CPT CODE LIST 2014-2015 (1)

8/19/2019 CPT CODE LIST 2014-2015 (1)

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CPT CODE LIST

CPT CODE LIST – 2014- 2015

CPTCODE

DESCRIPTION OF SERVICE FEE

EYEBALL – REMOVAL OF EYE65091 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 TOIMPLANT

51.99

65110 E!ENTERATION OF OR"IT W/O S#IN $RAFT REMOR"IT CONTENT

5.%0

6511% E!ENTERATION, W/THERAPEUTIC REMOVALOF"ONE

890.15

65114 E!ENTERATION, WITH MUSCLE OR MYOCUTANEOUSFLAP

9%.9%

SECONDARY IMPLANT(S) PROCEDURES

651%5 MODIFICATION, OCULAR IMPLANT &SEPARATEPROCEDURE'

%5.36

65130 EVISCERATION, EYE IMPLANTATION IN SCLERALSHELL

444.63

65135 AFTER ENUCLEATION, MUSCLES NOT ATTAHCED TOIMPLANT

45%.88

65140 AFTER ENUCLEATION, MUSCLES ATTACHED TOIMPLANT

493.55

65150 REINSERTION/OCULAR IMPLANT W/WO 356.8

8/19/2019 CPT CODE LIST 2014-2015 (1)


CON(UNCTIVAL $RAFT

65155WITH USE OF FOREI$N MATERIAL FORREINFORCEMENT AND/OR ATTACHMENT OFMUSCLES TO IMPLANT

5%0.1

6515 REMOVAL OCULAR IMPLANT 400.19

REMOVAL OF FOREIGN BODY 65%05 REMOVAL FOREIN$ "ODY E!TERNAL EYE

CON(UNCTIVA35.39

CPT DESCRIPTION OF SERVICES FEE

REMOVAL OF FOREIGN BODY

65%10REMOVAL EM"EDDED CON(UNCTIVAL/SCLERALNONPERFORATIN$ 43.%5

65%%0 REMOVAL, CORNEAL WITHOUT SLIT SLAMP 36.15

65%%% REMOVAL, CORNEAL WITH SLIT LAMP 4.56

65%35 REMOVAL, INTRAOCULAR, ANTERIOR CHAM"ER ORLENS

4%9.03

65%60 REMOVAL, POSTERIOR SE$MENT MA$NETICE!TRACTION

588.65

65%65 REMOVAL, POSTERIOR SE$MENT NONMA$NETICE!TRACTION

663.%9

REPAIR OF LACERATION

65%0 REPAIR LACERATION CON(UNCTIVA W)W/O DIRECTCLOSURE

161.68

65%% REPAIR CON(UNCTIVA MO"ILE * REARRAN$E W/OHOSPITAL

300.48

65%3 REPAIR CON(UNCTIVA MO"ILE * RERRAN$EW/HOSPITAL

%34.%3

65%5 REPAIR CORNEA NONPERFORATIN$ W)W/O REMFOR$N "ODY

339.3

65%80 CORNEA AND/OR SCLERA, PEFORATIN$, NOTINVOLVIN$ UVEAL TISSUE 411.04

8/19/2019 CPT CODE LIST 2014-2015 (1)


65%85 CORNEA/SCLERA, PERFORATIN$ W/REPOSITION ORRESECTION OF UVEAL TISSUE 64%.35

65%86 APPLICATION, TISSUE $LUE, WOUNDS

CORNEA/SCLERA

4%5.44

65%90 REPAIR WOUND, E!TRAOCULAR MUSCLE TENDON )CAPSULE

301.30

CORNEA- Exc!"#65400 E!CISION LESION, CORNEA E!CEPT PTERY$IUM 40.34

65410 "IOPSY, CORNEA 88.3

654%0 E!CISION OR TRANSPOSITION OF PTERY$IUMWITHOUT $RAFT

311.0%

CPTCODE


CORNEA- REMOVAL OR DESTRUCTION654%6 E!CISION OR TRANSPOSITION OF PTERY$IUM WITH

$RAFT393.4

65430 SCRAPIN$ CORNEA, DIA$NOSTIC, FORSMEAR/CULTURE

%.06

65435 REMOVAL CORNEAL EPITHELIUM W)W/OCHEMOCAUTHERI+ATIO

49.58

65436 REMOVAL WITH APPLICATION CHELATIN$ A$ENT&EDTA'

%36.09

65450 DESTRUCTION LESION CORNEA&CRYTO/PHOTO/THERMO'

194.1%

65600 MULTIPLE PUNCTURES OF ANTERIOR CORNEA

$ERATOPLASTY (C"%#&' T%'#!'#*)6510 #ERATOPLASTY &CORNEAL TRANSPLANT',

ANTERIOR LAMELLAR6.

