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CMS RVU26D · Effective 2026-10-01

65155 Ocular implant Medicare reimbursement rates in Colorado

Reports surgery to return a previously placed ocular implant to its position in the socket, such as after displacement or extrusion. Compare 65155 office and facility rates across CMS payment localities in Colorado.

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

What does Medicare pay for 65155 in Colorado?

Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$885.21

1 of 1 localities have a supported rate.

Payment area: Colorado

One mapped payment locality.

These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.

Find 65155 in your payment locality →

Ophthalmic surgery

About 65155: Reinsertion of ocular implant

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

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.

CMS billing rules for 65155

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU9.85 · 38%
  • Practice expense (office) RVU14.96 · 58%
  • Malpractice RVU0.79 · 3%

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.

65155 compared with similar codes

Office rates for Colorado, from the same CMS release.

65150

Ocular implant revision

With graft

No office rate

65155 is for returning an existing implant to position. 65150 is for revising the implant.

65130

Ocular implant insertion

Extraocular muscles attached

No office rate

Use 65130 for insertion of an ocular implant; use 65155 when the service is reinsertion of an existing implant.

65135

Ocular implant

Extraocular muscles attached

No office rate

65135 describes implant insertion, not reinsertion. Choose 65155 when the operative service returns an existing implant to position.

65175

Ocular implant removal

Implant removal alone

No office rate

65175 describes removal of an ocular implant. 65155 describes reinsertion rather than removal.

Compare 65155 by payment locality

Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 65155 in Colorado.

PPRRVU2026_Oct_nonQPP.csv

7,301

Code
65155
Physician work
9.85
Practice expense
14.96
Malpractice
0.79

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Facility calculation for 65155 in Colorado
ComponentRVULocality factorAdjusted
Physician work9.85× 1.0129.9682
Practice expense14.96× 1.06415.9174
Malpractice0.79× 0.7810.6170
Total RVUs26.5026
Conversion factor× 33.4009

Facility rate, Colorado$885.21

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work9.851.012
Practice expense14.961.064
Malpractice0.790.781

(9.85 × 1.012 + 14.96 × 1.064 + 0.79 × 0.781) × $33.4009 = $885.21

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 65155PPRRVU2026_Oct_nonQPP.csv, line 7,301 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)