2025 CPT code 66183
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Surgery Feed
Insertion of an anterior segment aqueous drainage device, without an extraocular reservoir, using an external approach.
Modifiers may be applicable depending on the circumstances.Refer to the modifier list and consider using modifiers such as -22 (increased procedural services), -51 (multiple procedures), -52 (reduced services), or others as appropriate.
Medical necessity for this procedure is established when a patient has glaucoma with uncontrolled intraocular pressure despite maximal medical therapy.Documentation must demonstrate the failure of previous medical management and the clinical need for surgical intervention to prevent vision loss.
The ophthalmologist is responsible for performing the surgery, including pre-operative assessment, surgical technique (scleral flap creation, device implantation, and watertight closure), and post-operative care.Anesthesiology may be provided by a separate provider.
In simple words: A small device is surgically placed into the front part of the eye to lower eye pressure in patients with glaucoma who haven't responded to other treatments. This helps drain fluid from the eye, reducing pressure.
This procedure involves the surgical insertion of an anterior segment aqueous drainage device into the eye's anterior chamber.The device is implanted without the use of an extraocular reservoir, employing an external approach. This is a surgical modification of a trabeculectomy, typically used to manage medication-refractory intraocular pressure (IOP) in glaucoma patients. The procedure includes creating a scleral flap (fornix-based partial thickness or limbal-based), possibly utilizing mitomycin-C, creating an anterior chamber needle tract, inserting the device, and achieving a watertight closure of the scleral flap.The device facilitates aqueous humor drainage, reducing IOP.
Example 1: A 65-year-old male patient with uncontrolled glaucoma despite maximal medical therapy undergoes implantation of an Ex-PRESS® shunt. The procedure is performed under retrobulbar anesthesia., A 72-year-old female patient with refractory glaucoma, previously having undergone unsuccessful trabeculectomy, receives a Solx® gold shunt implant.A limbal-based scleral flap is used., A 58-year-old patient with neovascular glaucoma presents for implantation of an Aquashunt® implant.Mitomycin-C is used to manage scarring.Postoperative care includes IOP monitoring.
Preoperative documentation should include a complete ophthalmologic exam, including IOP measurement, visual acuity, gonioscopy, and optic nerve assessment. Intraoperative documentation should describe the surgical technique (flap type, device used, and complications). Postoperative documentation should include IOP measurements, visual acuity, and assessment of the surgical site.
** The specific device used (e.g., Ex-PRESS®, Solx®, Aquashunt®) may be documented in the medical record, but is not part of the code itself.Appropriate ICD-10 codes should accompany this CPT code to accurately reflect the diagnosis.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- RVU: This information requires access to a specific payer's fee schedule and may vary based on geographic location, facility type, and other factors. RVUs are not directly provided in the source data.
- Global Days : The global surgical period for this procedure isn't explicitly defined in the provided data.It would likely be determined by payer-specific guidelines and could range from 0 to 90 days post-operation.
- Payment Status: Active
- Modifier TC rule: The application of a technical component (TC) modifier depends on payer-specific guidelines and the arrangement between the surgeon and the facility where the procedure is performed.Refer to payer guidelines for clarification.
- Fee Schedule : Historical fee schedule data is not included in this source. Consult a fee schedule database for specific historical reimbursement rates.
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Office, Inpatient Hospital