6530 #ERATOPLASTY, PENETRATIN$ &E!CEPT APHA#IAOR PSEUDO'

54.53

8/19/2019 CPT CODE LIST 2014-2015 (1)


6550 #ERATOPLASTY PENETRATIN$ &IN APHA#IA' 65.81

6555 #ERATOPLASTY, PENETRATIN$ &IN PSEUDOPHA#IA' 61.3%

6556 #ERTOPLASTY ENDOTHELIAL 34.3%

655

"AC#"ENCH PREPARATION OF CORNEALENDOTHELIAL ALLO$RAFT PRIOR TO TRANSPLANTATION (USE IN CON+UCTION ,IT.5/5.)

M

6560 #ERATOMILEUSIS 83.9

6565 #ERATOPHA#IA 83.9

656 EPI#ERATOPLASTY 83.9

650 #ERATOPROSTHESIS 86.31

65% CORNEAL RELA!IN$ INCISION SUR$ICALLY INDUCEDASTI$MATISM

%%.66

655 CORNEAL WED$E RESECTION CORRECTION SUR$.ASTII$MATISM

336.34

CPTCODE


ANTERIOR CAMBER - INCISION65800 PARACENTESIS, ANTERIOR CHAM"ER

W/DIA$NOSTIC ASP94.11

65810PARACENTESIS W/REMOVAL OF VITREOUS AND/ORDISCISSION HYALOID MEM"RANE, WITH/WO AIRIN(ECTION

%85.11

65815 PARACENTESIS, W/REML "LOOD W)W/O

IRRI$ATION/AIR

385.3

658%0 $ONIOTOMY 458.06

65850 TRA"ECULTOMY A" E!TERNO 5%3.5

65855 LASER TRA"ECULOPLASTY ONE OR MORESESSIONS

%08.44

8/19/2019 CPT CODE LIST 2014-2015 (1)


65860 SEVERIN$ ADHESIONS OF ANTERIOR SE$MENT,LASER

19%.38

65865 SEVERIN$ ADESIONS OF ANTERIOR SE$MENT OF

EYE

%91.55

6580 ANTERIOR SYNCHEIAE 360.33

6585 POSTERIOR SYNECHIAE 383.00

65880 SEVERIN$ CORNEOVITREAL ADHESIONS &"R' 403.95

ANTERIOR CAMBER - REMOVAL

65900REMOVAL OF EPITHELIAL DOWN$ROWTH,ANTERIOR CHAM"ER OF EYE 593.%9

659%0 REMOVAL OF IMPLANTED MARTERIAL, ANTERIORCHAM"ER

49.4

65930 REMOVAL OF "LOOD CLOT, ANTERIOR SE$MENT 395.%3

660%0 IN(ECTION, ANTERIOR CHAM"ER, AIR/LI-UID, SEPPROC

113.08

66030 IN(ECTION, ANTERIOR CHAM"ER, MEDICATION 99.69

ANTERIOR SCLERA - ECISION66130 E!CISION OF LESION, SCLERA 431.6

66150 FISTUI+ATION OF SCLERA FOR $LAUCOMA TREPHINATION WITH IRIDECTOMY

5%6.38

CPTCODE

DESCRIPTION OF SERVICES FEE

ANTERIOR SCLERA - ECISION66155 THERMOCAUTERI+ATION WITH IRIDECTOMY 5%4.96

65160 SCLERECTOMY WITH PUNCH OR SCISSORS, WITHIRIDECTOMY

598.33

66165 IRIDENCLEISIS OR IRIDOTASIS 514.16

6610 TRA"ECLECTOMY A" E!TERNO IN A"SENCE OFPREVIOUS SUR$ERY

%4.53

8/19/2019 CPT CODE LIST 2014-2015 (1)


661% TRA"ECULECTOMY &INCLUED IN(ECTION OFANTIFI"ROTIC A$NT'

