No office rate
Use 65101 for enucleation without an implant. Code 65103 includes implant placement and attachment of the extraocular muscles.
On this page
CMS RVU26D · Effective 2026-10-01
65103 Eye removal Medicare reimbursement rates in Wyoming
Reports removal of the entire globe with placement of an orbital implant and attachment of the extraocular muscles to the implant. Compare 65103 office and facility rates across CMS payment localities in Wyoming.
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 65103 in Wyoming?
Wyoming 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
$774.67
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Ophthalmic surgery
About 65103: Eye enucleation with implant and muscle attachment
Reports removal of the entire globe with placement of an orbital implant and attachment of the extraocular muscles to the implant.
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.
CMS billing rules for 65103
- 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 RVU8.62 · 37%
- Practice expense (office) RVU14.07 · 60%
- Malpractice RVU0.68 · 3%
152
Medicare services in 2024 · #4556 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.
65103 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Both describe implant-and-muscle enucleation, but 65105 also includes a temporary tarsorrhaphy.
No office rate
65112 is evisceration with an implant, removing the eye's contents while retaining the scleral shell; 65103 removes the globe intact.
Compare 65103 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$774.67
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 65103 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
7,291
- Code
- 65103
- Physician work
- 8.62
- Practice expense
- 14.07
- Malpractice
- 0.68
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.62 | × 1.000 | 8.6200 |
| Practice expense | 14.07 | × 1.000 | 14.0700 |
| Malpractice | 0.68 | × 0.740 | 0.5032 |
| Total RVUs | 23.1932 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$774.67
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.62 | 1 |
| Practice expense | 14.07 | 1 |
| Malpractice | 0.68 | 0.74 |
(8.62 × 1 + 14.07 × 1 + 0.68 × 0.74) × $33.4009 = $774.67
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.
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 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.
7,28865091,,Revise eye,A,,7.08,12.20,NA,12.20,,0.56,19.84,19.84,0,090,0.10,0.70,0.20,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,28965093,,Revise eye with implant,A,,6.86,12.34,NA,12.34,,0.55,19.75,19.75,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29065101,,Removal of eye,A,,8.09,14.01,NA,14.01,,0.64,22.74,22.74,0,090,0.10,0.70,0.20,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29165103,,Remove eye/insert implant,A,,8.62,14.07,NA,14.07,,0.68,23.37,23.37,0,090,0.10,0.70,0.20,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29265105,,Remove eye/attach implant,A,,9.68,14.91,NA,14.91,,0.79,25.38,25.38,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29365110,,Removal of eye,A,,15.31,17.77,NA,17.77,,1.23,34.31,34.31,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,29465112,,Remove eye/revise socket,A,,18.05,19.63,NA,19.63,,1.44,39.12,39.12,0,090,0.10,0.70,0.20,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,