Billing code 65130: Ocular implant insertionMedicare rate & RVUs in Nevada
Reports insertion of an ocular implant with extraocular muscles attached, typically when placing an implant in an anophthalmic socket.
CMS doesn’t publish an office rate for 65130 in Nevada.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 65130 covers
An ophthalmic or oculoplastic surgeon inserts an implant into an anophthalmic socket and attaches the extraocular muscles to the implant. This is distinct from removing the eye and placing an implant during the same operation. The service is generally performed in an operating room when a patient needs implant placement in a socket after a prior eye removal or other circumstance leaving the socket without an implant.
Select this code when the operative report supports both implant insertion and attachment of the muscles; use the sibling code when the muscles are not attached. Document the socket and implant work, the muscle attachment, and whether another procedure was performed in the same session. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the global period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are reduced. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
65130 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $758.38 |
How the 65130 rate is calculated
Each of 65130’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 65130
RVUs × geographic indexes × conversion factor
Work8.21
8.21 RVUs× 1.000 GPCI
Practice expense13.94
13.94 RVUs× 1.000 GPCI
Malpractice0.65
0.65 RVUs× 1.000 GPCI
Adjusted RVUs
22.8000
Conversion factor
$33.4009
Medicare rate
$761.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 65130
65130 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65130
Ocular implant insertion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.70/0.20 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 65130
Ocular implant insertion
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
65130 without 50 · national facility
$761.54
Ocular implant insertion
65130-50 · Bilateral: 150%
$1,142.31
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
65130 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 65135Ocular implant
- Both report ocular implant insertion. Choose 65130 when the extraocular muscles are attached to the implant; choose 65135 when they are not.
- 65103Eye removal
- 65103 combines enucleation with implant placement. 65130 reports implant insertion into a socket without the eye-removal service.
- 65140Ocular implant
- 65140 concerns attachment of extraocular muscles to an implant. 65130 includes insertion of the implant with muscle attachment.
- 65125Ocular implant revision
- 65125 is for revision of an existing ocular implant, not insertion of an implant into the socket.
65130 billing questions
How does this differ from 65135?
Use 65130 when the extraocular muscles are attached to the inserted implant. Use 65135 when the implant is inserted without attaching the muscles.
Is this the code for implant placement during enucleation?
No. When the eye is removed and an implant is placed during that operation, consider the enucleation code that includes implant placement, such as 65103 when its requirements are met.
What documentation supports reporting 65130?
The operative report should establish that an ocular implant was inserted and that the extraocular muscles were attached to it. Document the socket and any other procedures performed in the same session.
Can the surgeon report routine postoperative visits separately?
Related postoperative care during the 90-day global period is included. The day-before preoperative visit is also included.
How are bilateral procedures and assistant surgeons handled?
CMS pays bilateral reporting with modifier 50 at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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