910.38

6514 TRANSLUMINAL DILATION OF A-UEOUS OUTFLOW

CANAL WITHOUT RETENTION OF DEVICE OR STENT 50.8%

6515 WITH RETENTION OF DEVICE OR STENT 6%3.%

AUEOUS SUNT66180 A-UEOUS SHUNT TO E!TRAOCULAR RESERVIOR

&MOLTENO'%3.63

66183INSERTION OF ANTERIOR SE$MENT A-UEOUSDRAINA$E DEVICE, WITHOUT E!TRAOCULARRESERVIOR, E!TERNAL APPROACH

59%.43

66185 REVISION OF A-UEOUS SHUNT E!TRAOCULARRESERVIOR

455.39

REPAIR OR REVISION66%%0 REPAIR OF SCLERAL STAPHYLOMA WITHOUT $RAFT 444.4

66%%5 REPAIR OF SCLERAL STAPHYLOMA WITH $RAFT 53.60

66%50 REVISION, REPAIR OPERATIVE WOUND OFANTERIOR SE$MENT

45%.81

IRIS CILIARY BODY 66500 IRIDOTOMY "Y STA" INCISION, E!CEPT

TRANSFI!ION%14.55

66505 IRIDOTOMY WITH TRANSFI!ION AS FOR IRIS "OM"E %34.9%

ECISION

66600IRIDECTOMY, WITH CORNEOSCLERAL OR CORNEALSECTION FOR REMOVAL OF LESION 500.01

66605 IRIDECTOMY WITH CYCLECTOMY 651.48CPTCODE


ECISION

666%5 IRIDECTOMY PERIPHERAL FOR $LAUCOMA %6%.69

66630 IRIDECTOMY SECTOR FOR $LAUCOMA 346.36

8/19/2019 CPT CODE LIST 2014-2015 (1)


66635 IRIDECTOMY OPTICAL 349.91

REPAIR66680 REPAIR OF IRIS, CILIARY "ODY &IRIDODIALYSIS' 31%.4

6668% SUTURE OF IRIS CILIARY "ODY &SEPERATEPROCEDURE'

39.84

DESTRUCTION6600 CILIARY "ODY DESTRUCTION DIATHERMY %3.30

6610 CYCLOPHOTOCOA$ULATION TRANSSCLERAL %68.85

6611 CYCOLPHOTOCOA$ULATION, ENDOSCOPIC 386.56

66%0 CILIARY "ODY DESTRUCTION CRYOTHERAPY %80.93

6640 CILIARY "ODY DESTRUCTION CYCLODIALYSIS %6.03

6661 IRIDOTOMY/IRIDECTOMY "Y LASER SUR$ERY &FOR$LAUCOMA PER SESSION' %3.58

666% IRIDOPLASTY, PHOTOCOA$ULATION &1 OR MORESESSIONS'

%86.94

660 DESTRUCTION OF CYST OR LESION IRIS OR CILIARY"ODY

319.0

LENS – INCISION668%0 DISCUSSION SECONDARY MEM"RANOUS

CATARACT &#NIFE'%40.38

668%1 LASER SUR$RY &YA$ LASER' &1 OR MORE STA$ES' 195.1

668%5

REPOSITIONIN$ OF INTRAOCULAR LENS

PROTHESIS, RE-UIRIN$ AN INCISION &SEPARATEPROCEDURE'

464.44

CPTCODE


LENS - REMOVAL

8/19/2019 CPT CODE LIST 2014-2015 (1)


