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See a sample rate comparisonCPT 65135 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Insertion Of Ocular Implant Se, Insertion Of Ocular Implant Secondary After Enucleationmuscles Not Attached To Implant Insertion Of Ocular Implant Secondary After Enucleation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Eye and Ocular Adnexa |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 65135 |
| Medicaid Fee Schedule | View Medicaid rates for 65135 |
National average reimbursement for CPT 65135 by major payers:
$994.04
$996.03
$1,134.89
$1,324.24
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CPT 65135
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center, Memorial Hermann Surgery Center, The Woodlands
Memorial Hermann Surgery Center
$6,904.00Published rateFairfield Surgery Center, LLC
Fairfield Surgery Center LLC
$3,161.00Published rateCorona Surgical LLC, Corona Summit Surgical Center
Corona Surgical LLC
$2,274.00Published rateSurgery Center Of Anaheim Hills, LLC
Surgery Center Of Anaheim Hills LLC
$1,500.00Published rateMid-Michigan Endoscopy Center, PLLC, Charter Endoscopy Center
Mid Michigan Endoscopy Center
$640.00Published rate
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See a sample payer proposalCPT 65135 vs. Other Surgical Procedures on the Eye and Ocular Adnexa Codes
The CPT 65135 code is part of the Surgery services used for Surgical Procedures on the Eye and Ocular Adnexa. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 65135 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 65112-CPT | High | Remove Eye Socket Contents, Surgery To Remove The Orbital Contents (Includes Eyeball Muscles Nerves And Blood Vessels). May Include Removal Of Bone. |
| 65114-CPT | High | Remove Eye Socket Contents, Surgery To Remove The Orbital Contents (Includes Eyeball Muscles Nerves And Blood Vessels). May Include Removal Of Bone. |
| 65125-CPT | Moderate | Modification Of Ocular Implant, Modification Of Ocular Implant With Placement Or Replacementof Pegs (Eg Drilling Receptacle For Prosthesis Appendage) (Separate Procedure) |
| 65135-CPT | Moderate | Insertion Of Ocular Implant Se, Insertion Of Ocular Implant Secondary After Enucleationmuscles Not Attached To Implant Insertion Of Ocular Implant Secondary After Enucleation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 65135. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 65135 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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