No office rate
This code concerns removal of an eye lesion. Code 65920 is for removing implanted material from the anterior segment.
On this page
CMS RVU26D · Effective 2026-10-01
65920 Implant removal Medicare reimbursement rates in Massachusetts
Ophthalmic surgeons report this service when surgically removing implanted material from the eye’s anterior segment rather than repositioning or exchanging it. Compare 65920 office and facility rates across CMS payment localities in Massachusetts.
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 65920 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$698.35–$755.37
2 of 2 localities have a supported rate.
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 65920: Anterior segment implant removal
Ophthalmic surgeons report this service when surgically removing implanted material from the eye’s anterior segment rather than repositioning or exchanging it.
An ophthalmic surgeon uses this service to remove implanted material from the anterior portion of the eye when the material must be taken out, rather than left in place or repositioned. A previously placed anterior-segment device or other implant may require removal during operative treatment of an implant-related problem. The procedure is generally performed in an operating-room setting by an ophthalmologist.
Report the code for removal of the implant itself, not for a lesion excision or removal of an anterior-segment blood clot. The operative report should identify the implant and its location and describe the removal performed. CMS classifies the service as major surgery: 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 others at 50%. For bilateral reporting with modifier 50, payment is at 150%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 65920
- 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 RVU9.74 · 48%
- Practice expense (office) RVU9.86 · 48%
- Malpractice RVU0.79 · 4%
2.3K
Medicare services in 2024 · #2349 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.
65920 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
This code is for removing a blood clot from the anterior segment; code 65920 concerns implanted material.
$692.36–$759.16
Both involve removal of implanted material, but 67120 applies to the posterior segment rather than the anterior segment.
No office rate
Use 66986 for an intraocular lens exchange. Code 65920 describes removal of implanted material without identifying an exchange as the service.
Compare 65920 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$755.37
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$698.35
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65920 billing questions
How is this code different from repositioning an intraocular lens?
Use this code when implanted material is removed from the anterior segment. If an intraocular lens is repositioned and remains in the eye, consider the repositioning service instead.
Does the 90-day global period include postoperative care?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the major-surgery global period.
How is bilateral removal reported?
When the procedure is performed bilaterally, report modifier 50; CMS payment for the bilateral procedure is at 150%.
Can an assistant at surgery be paid for this procedure?
No. CMS lists a statutory restriction on assistant-at-surgery payment for this code.
What documentation supports reporting this code?
Document what implanted material was removed, its anterior-segment location, and the removal performed. Co-surgeon payment requires supporting documentation.
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.
7,35565875,,Incise inner eye adhesions,A,,7.61,8.20,NA,8.20,,0.60,16.41,16.41,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35665880,,Incise inner eye adhesions,A,,8.15,8.38,NA,8.38,,0.64,17.17,17.17,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35765900,,Remove eye lesion,A,,12.20,12.25,NA,12.25,,0.99,25.44,25.44,0,090,0.10,0.70,0.20,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35865920,,Remove implant of eye,A,,9.74,9.86,NA,9.86,,0.79,20.39,20.39,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,35965930,,Remove blood clot from eye,A,,8.18,7.58,NA,7.58,,0.64,16.40,16.40,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36066020,,Injection treatment of eye,A,,1.60,4.16,,1.68,,0.13,5.89,3.41,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,36166030,,Injection treatment of eye,A,,1.27,3.93,,1.56,,0.09,5.29,2.92,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00