CPT CODE
|
DESCRIPTION OF SERVICE
|
FEE
|
|
EYEBALL – REMOVAL OF EYE
|
|
65091
|
EVISCERATION OF EYE, WITHOUT IMPLANT
|
389.63
|
|
|
|
65093
|
EVISCERATION OF EYE WITH IMPLANT
|
388.84
|
|
|
|
65101
|
ENUCLEATION WITHOUT IMPLANT
|
448.91
|
|
|
|
65103
|
ENUCLEATION W/IMPLANT, MUSCLES NOT ATTACHED
|
469.19
|
|
|
|
65105
|
ENUCLEATION W/IMPLANT, MUSCLES ATTACHED TO IMPLANT
|
517.99
|
|
|
|
65110
|
EXENTERATION OF ORBIT W/O SKIN GRAFT REM ORBIT CONTENT
|
757.20
|
|
|
|
65112
|
EXENTERATION, W/THERAPEUTIC REMOVALOF BONE
|
890.15
|
|
|
|
65114
|
EXENTERATION, WITH MUSCLE OR MYOCUTANEOUS FLAP
|
927.92
|
|
|
|
|
SECONDARY IMPLANT(S) PROCEDURES
|
|
|
|
|
65125
|
MODIFICATION, OCULAR IMPLANT (SEPARATE PROCEDURE)
|
275.36
|
|
|
|
65130
|
EVISCERATION, EYE IMPLANTATION IN SCLERAL SHELL
|
444.63
|
|
|
|
65135
|
AFTER ENUCLEATION, MUSCLES NOT ATTAHCED TO IMPLANT
|
452.88
|
|
|
|
65140
|
AFTER ENUCLEATION, MUSCLES ATTACHED TO IMPLANT
|
493.55
|
|
|
|
65150
|
REINSERTION/OCULAR IMPLANT W/WO CONJUNCTIVAL GRAFT
|
356.78
|
|
|
|
|
65155
|
WITH USE OF FOREIGN MATERIAL FOR REINFORCEMENT AND/OR ATTACHMENT OF MUSCLES TO IMPLANT
|
520.71
|
|
|
|
65175
|
REMOVAL OCULAR IMPLANT
|
400.19
|
|
REMOVAL OF FOREIGN BODY
|
|
65205
|
REMOVAL FOREING BODY EXTERNAL EYE CONJUNCTIVA
|
35.39
|
CPT
|
DESCRIPTION OF SERVICES
|
FEE
|
|
REMOVAL OF FOREIGN BODY
|
|
|
65210
|
REMOVAL EMBEDDED CONJUNCTIVAL/SCLERAL NONPERFORATING
|
43.25
|
|
|
|
65220
|
REMOVAL, CORNEAL WITHOUT SLIT SLAMP
|
36.15
|
|
|
|
65222
|
REMOVAL, CORNEAL WITH SLIT LAMP
|
47.56
|
|
|
|
65235
|
REMOVAL, INTRAOCULAR, ANTERIOR CHAMBER OR LENS
|
429.03
|
|
|
|
|
|
|
65260
|
REMOVAL, POSTERIOR SEGMENT MAGNETIC EXTRACTION
|
588.65
|
|
|
|
65265
|
REMOVAL, POSTERIOR SEGMENT NONMAGNETIC EXTRACTION
|
663.29
|
|
REPAIR OF LACERATION
|
|
|
|
|
65270
|
REPAIR LACERATION CONJUNCTIVA W-W/O DIRECT CLOSURE
|
161.68
|
|
|
|
65272
|
REPAIR CONJUNCTIVA MOBILE & REARRANGE W/O HOSPITAL
|
300.48
|
|
|
|
65273
|
REPAIR CONJUNCTIVA MOBILE & RERRANGE W/HOSPITAL
|
234.23
|
|
|
|
65275
|
REPAIR CORNEA NONPERFORATING W-W/O REM FORGN BODY
|
339.37
|
|
|
|
65280
|
CORNEA AND/OR SCLERA, PEFORATING, NOT INVOLVING UVEAL TISSUE
|
411.04
|
|
|
|
65285
|
CORNEA/SCLERA, PERFORATING W/REPOSITION OR RESECTION OF UVEAL TISSUE
|
642.35
|
|
|
|
65286
|
APPLICATION, TISSUE GLUE, WOUNDS CORNEA/SCLERA
|
425.44
|
|
|
|
65290
|
REPAIR WOUND, EXTRAOCULAR MUSCLE TENDON - CAPSULE
|
301.30
|
|
CORNEA- Excision
|
|
65400
|
EXCISION LESION, CORNEA EXCEPT PTERYGIUM
|
407.34
|
|
|
|
65410
|
BIOPSY, CORNEA
|
88.37
|
|
|
|
65420
|
EXCISION OR TRANSPOSITION OF PTERYGIUM WITHOUT GRAFT
|
