No office rate
65155 is for returning an existing implant to position. 65150 is for revising the implant.
On this page
CMS RVU26D · Effective 2026-10-01
65155 Ocular implant Medicare reimbursement rates in Idaho
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 Idaho.
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 Idaho?
Idaho 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
$801.18
1 of 1 localities have a supported rate.
Payment area: Idaho
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.
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 Idaho, from the same CMS release.
No office rate
Use 65130 for insertion of an ocular implant; use 65155 when the service is reinsertion of an existing implant.
No office rate
65135 describes implant insertion, not reinsertion. Choose 65155 when the operative service returns an existing implant to position.
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
Idaho →
Office / nonfacility
Unavailable
Facility
$801.18
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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 Idaho.
PPRRVU2026_Oct_nonQPP.csv
7,301
- Code
- 65155
- Physician work
- 9.85
- Practice expense
- 14.96
- Malpractice
- 0.79
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.85 | × 1.000 | 9.8500 |
| Practice expense | 14.96 | × 0.920 | 13.7632 |
| Malpractice | 0.79 | × 0.473 | 0.3737 |
| Total RVUs | 23.9869 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$801.18
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.85 | 1 |
| Practice expense | 14.96 | 0.92 |
| Malpractice | 0.79 | 0.473 |
(9.85 × 1 + 14.96 × 0.92 + 0.79 × 0.473) × $33.4009 = $801.18
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.
7,29865135,,Insert ocular implant,A,,8.39,14.01,NA,14.01,,0.66,23.06,23.06,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29965140,,Attach ocular implant,A,,9.22,14.74,NA,14.74,,0.73,24.69,24.69,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30065150,,Revise ocular implant,A,,6.27,12.11,NA,12.11,,0.48,18.86,18.86,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30165155,,Reinsert ocular implant,A,,9.85,14.96,NA,14.96,,0.79,25.60,25.60,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30265175,,Removal of ocular implant,A,,7.22,13.15,NA,13.15,,0.57,20.94,20.94,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30365205,,Remove foreign body from eye,A,,0.48,0.34,,0.23,,0.02,0.84,0.73,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30465210,,Remove foreign body from eye,A,,0.59,0.52,,0.28,,0.03,1.14,0.90,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772