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CPT code 65135: Ocular implant, extraocular muscles attached2026 Medicare rate & RVUs

Reports placement of an orbital implant with extraocular muscles attached, generally to restore socket volume and support movement of an external eye prosthesis.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $770.22 for 65135 nationally in a facility.

Medicare rate · 65135

Ocular implant, extraocular muscles attached

Office or facility?

Work RVUs
8.39
Total RVUs
23.06
Global days
090

National rate · 2026

$770.22

Facility setting, before claim adjustments.

See every locality for 65135 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 65135 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 65135 covers

An ophthalmic or oculoplastic surgeon places an orbital implant in the socket and attaches the extraocular muscles to the implant. This may be part of reconstruction after loss or removal of an eye. The implant is internal; an external prosthetic eye is a separate device. Code selection turns on whether the muscles are attached to the implant, rather than simply placed over or around it. If the eye is removed during the same operation and the applicable enucleation code includes implant placement, that combined service is represented by the enucleation code rather than a separate insertion code.

The operative report should identify the implant placement and describe the muscle attachment. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are 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 65135 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

65135 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$702.16
AlaskaUnavailable$930.86
ArizonaUnavailable$752.54
ArkansasUnavailable$693.55
Atlanta, GAUnavailable$782.98
Austin, TXUnavailable$795.41
Bakersfield, CAUnavailable$811.85
Baltimore area, MDUnavailable$814.09
Beaumont, TXUnavailable$726.54
Brazoria, TXUnavailable$763.41

65135 rates by state

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

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Local rates. Clear comparisons.

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

View every state and territory as a table
65135 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 65135 rate is calculated

Each of 65135’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 · 65135

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.39

8.39 RVUs× 1.000 GPCI

Practice expense14.01

14.01 RVUs× 1.000 GPCI

Malpractice0.66

0.66 RVUs× 1.000 GPCI

Adjusted RVUs

23.0600

Conversion factor

$33.4009

Medicare rate

$770.22

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

Payment rules and modifiers for 65135

65135 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 65135

Ocular implant, extraocular muscles attached

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)0Not permitted.
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 · 65135

Ocular implant, extraocular muscles attached

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

65135 without 50 · national facility

$770.22

Ocular implant, extraocular muscles attached

65135-50 · Bilateral: 150%

$1,155.33

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

65135 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 65135

    Ocular implant, extraocular muscles attached8.39 wRVU

    Not priced

  • 65130

    Ocular implant insertion, extraocular muscles attached8.21 wRVU

    Not priced

  • 65103

    Eye removal, implant with muscle attachment8.62 wRVU

    Not priced

  • 65140

    Ocular implant, secondary attachment9.22 wRVU

    Not priced

  • 65125

    Ocular implant revision, with graft3.19 wRVU

    $455.59

How to choose

65130Ocular implant insertionExtraocular muscles attached
Choose 65135 when the extraocular muscles are attached to the implant; choose 65130 when they are not.
65103Eye removalImplant with muscle attachment
65103 represents eye removal with implant placement in the same operation. 65135 describes implant insertion with muscle attachment, without that combined enucleation service.
65140Ocular implantSecondary attachment
65140 concerns attachment of muscles to an ocular implant; 65135 describes insertion of the implant with the muscles attached.
65125Ocular implant revisionWith graft
65125 describes revision of an existing ocular implant, not placement of an implant with muscle attachment.

Codes related to 65135

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

Codes related to 65135
CodeHow it relatesNational office range
Same family
65130Ocular implant insertion, extraocular muscles attachedRelated implant insertion code; extraocular muscles are not attached to the implant.No office rate
65140Ocular implant, secondary attachmentRelated ocular implant code focused on muscle attachment rather than this insertion service.No office rate
Used instead
65103Eye removal, implant with muscle attachmentRepresents eye removal with implant placement when both are performed in the same operation.No office rate

65135 billing questions

How is 65135 different from 65130?

65135 is selected when the extraocular muscles are attached to the implant. 65130 is the related insertion service when the muscles are not attached to it.

Can 65135 be reported with an enucleation code?

When the eye is removed and implant placement is included in the applicable enucleation service, report that combined service rather than separately reporting 65135. Code 65103 is the nearby enucleation option that includes implant placement.

What documentation supports 65135?

The operative report should document implant placement and attachment of the extraocular muscles to the implant. Documentation of implant placement alone does not establish the distinction from 65130.

How does the global period affect postoperative visits?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Those related visits are included in the surgical service.

How are bilateral and multiple procedures handled?

For bilateral reporting, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.

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 65135PPRRVU2026_Oct_nonQPP.csv, line 7,298 (RVU26D)

Open CMS sourceHow we calculate rates

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