2025 CPT code 67550
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Ocular Adnexa Surgery Feed
Insertion of an orbital implant (placed outside the muscle cone).
Modifiers may be applicable. Common modifiers include 22 (increased procedural services), 50 (bilateral procedure), 78 (return to the operating room), and others as appropriate.
Medical necessity is established by the underlying condition requiring eye removal (e.g., malignancy, trauma, infection) and the need to restore orbital volume and support a prosthetic eye for cosmetic and functional purposes.
The ophthalmologist or oculoplastic surgeon performs the procedure under general anesthesia. They prepare the socket, carefully fit and position the implant outside the muscle cone, secure it with sutures, and close the conjunctiva over the implant.
In simple words: A surgery to place an artificial eye into the eye socket after an eye has been removed. The artificial eye is placed outside the eye muscles to help maintain the shape of the eye socket and allow for a more natural appearance with a prosthetic eye.
This procedure involves the insertion of a prosthetic implant into the eye socket (orbit) outside of the muscle cone, which is the point where the extraocular muscles converge. This is typically done to restore volume and support to the orbit after eye removal (enucleation or evisceration). The implant is positioned and secured, and the conjunctiva is closed over it. This procedure prepares the socket for a prosthetic eye.
Example 1: A patient undergoes enucleation (eye removal) due to a malignant melanoma of the eye. An orbital implant (67550) is inserted to maintain orbital volume and support a prosthetic eye., A patient who has had a previous evisceration (removal of eye contents) experiences socket contracture, making it difficult to wear a prosthetic eye. An orbital implant (67550) is inserted to expand the socket and improve the fit of the prosthesis., A child with a congenital absence of an eye undergoes placement of an orbital implant (67550) to promote symmetrical facial development as they grow.
Documentation should include the reason for eye removal (diagnosis), type of implant used, surgical technique, and any complications encountered.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- Payment Status: Active
- Specialties:Ophthalmology, Oculoplastic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient