No office rate
65101 is enucleation without an implant. Choose 65105 when an orbital implant is placed and the extraocular muscles are attached to it.
On this page
CMS RVU26D · Effective 2026-10-01
65105 Eye removal Medicare reimbursement rates in Nebraska
Reports removal of an entire eye with placement of an orbital implant to which the extraocular muscles are attached during the same operation. Compare 65105 office and facility rates across CMS payment localities in Nebraska.
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 65105 in Nebraska?
Nebraska 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
$792.96
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 65105: Eye removal with muscle-attached implant
Reports removal of an entire eye with placement of an orbital implant to which the extraocular muscles are attached during the same operation.
An ophthalmic surgeon, often an oculoplastic surgeon, removes the entire globe and places an orbital implant, attaching the extraocular muscles to it. Enucleation may be selected for an intraocular malignancy, a severely damaged eye, or an irreversibly blind, painful eye. The implant replaces volume within the orbit; it is not the external ocular prosthesis worn later. These operations are commonly performed in a surgical facility.
Report 65105 when the operative record supports both removal of the globe and muscle attachment to the implant. Distinguish it from enucleation with an implant but no muscle attachment, and from removal without an implant. The note should identify the operative method, implant placement, and muscle attachment. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures receive the standard reduction. Modifier 50 for bilateral surgery is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 65105
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.68 · 38%
- Practice expense (office) RVU14.91 · 59%
- Malpractice RVU0.79 · 3%
718
Medicare services in 2024 · #3237 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.
65105 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
65103 includes an implant but not attachment of the extraocular muscles to it. That muscle attachment distinguishes 65105.
No office rate
65112 uses evisceration, removing ocular contents while retaining the scleral shell, rather than removing the entire globe as in 65105.
Compare 65105 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$792.96
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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 65105 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
7,292
- Code
- 65105
- Physician work
- 9.68
- Practice expense
- 14.91
- Malpractice
- 0.79
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.68 | × 1.000 | 9.6800 |
| Practice expense | 14.91 | × 0.923 | 13.7619 |
| Malpractice | 0.79 | × 0.378 | 0.2986 |
| Total RVUs | 23.7405 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$792.96
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.68 | 1 |
| Practice expense | 14.91 | 0.923 |
| Malpractice | 0.79 | 0.378 |
(9.68 × 1 + 14.91 × 0.923 + 0.79 × 0.378) × $33.4009 = $792.96
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.
65105 billing questions
How is 65105 different from 65103?
Both include enucleation and an implant. Use 65105 when the extraocular muscles are attached to the implant; 65103 describes an implant without that muscle attachment.
When is 65101 a better fit?
65101 describes enucleation without placement of an implant. Report 65105 when an implant is placed and the extraocular muscles are attached to it.
Does 65105 include the external eye prosthesis?
No. The implant is placed within the orbit during surgery; an external ocular prosthesis is a separate device fitted after healing.
What documentation supports reporting 65105?
The operative report should document removal of the globe, placement of the implant, and attachment of the extraocular muscles to that implant.
How does Medicare handle bilateral 65105?
CMS lists modifier 50 for bilateral reporting and pays the bilateral procedure at 150%. The code also has a 90-day global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted under the listed CMS rules.
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.
7,28965093,,Revise eye with implant,A,,6.86,12.34,NA,12.34,,0.55,19.75,19.75,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29065101,,Removal of eye,A,,8.09,14.01,NA,14.01,,0.64,22.74,22.74,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29165103,,Remove eye/insert implant,A,,8.62,14.07,NA,14.07,,0.68,23.37,23.37,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29265105,,Remove eye/attach implant,A,,9.68,14.91,NA,14.91,,0.79,25.38,25.38,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29365110,,Removal of eye,A,,15.31,17.77,NA,17.77,,1.23,34.31,34.31,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29465112,,Remove eye/revise socket,A,,18.05,19.63,NA,19.63,,1.44,39.12,39.12,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29565114,,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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068