Billing code 65103: Eye removalMedicare rate & RVUs in Utah
Reports removal of the entire globe with placement of an orbital implant and attachment of the extraocular muscles to the implant.
CMS doesn’t publish an office rate for 65103 in Utah.
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 65103 covers
An ophthalmic surgeon removes the globe intact and places an implant in the orbit, attaching the extraocular muscles to the implant. This enucleation may be performed for an intraocular malignancy or a severely damaged, blind, painful eye. The service is generally performed in a hospital or ambulatory surgical setting; Medicare recorded facility services for this code in 2024.
Select this code when the operative report supports enucleation, implant placement, and muscle attachment. Documentation should identify the eye, the reason for removal, and the implant and muscle work performed; use a different code when no implant is placed or when the procedure is evisceration rather than enucleation. The procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 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.
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.
65103 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $750.07 |
How the 65103 rate is calculated
Each of 65103’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 · 65103
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.62Practice expense 14.07Malpractice 0.68
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 65103
65103 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65103
Eye removal
| 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 · 65103
Eye removal
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
65103 without 50 · national facility
$780.58
Eye removal
65103-50 · Bilateral: 150%
$1,170.87
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).
65103 compared with similar codes
Compare codes
65103 vs 65101 vs 65105 vs 65112: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65101Eye removal
- Use 65101 for enucleation without an implant. Code 65103 includes implant placement and attachment of the extraocular muscles.
- 65105Eye removal
- Both describe implant-and-muscle enucleation, but 65105 also includes a temporary tarsorrhaphy.
- 65112Eye evisceration
- 65112 is evisceration with an implant, removing the eye's contents while retaining the scleral shell; 65103 removes the globe intact.
65103 billing questions
How is this different from 65101?
65103 includes an orbital implant with the extraocular muscles attached. Use 65101 when the globe is removed without an implant.
How is this different from 65105?
65105 describes the implant-and-muscle enucleation with a temporary tarsorrhaphy. Report 65103 when that additional procedure is not performed.
Can enucleation and implant placement be billed as separate procedures?
The implant placement and muscle attachment are part of the service described by 65103. Do not separately report a code for those same steps.
What documentation supports 65103?
The operative report should establish removal of the entire globe, placement of an orbital implant, attachment of the extraocular muscles, and the eye treated.
How does Medicare handle bilateral reporting and other procedures in the same session?
Modifier 50 is paid at 150% for bilateral performance. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.
Is an assistant surgeon payable for this procedure?
Medicare's assistant-at-surgery payment is subject to a statutory restriction for this code. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
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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