66830 REMOVAL SECONDARY MEM"RANOUS CATARACT 43.09

66840 REMOVAL OF LENS ASPIRATION &ONE OR MORESESSIONS'

4%5.4

66850 REMOVALOF LENS PHACOFRA$MENTATION,W/ASPIRATION

486.10

6685% REMOVAL OF LENS PARS PLANA W)W/PVITRECTOMY

5%0.49

669%0 REMOVAL OF LENS INTRACAPSULAR 464.30

66930 REMOVAL OF LENS INTRACAPSULAR F/DISLOCATEDLENS

5%.90

66940 REMOVAL OF LENS E!TRACAPSULAR 49.01

INTRAOCULAR LEN PROCEDURES6698% E!TRACAPULAR CATARACT E!TRACTION W/IOL 661.11

66983 INTRACAPSULAR CATARACT E!TRACTION W/IOL 45.1

66984 E!TRACAPSULAR CATARACT E!TRACTION W/IOL 43.3

66985 INSERTION OF I.O.L. , &SECONDARY IMPLANT' NOT

ASSOCIATED WITH CONCURRENT CATARACTREMOVAL

46.61

66986 E!CHAN$E OF INTRAOCULAR LENS 5%.38

66990USE OF OPHTHALMIC ENDOSCOPE &LIST SEPARETLYIN ADDITION TO CODE FOR PRIMARY PROCEDURE' 59.16

VITREOUS6005 REMOVAL VITREOUS, ANTERIOR APPROACH

&S#Y/LIM"AL'%8.66

6010 REMOVAL VITREOUS, SU"TOTAL/MECHANICALVITRECTOMY

333.5

6015 ASPIRATION OR RELEASE OF VITREOUS PARSPLANA APPROACH

355.13

8/19/2019 CPT CODE LIST 2014-2015 (1)


60%5 IN(ECTION, VITREOUS SU"STITUTE, PARSPLANA/LIM"AL

440.1%

CPTCODE


VITREOUS

60%IMPLANTATION OF INTRAVITREAL DRU$ DELIVERYSYSTEM INCLUDES CONCOMITANT REMOVAL OFVITREOUS

5%.1%

60%8 INTRAVITREALM IN(ECTION OF PHARMACOLO$ICA$ENT

13%.30

6030 DISCUSSION, VITREOUS STRANDS W/O REML PARSPLANA

316.84

6031 SEVERIN$ OF VITREOUS STRANDS %34.%0

6036 VITRECTOMY, MECHANICAL, PARS PLANAAPPROACH

595.99

6039 VITRECTOMY, WITH FOCAL ENDOLASERPHOTOCOA$ULATION

6%.59

6040 VITRECTOMY WITH ENDOLASER, PANRETINALPHOTOCOA$ULATI 880.43

6041 VITRECTOMY WITH REMOVAL OF PRERETINALCELLULAR MEM"

8%5.40

604% VITRECTOMY WITH REMOVAL OF INTERNALLIMITIN$ MEM"R

946.31

6043 VITRECTOMY WITH REMOVAL OF SU"RETINALMEM"RANE

99%.%8

RETINA OR COROID - REPAIR6101 REPAIR RETINAL DETACHMENT &ONE OR MORE

SESSIONS'41.63

6105 PHOTOCOA$ULATION W)W/O DRAINA$ESU"RETINAL

43.33

8/19/2019 CPT CODE LIST 2014-2015 (1)


610 REPAIR OF RETINA DETACHMENT, SCLERAL"UC#LIN$

49.%%

6108 REPAIR, SCLERAL "UD#LIN$ W/VITRECTOMY 999.00

6110 "Y IN(ECTION OF AIR OR OTHER $AS &PNEUMATICRETINOPE!Y'

5%9.03

611%REPAIR "Y SCLERAL "UC#LIN$ OR VITRECTOMY, ONPATIENT HAVIN$ HAD PREVIOUS DETACHMENTREPAIR

8%4.09

6113 REPAIR OF COMPLE! RETINAL DETACHMENT 1,086.%8

6115 RELEASE ENCIRCLIN$ MATERIAL &POSTERIOR

SE$MENT'

300.%0

CPTCODE


RETINA OR COROID - REPAIR61%0 REMOVAL OF IMPLANTED MATERIAL, E!TRAOCULAR 39.11

61%1 REMOVAL OF IMPLANTED MATERIAL, INTRAOCULAR 558.0

PROPYLAIS6141 PROPHYLA!IS RETINAL DETACHMENT

DIATHERMY/CRYOTHERAP

316.06

6145 PROPHYSA!IS PHOTOCOA$ULATION LASER 318.93

DESTRUCTION6%08 DESTRUCTION OF LOCALI+ED LESION OF RETINA

1 SESSION366.53

6%10 PHOTOCOA$ULATION, LASER OR SENON ARC FOCAL LASER

4%9.38

6%18 RADIATION "Y IMPLANTATION OF SOURCE &INC.REMOVAL'

83.99

6%%0 DESTRUCTION OF LOCALI+ED LESION OF CHOROID 658.91

DESTRUCTION6%%1 PHOTODYNAMIC THERAPY &INCLUDES 184.95

8/19/2019 CPT CODE LIST 2014-2015 (1)


INTRAVENOUS INFUSION'

6%%5

PHTODYNAMIC THERAPY, &SECOND EYE' LISTSEPERATELY IN ADDITION TO PRIMARY CODE &USEIN CON(UNCTION WITH 6%%1' 19.34

6%% DESTRUCTION, E!TENSIVE/PRO$RESSIVERETINOPATHY

3%.58

6%%8 PHOTOCOA$ULATION PAN RETINAL &SAME EYE 6MONTHS'

