Billing code 65150: Ocular implant revisionMedicare rate & RVUs in Virginia
Revision of an existing orbital implant with graft material, reported when an ophthalmic surgeon addresses implant-related socket coverage or contour problems.
CMS doesn’t publish an office rate for 65150 in Virginia.
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 65150 covers
billing code 65150 describes revision of an existing orbital implant using graft material. An ophthalmologist, often an oculoplastic surgeon, performs the operation in an operating room for an anophthalmic socket, such as after enucleation or evisceration. Situations may include implant exposure or inadequate tissue coverage that requires grafting as part of the revision. This is an orbital socket implant, not an intraocular lens.
Report 65150 when the surgeon revises the existing implant and uses a graft; the operative note should identify the implant, the revision performed, the graft, and the reason for surgery. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are 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.
Where 65150 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $715.06 |
| Virginia | Unavailable | $618.35 |
How the 65150 rate is calculated
Each of 65150’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 · 65150
RVUs × geographic indexes × conversion factor
Work6.27
6.27 RVUs× 1.000 GPCI
Practice expense12.11
12.11 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
18.8600
Conversion factor
$33.4009
Medicare rate
$629.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 65150
65150 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 65150
Ocular implant revision
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 65150
Ocular implant revision
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
65150 without 50 · national facility
$629.94
Ocular implant revision
65150-50 · Bilateral: 150%
$944.91
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).
65150 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 65125Ocular implant revision
- 65125 describes ocular implant revision without a graft; 65150 is the graft-based revision.
- 65155Ocular implant
- Choose 65155 for reinsertion of an existing implant. Choose 65150 when the work is graft-assisted revision of the implant.
- 65175Ocular implant removal
- 65175 describes removal of an ocular implant. It does not represent graft-assisted revision of an implant left in place.
- 65130Ocular implant insertion
- 65130 describes insertion of an ocular implant; 65150 revises an implant that is already present.
65150 billing questions
How does 65150 differ from 65125?
65150 is the graft-based revision. Use 65125 for revision without a graft.
Does 65150 describe placing a new orbital implant?
No. It describes graft-assisted revision of an existing implant. A new implant placement is a different service.
What should the operative note document?
Document the existing implant, the specific revision, the graft used, and the clinical problem, such as implant exposure or inadequate tissue coverage.
How is bilateral 65150 reported?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant-at-surgery be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are 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
Fee sheets
Put 65150 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →