65112 Eye evisceration Medicare reimbursement rates in Washington

This operation removes the eye’s internal contents while preserving the scleral shell and placing an orbital implant. An ophthalmologist, typically an oculoplastic or other ophthalmic surgeon, may perform it in a hospital or ambulatory surgery setting for a severely damaged or painful eye. Evisceration is distinct from enucleation, which removes the globe itself. The implant and the muscle-attachment details help distinguish this service from nearby procedures.

Report 65112 when the operative record supports evisceration with implant placement, rather than evisceration without an implant or enucleation. Documentation should identify the procedure performed, the implant placement, and relevant operative findings. The CMS global period is 90 days and includes the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation. Team surgery is not permitted.