3%.%

POSTERIOR SCLERA - REPAIR6%50 SCLERAL REINFORCEMENT WITHOUT $RAFT 48%.55

6%55 SCLERAL REINFORCEMENT WITH $RAFT 515.89

ORBIT – EPLORATION ECISIONDECOMPRESSION

6400

OR"ITOTOMY WITHOUT "ONE FLAP &FRONTAL OR TRANSCON(UNTIVAL APPROACH' FORE!PLORATION, WITH OR WITHOUT "IOPSY 53.3%

CPTCODE


ORBIT – EPLORATION ECISIONDECOMPRESSION

6405 OR"ITOTOMY WITH DRAINA$E ONLY 48.33

641% OR"ITOTOMY WITH REMOVAL OF LESION 530.95

6413 OR"ITOTOMY W/REMOVAL OF FOREI$N "ODY 530.99

6414 OR"ITOTOMY WITH REMOVAL OF "ONE FORDECOMPRESSION

819.03

6415 FINE NEEDLE ASPIRATION OF OR"ITAL CONTENTS 68.%3

64%0 OR"ITOTOMY W/"ONE FLAP/WINDOW LATERIAL APPW/LESION

1,018.%1

6430 O"ITOTOMY WITH REMOVAL OF FOREI$N "ODY 0.1

6440 OR"ITOTOMY WITH DRAINA$E 48.86

8/19/2019 CPT CODE LIST 2014-2015 (1)


6445 OR"ITOTOMY WITH REMOVAL OF "ONE FORDECOMPRESSION

8.80

6450 OR"ITOTOMY FOR E!PLORATION, WITH ORWITHOUT "IOPSY

%.08

ORBIT – OTER PROCEDURES

6500RETRO"UL"AR IN(ECTION MEDICATION &SEPARATEPROCEDURE, DOES NOT INCLUDE SUPPLY OFMEDICATION'

5.%0

6505 RETRO"U"AR IN(ECTIONS ALCOHOL 55.4

6515 IN(ECTION OF THERAPEUTIC AN$ENT INTO TENONCAPSULE

59.13

6550 OR"ITAL IMPLANT &OUTSIDE MUSCLE CONE'INSERTION

59.1

6560 REMOVAL OF REVISION 908.98

650 OPTIC NERVE DECOMPRESSION&INCISION/FENESTRATION

16.1

EYELIDS – ECISION DESTRUCTION6800 E!CISION OF CHALA+ION SIN$LE .0

6801 E!CISION OF CHALA+ION MULTIPLE, SAME LID 99.9%

CPTCODE


EYELIDS – ECISION DESTRUCTION600 "LEPHAROTOMY, DRAINA$E OF A"SCESS, EYELID 160.%3

610 SEVERIN$ OF TARSORRHPHY 134.89

615 CANTHOTOMY &SEPARATE PROCEDURE' 14%.43

6805 E!CISION OF CHALA+ION MULTIPLE, DIFFERENCELIDS

1%3.53

6808 E!CISION, $EN ANESTHESIA, RE-D HOSPSIN$LE/MULTI

%%3.%0

6810 "IOPSY EYELID 138.4

8/19/2019 CPT CODE LIST 2014-2015 (1)


68%0 CORRECTION OF TRICHIASIS EPILATION "YFORCEPS

3%.96

68%5 EPILATION, "Y ELECTROSUR$ERY OR

CRYOTHERPHY

8.5

6830 INCISION OF LID MAR$IN FOR TRICHIASIS 161.%8

6835 INCISION OF LID MAR$IN, WITH MUCOUSMEM"RANE $RAFT

%1.0

6840 E!CISION OF LESION EYELID &E!CEPT CHAL+AION' 169.31

6850 DESTRUCTION OF LESIONOFLID MAR$IN &UP TO 1CM'

136.41

TARSORRAPY 685 TEMPORARY CLOSURE OF EYELIDS "Y SUTURE

&FROST'105.89

6880 CONSTRUCTION, INTERMAR$INAL ADHESIONS,MEDIAN

%6.%1

688% WITH TRANSPOSITION OF TRASAL PLATE 341.59

REPAIR (BRO, PTOSIS

BLEPAROPTOSIS LID RETRACTION)6900 REPAIR OF "ROW PTOSIS 394.3%

6901 REPAIR OF "LEPHAROPTOSIS FRONTAL MUSCLE TECHNI-UE

4%5.9%

690% REPAIR FRONTAL MUSCLE TECHNI-UE W/FASCIALSLIN$

44%.46

CPTCODE


REPAIR (BRO, PTOSISBLEPAROPTOSIS LID RETRACTION)

