No office rate
Use 65103 when implant placement accompanies enucleation. Use 67550 for separate implant placement in an existing socket.
On this page
CMS RVU26D · Effective 2026-10-01
67550 Orbital implant Medicare reimbursement rates in Kentucky
Reports separate placement of an orbital implant with extraocular muscle attachment in an anophthalmic socket, typically after prior enucleation or evisceration. Compare 67550 office and facility rates across CMS payment localities in Kentucky.
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 67550 in Kentucky?
Kentucky 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
$893.24
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Oculoplastic surgery
About 67550: Secondary orbital implant placement
Reports separate placement of an orbital implant with extraocular muscle attachment in an anophthalmic socket, typically after prior enucleation or evisceration.
An oculoplastic surgeon places an implant in an anophthalmic orbit and attaches the extraocular muscles to it, restoring socket volume and providing support for a prosthetic eye. The service is typically performed in an operating room after enucleation or evisceration when implant placement is done as a separate operation, rather than during globe removal.
Report the service for the orbit treated and document the prior removal of the globe, implant placement, and muscle attachment. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 67550
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.48 · 40%
- Practice expense (office) RVU16.16 · 56%
- Malpractice RVU0.98 · 3%
113
Medicare services in 2024 · #4787 by national volume
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.
67550 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
Use 65112 when implant placement accompanies evisceration. 67550 describes a separate operation after globe removal.
No office rate
67560 addresses revision of an existing orbital implant; 67550 is for implant placement.
Compare 67550 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$893.24
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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 67550 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
7,483
- Code
- 67550
- Physician work
- 11.48
- Practice expense
- 16.16
- Malpractice
- 0.98
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.48 | × 1.000 | 11.4800 |
| Practice expense | 16.16 | × 0.889 | 14.3662 |
| Malpractice | 0.98 | × 0.915 | 0.8967 |
| Total RVUs | 26.7429 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$893.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.48 | 1 |
| Practice expense | 16.16 | 0.889 |
| Malpractice | 0.98 | 0.915 |
(11.48 × 1 + 16.16 × 0.889 + 0.98 × 0.915) × $33.4009 = $893.24
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.
67550 billing questions
How does 67550 differ from implant placement during enucleation?
67550 is for a separate operation to place the implant in an existing anophthalmic socket. When an implant is placed during enucleation, use the applicable enucleation code, such as 65103.
Can 67550 be reported with evisceration?
When implant placement accompanies evisceration in the same operation, use the applicable evisceration code, such as 65112. 67550 describes separate implant placement.
What documentation supports 67550?
Document the anophthalmic socket, the implant placement, and attachment of the extraocular muscles. The record should establish that this was a separate operation rather than implant placement during globe removal.
How is bilateral 67550 reported?
For procedures on both orbits, report modifier 50. CMS pays bilateral procedures at 150%.
Is an assistant-at-surgery payable for 67550?
CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
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 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.
7,48067505,,Inject/treat eye socket,A,,1.15,1.31,,0.51,,0.08,2.54,1.74,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48167515,,Inject/treat eye socket,A,,0.73,0.76,,0.36,,0.06,1.55,1.15,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48267516,,Sprchoroidal spc njx rx agt,A,,1.49,2.02,,0.78,,0.12,3.63,2.39,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48367550,,Insert eye socket implant,A,,11.48,16.16,NA,16.16,,0.98,28.62,28.62,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48467560,,Revise eye socket implant,A,,11.88,16.27,NA,16.27,,1.06,29.21,29.21,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48567570,,Decompress optic nerve,A,,14.04,18.02,NA,18.02,,1.12,33.18,33.18,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,48667599,,Unlisted procedure orbit,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631