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Billing code 65175: Ocular implant removalMedicare rate & RVUs

Removal of an existing ocular implant, such as an orbital implant after eye removal, when the implant itself must be taken out.

CMS RVU26DEffective Oct 1, 2026109 payment localities82 Medicare services in 2024

Medicare pays $699.41 for 65175 nationally in a facility.

Medicare rate · 65175

Ocular implant removal

Work RVUs
7.22
Total RVUs
20.94
Global days
090

National rate · 2026

$699.41

Facility setting, before claim adjustments.

See every locality for 65175 →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 65175 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 65175 covers

An ophthalmologist, often an oculoplastic surgeon, removes an existing implant from the orbit or socket. This may be needed when an implant becomes exposed, displaced, or infected. The service concerns removal of the implant, not removal of the eye or evisceration of its contents. It is typically performed in an operating-room setting; 2024 Medicare claims show facility use for this code.

Report 65175 when the documented operation removes the ocular implant. The operative note should identify the implant and describe its removal; if the surgeon instead revises or reinserts an implant, select the code that describes that work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral services, modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment is statutorily restricted; co-surgeons require supporting documentation, and 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 65175 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

65175 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$636.25
Alaska*Unavailable$839.99
ArizonaUnavailable$683.06
ArkansasUnavailable$628.25
AtlantaUnavailable$710.99
AustinUnavailable$723.20
BakersfieldUnavailable$738.72
Baltimore/Surr. CntysUnavailable$739.85
BeaumontUnavailable$658.53
BrazoriaUnavailable$693.20

65175 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
65175 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 65175 rate is calculated

Each of 65175’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 · 65175

RVUs × geographic indexes × conversion factor

Work7.22

7.22 RVUs× 1.000 GPCI

Practice expense13.15

13.15 RVUs× 1.000 GPCI

Malpractice0.57

0.57 RVUs× 1.000 GPCI

Adjusted RVUs

20.9400

Conversion factor

$33.4009

Medicare rate

$699.41

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

Payment rules and modifiers for 65175

65175 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 65175

Ocular implant removal

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)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 · 65175

Ocular implant removal

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

65175 without 50 · national facility

$699.41

Ocular implant removal

65175-50 · Bilateral: 150%

$1,049.12

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

65175 compared with similar codes

Compare codes · National

5 codes, side by side

  • 65175

    Ocular implant removal7.22 wRVU

    Not priced

  • 65125

    Ocular implant revision3.19 wRVU

    $455.59

  • 65155

    Ocular implant9.85 wRVU

    Not priced

  • 65101

    Eye removal8.09 wRVU

    Not priced

  • 65103

    Eye removal8.62 wRVU

    Not priced

How to choose

65125Ocular implant revision
Choose 65175 when the implant is removed. Choose the revision code when the operation revises the implant rather than taking it out.
65155Ocular implant
65175 captures implant removal; 65155 concerns reinsertion. The operative plan and documented work distinguish removal alone from putting an implant back.
65101Eye removal
65101 describes removal of the eye without an implant. 65175 is for removal of an ocular implant, not removal of the eye itself.
65103Eye removal
65103 describes removal of the eye with implant placement. 65175 describes removal of an existing implant.

Codes related to 65175

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

Codes related to 65175
CodeHow it relatesNational office range
Used instead
65125Ocular implant revisionRevision is the relevant choice when the implant is revised rather than removed.$403.50–$614.02
65155Ocular implantReinsertion describes putting an implant back, rather than removal alone.No office rate
65101Eye removalDescribes removal of the eye without an implant, not removal of an existing implant.No office rate
65103Eye removalDescribes eye removal with implant placement, rather than removal of an existing implant.No office rate
Often billed with
65130Ocular implant insertionMay accompany removal when a distinct new ocular implant is inserted during the same operation.No office rate

65175 billing questions

When should 65175 be chosen instead of an implant revision code?

Use 65175 when the operation removes the implant. When the implant remains in place and is revised, report the applicable revision code instead.

Does 65175 describe removal of the eye?

No. It describes removal of the ocular implant. Enucleation or evisceration codes describe removal of the eye or its contents.

Can implant insertion be reported with 65175?

A separately performed insertion may be relevant when the surgeon removes the existing implant and places a new one during the same operation. The operative record should support both services; same-session procedures are subject to CMS multiple-procedure payment reduction.

What documentation supports 65175?

Document the implant being removed, the reason for removal, and the operative work showing that the implant was taken out rather than revised or reinserted.

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.

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 65175PPRRVU2026_Oct_nonQPP.csv, line 7,302 (RVU26D)

Open CMS sourceHow we calculate rates

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