No office rate
Choose 65135 when the extraocular muscles are attached to the implant; choose 65130 when they are not.
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CMS RVU26D · Effective 2026-10-01
65135 Ocular implant Medicare reimbursement rates in Kansas
Reports placement of an orbital implant with extraocular muscles attached, generally to restore socket volume and support movement of an external eye prosthesis. Compare 65135 office and facility rates across CMS payment localities in Kansas.
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 65135 in Kansas?
Kansas 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
$714.37
1 of 1 localities have a supported rate.
Payment area: Kansas
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.
Ophthalmology surgery
About 65135: Ocular implant insertion with muscle attachment
Reports placement of an orbital implant with extraocular muscles attached, generally to restore socket volume and support movement of an external eye prosthesis.
An ophthalmic or oculoplastic surgeon places an orbital implant in the socket and attaches the extraocular muscles to the implant. This may be part of reconstruction after loss or removal of an eye. The implant is internal; an external prosthetic eye is a separate device. Code selection turns on whether the muscles are attached to the implant, rather than simply placed over or around it. If the eye is removed during the same operation and the applicable enucleation code includes implant placement, that combined service is represented by the enucleation code rather than a separate insertion code.
The operative report should identify the implant placement and describe the muscle attachment. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 reporting with modifier 50, CMS pays 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 65135
- 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 RVU8.39 · 36%
- Practice expense (office) RVU14.01 · 61%
- Malpractice RVU0.66 · 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.
65135 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
65103 represents eye removal with implant placement in the same operation. 65135 describes implant insertion with muscle attachment, without that combined enucleation service.
No office rate
65140 concerns attachment of muscles to an ocular implant; 65135 describes insertion of the implant with the muscles attached.
$418.74
65125 describes revision of an existing ocular implant, not placement of an implant with muscle attachment.
Compare 65135 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
Kansas →
Office / nonfacility
Unavailable
Facility
$714.37
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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 65135 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
7,298
- Code
- 65135
- Physician work
- 8.39
- Practice expense
- 14.01
- Malpractice
- 0.66
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.39 | × 1.000 | 8.3900 |
| Practice expense | 14.01 | × 0.904 | 12.6650 |
| Malpractice | 0.66 | × 0.504 | 0.3326 |
| Total RVUs | 21.3877 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$714.37
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.39 | 1 |
| Practice expense | 14.01 | 0.904 |
| Malpractice | 0.66 | 0.504 |
(8.39 × 1 + 14.01 × 0.904 + 0.66 × 0.504) × $33.4009 = $714.37
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.
65135 billing questions
How is 65135 different from 65130?
65135 is selected when the extraocular muscles are attached to the implant. 65130 is the related insertion service when the muscles are not attached to it.
Can 65135 be reported with an enucleation code?
When the eye is removed and implant placement is included in the applicable enucleation service, report that combined service rather than separately reporting 65135. Code 65103 is the nearby enucleation option that includes implant placement.
What documentation supports 65135?
The operative report should document implant placement and attachment of the extraocular muscles to the implant. Documentation of implant placement alone does not establish the distinction from 65130.
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. Those related visits are included in the surgical service.
How are bilateral and multiple procedures handled?
For bilateral reporting, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are paid at 50%.
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.
7,29565114,,Remove eye/revise socket,A,,19.16,20.02,NA,20.02,,1.51,40.69,40.69,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29665125,,Revise ocular implant,A,,3.19,10.20,,4.37,,0.25,13.64,7.81,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29765130,,Insert ocular implant,A,,8.21,13.94,NA,13.94,,0.65,22.80,22.80,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29865135,,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
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958