CPT code 65155: Ocular implant, reinsertion2026 Medicare rate & RVUs in Missouri
Reports surgery to return a previously placed ocular implant to its position in the socket, such as after displacement or extrusion.
CMS doesn’t publish an office rate for 65155 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 65155 covers
An ophthalmic or oculoplastic surgeon reports this service when a previously placed ocular implant has shifted or come out of position and is surgically returned to the socket. The operative work centers on reinserting the existing implant, rather than placing a new implant or removing the eye as part of the same procedure. These cases are typically managed in an operating room.
The operative report should identify the implant, describe its position or displacement, and document the steps taken to reinsert it. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 surgery reported with modifier 50, payment is at 150%. Assistant-at-surgery services are not paid; 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 65155 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $823.98 |
| Metropolitan St. Louis, MO | Unavailable | $831.13 |
| Rest of Missouri | Unavailable | $785.42 |
How the 65155 rate is calculated
Each of 65155’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 · 65155
RVUs × geographic indexes × conversion factor
Work9.85
9.85 RVUs× 1.000 GPCI
Practice expense14.96
14.96 RVUs× 1.000 GPCI
Malpractice0.79
0.79 RVUs× 1.000 GPCI
Adjusted RVUs
25.6000
Conversion factor
$33.4009
Medicare rate
$855.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 65155
65155 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65155
Ocular implant, reinsertion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 65155
Ocular implant, reinsertion
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
65155 without 50 · national facility
$855.06
Ocular implant, reinsertion
65155-50 · Bilateral: 150%
$1,282.59
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).
65155 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 65150Ocular implant revisionWith graft
- 65155 is for returning an existing implant to position. 65150 is for revising the implant.
- 65130Ocular implant insertionExtraocular muscles attached
- Use 65130 for insertion of an ocular implant; use 65155 when the service is reinsertion of an existing implant.
- 65135Ocular implantExtraocular muscles attached
- 65135 describes implant insertion, not reinsertion. Choose 65155 when the operative service returns an existing implant to position.
- 65175Ocular implant removalImplant removal alone
- 65175 describes removal of an ocular implant. 65155 describes reinsertion rather than removal.
65155 billing questions
When should 65155 be chosen instead of 65130 or 65135?
Use 65155 when the surgical service is reinsertion of an existing ocular implant. Codes 65130 and 65135 describe insertion of an implant, rather than returning an existing implant to position.
How does reinsertion differ from implant revision?
65155 describes reinserting the implant. Consider 65150 when the work is revision of the implant rather than reinsertion.
What documentation supports 65155?
The operative note should establish that an ocular implant was already present, describe its displacement or position, and record the reinsertion performed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is 65155 paid when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Bilateral surgery reported with modifier 50 is paid at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery services are not paid for this code. Co-surgeons and team surgery are 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
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