Oct_nonQPP.csv, line 7,296 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 65125 pays in King County, WA?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 65125 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist