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CPT code 67560: Socket implant revision, existing orbital implant2026 Medicare rate & RVUs

Reports surgical correction of an existing orbital implant, such as for displacement or exposure, in a patient with an anophthalmic socket.

CMS RVU26DEffective Oct 1, 2026109 payment localities192 Medicare services in 2024

Medicare pays $975.64 for 67560 nationally in a facility.

Medicare rate · 67560

Socket implant revision, existing orbital implant

Office or facility?

Work RVUs
11.88
Total RVUs
29.21
Global days
090

National rate · 2026

$975.64

Facility setting, before claim adjustments.

See every locality for 67560 →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 67560 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 67560 covers

An ophthalmologist, often an oculoplastic surgeon, reports this service when surgically correcting an implant already present in the socket after enucleation or evisceration. Clinical situations may include implant displacement, exposure, or an unsatisfactory socket contour related to the implant. The work is typically performed in an operating room, including a hospital outpatient department or ambulatory surgery center.

The operative report should identify the existing implant, the side, the problem being corrected, and the revision performed. Distinguish correction of an existing implant from initial implant placement or removal without revision. This major surgery has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For bilateral work, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment requires documented medical necessity; 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 67560 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

67560 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$892.35
AlaskaUnavailable$1,193.47
ArizonaUnavailable$953.70
ArkansasUnavailable$881.84
Atlanta, GAUnavailable$992.64
Austin, TXUnavailable$1,003.92
Bakersfield, CAUnavailable$1,021.51
Baltimore area, MDUnavailable$1,030.05
Beaumont, TXUnavailable$924.22
Brazoria, TXUnavailable$966.13

67560 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
67560 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 67560 rate is calculated

Each of 67560’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 · 67560

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.88

11.88 RVUs× 1.000 GPCI

Practice expense16.27

16.27 RVUs× 1.000 GPCI

Malpractice1.06

1.06 RVUs× 1.000 GPCI

Adjusted RVUs

29.2100

Conversion factor

$33.4009

Medicare rate

$975.64

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

Payment rules and modifiers for 67560

67560 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 67560

Socket implant revision, existing orbital implant

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)0Not paid without supporting documentation.
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 · 67560

Socket implant revision, existing orbital implant

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

67560 without 50 · national facility

$975.64

Socket implant revision, existing orbital implant

67560-50 · Bilateral: 150%

$1,463.46

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

67560 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 67560

    Socket implant revision, existing orbital implant11.88 wRVU

    Not priced

  • 67550

    Orbital implant, muscles attached11.48 wRVU

    Not priced

  • 65175

    Ocular implant removal, implant removal alone7.22 wRVU

    Not priced

  • 67599

    Unlisted orbit procedure, no dedicated CPT code0 wRVU

    Not priced

How to choose

67550Orbital implantMuscles attached
67550 is for placing an orbital implant. Choose 67560 when the patient already has an implant and the surgeon revises it.
65175Ocular implant removalImplant removal alone
65175 describes removal of an ocular implant. Use 67560 when the service includes surgical correction of the existing socket implant rather than removal alone.
67599Unlisted orbit procedureNo dedicated CPT code
67599 is for orbital work without a specific listed code. Use 67560 when the documented service is revision of an existing socket implant.

Codes related to 67560

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

Codes related to 67560
CodeHow it relatesNational office range
Used instead
67550Orbital implant, muscles attachedUsed for initial orbital implant placement rather than correction of an existing implant.No office rate
65175Ocular implant removal, implant removal aloneUsed when an ocular implant is removed without the revision work described by 67560.No office rate
67599Unlisted orbit procedure, no dedicated CPT codeUnlisted orbital procedure code when the work is not represented by a listed orbital procedure.No office rate

67560 billing questions

When should 67560 be chosen instead of 67550?

Use 67560 for surgical correction of an implant already in the socket. Code 67550 describes placing an orbital implant, not revising an existing one.

Does removing an implant alone support 67560?

No. If the service is removal without revision, consider 65175; the operative report should make clear whether the implant was corrected or removed.

What documentation supports the revision?

Document the implant's presence and side, the clinical problem such as displacement or exposure, and the corrective work performed.

How is bilateral revision reported?

For revision on both sides, report modifier 50; CMS pays the bilateral procedure at 150%.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full and other procedures are paid at 50% under the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 67560PPRRVU2026_Oct_nonQPP.csv, line 7,484 (RVU26D)

Open CMS sourceHow we calculate rates

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