311.02
|
|
|
|
|
|
|
CPT CODE
|
DESCRIPTION OF SERVICE
|
FEE
|
|
CORNEA- REMOVAL OR DESTRUCTION
|
|
65426
|
EXCISION OR TRANSPOSITION OF PTERYGIUM WITH GRAFT
|
393.74
|
|
|
|
65430
|
SCRAPING CORNEA, DIAGNOSTIC, FOR SMEAR/CULTURE
|
72.06
|
|
|
|
65435
|
REMOVAL CORNEAL EPITHELIUM W-W/O CHEMOCAUTHERIZATIO
|
49.58
|
|
|
|
65436
|
REMOVAL WITH APPLICATION CHELATING AGENT (EDTA)
|
236.09
|
|
|
|
65450
|
DESTRUCTION LESION CORNEA (CRYTO/PHOTO/THERMO)
|
194.12
|
|
|
|
65600
|
MULTIPLE PUNCTURES OF ANTERIOR CORNEA
|
|
|
|
|
|
KERATOPLASTY (Corneal Transplant)
|
|
65710
|
KERATOPLASTY (CORNEAL TRANSPLANT), ANTERIOR LAMELLAR
|
677.77
|
|
|
|
65730
|
KERATOPLASTY, PENETRATING (EXCEPT APHAKIA OR PSEUDO)
|
754.53
|
|
|
|
65750
|
KERATOPLASTY PENETRATING (IN APHAKIA)
|
765.81
|
|
|
|
65755
|
KERATOPLASTY, PENETRATING (IN PSEUDOPHAKIA)
|
761.32
|
|
|
|
65756
|
KERTOPLASTY ENDOTHELIAL
|
734.32
|
|
|
|
65757
|
BACKBENCH PREPARATION OF CORNEAL ENDOTHELIAL ALLOGRAFT PRIOR TO TRANSPLANTATION (USE IN CONJUCTION WITH 65756)
|
M
|
|
|
|
65760
|
KERATOMILEUSIS
|
873.97
|
|
|
|
65765
|
KERATOPHAKIA
|
873.97
|
|
|
|
65767
|
EPIKERATOPLASTY
|
873.97
|
|
|
|
65770
|
KERATOPROSTHESIS
|
876.31
|
|
|
|
65772
|
CORNEAL RELAXING INCISION SURGICALLY INDUCED ASTIGMATISM
|
272.66
|
|
|
|
65775
|
CORNEAL WEDGE RESECTION CORRECTION SURG. ASTIIGMATISM
|
336.34
|
|
|
|
CPT CODE
|
DESCRIPTION OF SERVICE
|
FEE
|
|
ANTERIOR CHAMBER - INCISION
|
|
65800
|
PARACENTESIS, ANTERIOR CHAMBER W/DIAGNOSTIC ASP
|
94.11
|
|
|
|
|
65810
|
PARACENTESIS W/REMOVAL OF VITREOUS AND/OR DISCISSION HYALOID MEMBRANE, WITH/WO AIR INJECTION
|
285.11
|
|
|
|
65815
|
PARACENTESIS, W/REML BLOOD W-W/O IRRIGATION/AIR
|
385.37
|
|
|
|
65820
|
GONIOTOMY
|
458.06
|
|
|
|
65850
|
TRABECULTOMY AB EXTERNO
|
523.57
|
|
|
|
65855
|
LASER TRABECULOPLASTY; ONE OR MORE SESSIONS
|
208.44
|
|
|
|
65860
|
SEVERING ADHESIONS OF ANTERIOR SEGMENT, LASER
|
192.38
|
|
|
|
65865
|
SEVERING ADESIONS OF ANTERIOR SEGMENT OF EYE
|
291.55
|
|
|
|
65870
|
ANTERIOR SYNCHEIAE
|
360.33
|
|
|
|
65875
|
POSTERIOR SYNECHIAE
|
383.00
|
|
|
|
65880
|
SEVERING CORNEOVITREAL ADHESIONS (BR)
|
403.95
|
|
|
|
|
ANTERIOR CHAMBER - REMOVAL
|
|
|
65900
|
REMOVAL OF EPITHELIAL DOWNGROWTH, ANTERIOR CHAMBER OF EYE
|
593.29
|
|
|
|
65920
|
REMOVAL OF IMPLANTED MARTERIAL, ANTERIOR CHAMBER
|
479.74
|
|
|
|
65930
|
REMOVAL OF BLOOD CLOT, ANTERIOR SEGMENT
|
395.23
|
|
|
|
66020
|
INJECTION, ANTERIOR CHAMBER, AIR/LIQUID, SEP PROC
|
113.08
|
|
|
|
66030
|
INJECTION, ANTERIOR CHAMBER, MEDICATION
|
99.69
|
|
ANTERIOR SCLERA - EXCISION
|
|
66130
|
EXCISION OF LESION, SCLERA
|
431.76
|
