CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 65135 RVU and Medicare Payment (2026)
Insert ocular implant — 8.39 work RVU, about $770.22 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 8.39
- PE RVU (non-facility)
- 14.01
- PE RVU (facility)
- 14.01
- MP RVU
- 0.66
- Office payment
- $770.22
- Facility payment
- $770.22
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 65135 in a non-facility setting with national GPCI: (8.39 + 14.01 + 0.66) × $33.4009 ≈ $770.22. The same code in a facility setting pays about $770.22 because facility PE RVU (14.01) replaces office PE RVU.
What changes by locality
GPCI moves 65135 non-facility payment from $693.55 to $997.65 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 65135?
8.39. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 65135 in 2026?
About $770.22 non-facility ($770.22 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (8.39) and malpractice RVU stay fixed; only practice expense changes (14.01 office vs 14.01 facility). That is the entire office-vs-facility payment gap.