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Billing code 65091: Eye eviscerationMedicare rate & RVUs

Reports removal of intraocular contents while preserving the scleral shell, without placing an orbital implant during the procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities64 Medicare services in 2024

Medicare pays $662.67 for 65091 nationally in a facility.

Medicare rate · 65091

Eye evisceration

Swap in your local Medicare rate.

Work RVUs
7.08
Total RVUs
19.84
Global days
090

National rate · 2026

$662.67

Facility setting, before claim adjustments.

See every locality for 65091 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 65091 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 65091 covers

An ophthalmologist removes the contents of the eye while preserving its outer scleral shell; no orbital implant is placed during this procedure. It may be performed in an operating room for a blind, painful eye or a severely infected or traumatized eye when removal is selected. Evisceration differs from enucleation, which removes the globe itself.

Report this code when the operative record supports evisceration without implant placement, rather than evisceration with an implant or enucleation. Documentation should identify the eye, the procedure performed, and whether an implant was placed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one 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 requires medical-necessity documentation, and co-surgeon payment requires supporting documentation. 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 65091 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

65091 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$603.62
Alaska*Unavailable$799.00
ArizonaUnavailable$647.35
ArkansasUnavailable$596.15
AtlantaUnavailable$673.66
AustinUnavailable$684.65
BakersfieldUnavailable$698.97
Baltimore/Surr. CntysUnavailable$700.64
BeaumontUnavailable$624.67
BrazoriaUnavailable$656.78

65091 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
65091 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 65091 rate is calculated

Each of 65091’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 · 65091

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.08Practice expense 12.20Malpractice 0.56

19.8400 adjusted RVUs×$33.4009 conversion factor=$662.67

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 65091

65091 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 65091

Eye evisceration

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)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 · 65091

Eye evisceration

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

65091 without 50 · national facility

$662.67

Eye evisceration

65091-50 · Bilateral: 150%

$994.01

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

65091 compared with similar codes

Compare codes

65091 vs 65093 vs 65101 vs 65103: national Medicare rates

Swap in your local Medicare rate.

  • 65091
    Eye evisceration · 7.08 wRVU
    —
  • 65093
    Eye evisceration · 6.86 wRVU
    —
  • 65101
    Eye removal · 8.09 wRVU
    —
  • 65103
    Eye removal · 8.62 wRVU
    —

How to choose

65093Eye evisceration
Both describe evisceration, but 65093 includes placement of an orbital implant; 65091 is for the procedure without an implant.
65101Eye removal
65101 describes enucleation without an implant, removing the globe. 65091 removes intraocular contents while preserving the scleral shell.
65103Eye removal
65103 describes enucleation with an implant. 65091 describes evisceration without implant placement.

Codes related to 65091

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

Codes related to 65091
CodeHow it relatesNational office range
Same family
65093Eye eviscerationEvisceration sibling for cases in which an orbital implant is placed.No office rate
Used instead
65101Eye removalEnucleation removes the globe rather than preserving the scleral shell.No office rate
65103Eye removalEnucleation with an implant is a different globe-removal approach.No office rate

65091 billing questions

How is 65091 distinguished from 65093?

65091 describes evisceration without an implant. Use 65093 when an implant is placed as part of the evisceration.

When is enucleation reported instead?

Enucleation removes the globe rather than emptying its contents while leaving the scleral shell. Select the enucleation code when that is the operation documented.

Can an orbital implant be billed separately with 65091?

65091 describes the procedure without implant placement. If an implant is placed during evisceration, the with-implant code 65093 distinguishes that service.

What postoperative care is included?

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

How does Medicare handle bilateral reporting?

Bilateral reporting with modifier 50 is paid at 150% under the CMS facts for this code.

What documentation supports assistant or co-surgeon payment?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation; 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 65091PPRRVU2026_Oct_nonQPP.csv, line 7,288 (RVU26D)

Open CMS sourceHow we calculate rates

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