FeeBase
Log inGet started
Menu

Billing code 65155: Ocular implantMedicare rate & RVUs

Reports surgery to return a previously placed ocular implant to its position in the socket, such as after displacement or extrusion.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $855.06 for 65155 nationally in a facility.

Medicare rate · 65155

Ocular implant

Swap in your local Medicare rate.

Work RVUs
9.85
Total RVUs
25.60
Global days
090

National rate · 2026

$855.06

Facility setting, before claim adjustments.

See every locality for 65155 → · 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 65155 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 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

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

65155 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$781.15
Alaska*Unavailable$1,040.19
ArizonaUnavailable$835.77
ArkansasUnavailable$771.81
AtlantaUnavailable$869.35
AustinUnavailable$881.69
BakersfieldUnavailable$898.97
Baltimore/Surr. CntysUnavailable$903.06
BeaumontUnavailable$808.22
BrazoriaUnavailable$847.39

65155 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.

View every state and territory as a table
65155 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 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

Swap in your local Medicare rate.

Work 9.85Practice expense 14.96Malpractice 0.79

25.6000 adjusted RVUs×$33.4009 conversion factor=$855.06

All indexes start 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

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 · 65155

Ocular 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.

  • 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

65155 without 50 · national facility

$855.06

Ocular implant

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).

When to use modifier 50

65155 compared with similar codes

Compare codes

65155 vs 65150 vs 65130 vs 65135 vs 65175: national Medicare rates

Swap in your local Medicare rate.

  • 65155
    Ocular implant · 9.85 wRVU
    —
  • 65150
    Ocular implant revision · 6.27 wRVU
    —
  • 65130
    Ocular implant insertion · 8.21 wRVU
    —
  • 65135
    Ocular implant · 8.39 wRVU
    —
  • 65175
    Ocular implant removal · 7.22 wRVU
    —

How to choose

65150Ocular implant revision
65155 is for returning an existing implant to position. 65150 is for revising the implant.
65130Ocular implant insertion
Use 65130 for insertion of an ocular implant; use 65155 when the service is reinsertion of an existing implant.
65135Ocular implant
65135 describes implant insertion, not reinsertion. Choose 65155 when the operative service returns an existing implant to position.
65175Ocular implant removal
65175 describes removal of an ocular implant. 65155 describes reinsertion rather than removal.

Codes related to 65155

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

Codes related to 65155
CodeHow it relatesNational office range
Used instead
65150Ocular implant revisionDescribes revision of an ocular implant rather than reinsertion.No office rate
65130Ocular implant insertionFor insertion of an ocular implant, not reinsertion of an existing implant.No office rate
65135Ocular implantAnother ocular implant insertion code, used instead when a new implant is inserted.No office rate
65175Ocular implant removalDescribes removal of an ocular implant when removal, rather than reinsertion, is performed.No office rate

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
RVUs for 65155PPRRVU2026_Oct_nonQPP.csv, line 7,301 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 65155 pays?

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

Fee sheets

Put 65155 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →