$434.30
Choose 65175 when the implant is removed. Choose the revision code when the operation revises the implant rather than taking it out.
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CMS RVU26D · Effective 2026-10-01
65175 Ocular implant removal Medicare reimbursement rates in Utah
Removal of an existing ocular implant, such as an orbital implant after eye removal, when the implant itself must be taken out. Compare 65175 office and facility rates across CMS payment localities in Utah.
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 65175 in Utah?
Utah 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
$671.12
1 of 1 localities have a supported rate.
Payment area: Utah
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.
Ophthalmology surgery
About 65175: Removal of an ocular implant
Removal of an existing ocular implant, such as an orbital implant after eye removal, when the implant itself must be taken out.
An ophthalmologist, often an oculoplastic surgeon, removes an existing implant from the orbit or socket. This may be needed when an implant becomes exposed, displaced, or infected. The service concerns removal of the implant, not removal of the eye or evisceration of its contents. It is typically performed in an operating-room setting; 2024 Medicare claims show facility use for this code.
Report 65175 when the documented operation removes the ocular implant. The operative note should identify the implant and describe its removal; if the surgeon instead revises or reinserts an implant, select the code that describes that work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral services, modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment is statutorily restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 65175
- 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 RVU7.22 · 34%
- Practice expense (office) RVU13.15 · 63%
- Malpractice RVU0.57 · 3%
82
Medicare services in 2024 · #5029 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.
65175 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
65175 captures implant removal; 65155 concerns reinsertion. The operative plan and documented work distinguish removal alone from putting an implant back.
No office rate
65101 describes removal of the eye without an implant. 65175 is for removal of an ocular implant, not removal of the eye itself.
No office rate
65103 describes removal of the eye with implant placement. 65175 describes removal of an existing implant.
Compare 65175 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
Utah →
Office / nonfacility
Unavailable
Facility
$671.12
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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 65175 in Utah.
PPRRVU2026_Oct_nonQPP.csv
7,302
- Code
- 65175
- Physician work
- 7.22
- Practice expense
- 13.15
- Malpractice
- 0.57
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.22 | × 1.000 | 7.2200 |
| Practice expense | 13.15 | × 0.940 | 12.3610 |
| Malpractice | 0.57 | × 0.898 | 0.5119 |
| Total RVUs | 20.0929 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$671.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.22 | 1 |
| Practice expense | 13.15 | 0.94 |
| Malpractice | 0.57 | 0.898 |
(7.22 × 1 + 13.15 × 0.94 + 0.57 × 0.898) × $33.4009 = $671.12
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.
65175 billing questions
When should 65175 be chosen instead of an implant revision code?
Use 65175 when the operation removes the implant. When the implant remains in place and is revised, report the applicable revision code instead.
Does 65175 describe removal of the eye?
No. It describes removal of the ocular implant. Enucleation or evisceration codes describe removal of the eye or its contents.
Can implant insertion be reported with 65175?
A separately performed insertion may be relevant when the surgeon removes the existing implant and places a new one during the same operation. The operative record should support both services; same-session procedures are subject to CMS multiple-procedure payment reduction.
What documentation supports 65175?
Document the implant being removed, the reason for removal, and the operative work showing that the implant was taken out rather than revised or reinserted.
How does the global period affect postoperative visits?
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.
7,29965140,,Attach ocular implant,A,,9.22,14.74,NA,14.74,,0.73,24.69,24.69,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30065150,,Revise ocular implant,A,,6.27,12.11,NA,12.11,,0.48,18.86,18.86,0,090,0.10,0.70,0.20,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30165155,,Reinsert ocular implant,A,,9.85,14.96,NA,14.96,,0.79,25.60,25.60,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30265175,,Removal of ocular implant,A,,7.22,13.15,NA,13.15,,0.57,20.94,20.94,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30365205,,Remove foreign body from eye,A,,0.48,0.34,,0.23,,0.02,0.84,0.73,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30465210,,Remove foreign body from eye,A,,0.59,0.52,,0.28,,0.03,1.14,0.90,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,30565220,,Remove foreign body from eye,A,,0.69,1.14,,0.35,,0.09,1.92,1.13,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985