6904&TARSO' LEVATOR RESECTION OR ADVANCEMENT,E!TERNAL APPROCAH 589.3

8/19/2019 CPT CODE LIST 2014-2015 (1)


CON+UNCTIVA – INCISION ANDDRAINAGE

680%0 INCISION OF CON(UNCTIVA, DRAINA$E OF CYST 3.%4

68040 E!PRESSION CON(UNCTIVAL FOLLICLESF/TRACHOMA

40.98

ECISION AND3OR DESTRUCTION68100 "IOPSY OF CON(UNCTIVA 105.1%

68110 E!ISION OF LESION OF CON(UNCTIVA UP TO 1 CM 136.8

68115 E!CISION OF LESIONOF CON(UNCTIVA OVER 1 CM 189.8

68130 E!CISION OF LESION/CON(UNCTIVA W/ AD(ACENTSCLERA

3%8.43

68135 DESTRUCTION OF LESION, CON(UNCTIVA 96.%8

IN+ECTION68%00 SU"CON(UCTIVAL IN(ECTIONS 13.14

CON+UNCTIVOPLASTY 683%0 CON(UNCTIVOPLASTY W/$RAFT OR

REARRAN$EMENT434.59

683%5 CON(UNCTIVOPLASTY W/"UCCAL MUCOUSMEM"RANE $RAFT

404.

683%6 CON(UNCTIVOPLASTY/ RECONSTRUCTION CUL)DE)SAC W/$)R

394.4%

68330 REPAIR SYM"LEMPHARON, CON(UNCTIOPLASTY, NO$RAFT

365.55

68335 REPAIR SY"LEPHARON W/FREE $RAFT

CON(/"UCCAL MUCO

395.6

68340DIVISION OF SYM"LEPHARON, WITH OR WITHOUTINSERTION OF CONFORMER OF CONTACT LENS 3%8.68

CPT DESCRIPTION OF SERVICES FEE

8/19/2019 CPT CODE LIST 2014-2015 (1)


CODE

OTER PROCEDURES68360 CON(UNCTIVAL FLAP "RID$E OR PARTIAL 3%1.1

6836% CON(UNCTIVAL FLAP TOTAL 401.1

LACRIMAL SYSTEM - INCISION68400 INCISION DRAINA$E LACRIMAL $LAND 169.95

684%0 INCISION, DRAINA$E LACRIMAL SAC 195.59

68440 SNIP INCISION OF LACRIMAL PUNCTUM 65.10

68500 E!CISION, LACRIMAL "LAND TOTAL E!CEPT FOR TUMOR

59.60

LACRIMAL SYSTEM - INCISION68505 E!CISION, LACRIMAL $LAND PARTICAL E!CEPT FOR

TUMOR600.95

68510 "IOPSY OF LACRIMAL $LAND %80.63

685%0 E!CISION OF LACRIMAL SAC 4%%.64

685%5 "IOPSY OF LACRIMAL SAC 1%.%

68530 REMOVAL FOREI$N "OYD OF DACRYOLITH,LACRIMAL PATH

%66.0

68540 E!CISION OF LACRIMAL $LAND TUMOR, FRONTALAPPROCAH

51.53

68550 E!CISION OF LACRIMAL $LAND TUMOR,W/OSTEOTOMY

0%.33

LACRIMAL SYSTEM -REPAIR

6800 PLASTIC REPAIR OF CANALICULI 368.89

6805 CORRECTION OF EVERTED PUNCTUM CAUTERY 145.15

68%0 DACRYOCYSTORHINOSTOMY &FISTULI+ATIONLACRIMAL SAC'

%68.%4

6845 CON(UNCTIVORHINOSTOMY &FIST CON(UNCTIVAL' 469.54

8/19/2019 CPT CODE LIST 2014-2015 (1)


W/O TU"E

6850 CON(UNCTIVORHINOSTOMY &FIST CON(UNCTIVA'W/TU"E

48%.88

CPTCODE


LACRIMAL SYSTEM -REPAIR6860 CLOSURE OF LACRIMAL PUNCTUM 1%3.00

6861 CLOSURE OF LACRIMAL PUNCTUM "Y PLU$ 89.9

680 CLOSURE OF LACRIMAL FISTULA &SEPARATEPROCEDURE'

365.9

68840 PRO"IN$ OF LACRIMAL CANALICULI, W)W/OIRRI$ATION

5.99

68850 IN(ECTION CONTRAST MEDIUMF/DARCRYOCYSTOPRAPHY

4%.88

DIAGNOSTIC ULTRASOUND - SCANS6510

%6

OPHTHALMIC ULTRASOUND, DIA$NOSTIC ")SCANAND -UANTITATIVE A)SCAN PERFORMED DURIN$ THE SAME PATIENT ENCOUNTER

INTREPRETATION

106.80

60.04

6511%6

-UANTITATIVE A)SCAN ONLYINTREPRETATION

69.%436.%5

651%%6

")SCAN &W)W/O SUPERIMPOSED NON)-UANTITATIVE A)SCAN'INTREPRETATION

64.9036.38

6513

%6

ANTERIOR SE$MENT ULTRASOUND, IMMERSION&WATER "ATH' ")SCAN OR HI$HER RESOLUTION"IOMICROSCOPY0INTREPRETATION

59.33

%4.94

6514%6

CORNEAL PACHYMETRY, UNILATERIAL OR"ILATERALINTREPRETATION

9.116.69

8/19/2019 CPT CODE LIST 2014-2015 (1)


6516%6

OPHTHALMIC "IOMETRY "Y ULTRASOUNDECHO$RAPHY, A)SCAN

INTREPRETATION

4.5%0.6

6519

%6

OPTHALMIC "IOMETRY ULTRASD E$RAPHY A)SCAN

W/ LENSINTREPRETATION

50.86

%0.93

OPTALMOLOGY – NE, PATIENT9%00% INTERMEDIATE EYE E!AM NEW PATIENT 49.48

9%004 COMPREHENSIVE EYE E!AM NEW PATIENT 93.50

CPTCODE


LO, VISION EAM

9%005 LOW VISION E!AMINATION &SCC" CLINIC' 95.00ESTABLISED PATIENT9%01% INTERMEDIATE/RE)E!AM ESTA"LISHED PATIENT 5%.13

9%014 DILATED/INTERMEDIATE E!AM ESTA"LISHEDPATIENT

6.%6

SPECIAL OPTALMOLOGICALSERVICES

9%015 DETERMINATION OF REFRACTIVE STATE %4.65

9%0%0 $ONIOSCOPY, NOT PART OF COMPLETE EYE E!AM 1.6

9%0%5

%6

COMPUTERI+ED CORNEAL TOPO$RAPHY,UNILATERAL OR "ILATERAL,INTERPRETATION AND REPORT

%%.59

13.%8

9%081%6

VISUAL FIELDS E!AMINATION, UNILATERAL OR"ILATERIALINTREPRETATION

34.5913.56

9%08%%6 HUMPHREY VISUAL FIELDS E!AMINATION,INTERMEDIATEINTREPRETATION

45.616.58

9%083%6

$OLDMANN VISUAL FIELDS E!TENDED E!AM INTREPRETATION

5%.%919.03

SERIAL TONOMETRY &SEPARATE PROCEDURE' WITH

8/19/2019 CPT CODE LIST 2014-2015 (1)


9%100 MULTIPLE MEASUREMENTS OF INTRAOCULARPRESSURE

59.01

9%13%%6

SCANNIN$ COMPUTERI+ED OPHTHALMICDIA$NOSTIC IMA$IN$

INTERPRETATION

%1.41%.45

9%133%6

SCANNIN$ COMPUTERI+ED OPHTHALMICDIA$NOSTIC &OCT'INTREPRETATION

%6.411.38

9%134%6

SCANNIN$ COMPUTERI+ED OPHTHALMIC &OCT'INTREPRETATION

%6.411.38

9%136

%6

OPHTHALMIC "IOMETRY "Y PARTIAL COHERENCEINTERFEROMETRY WITH IOL POWER CALCULATION

INTREPRETATION

53.91

%0.93CPT

CODEDESCRIPTION OF SERVICES FEE

SPECIAL OPTALMOLOGICALSERVICES

9%140 PROVOCATIVE TESTS FOR $LAUCOMA, WITHINTREPRETATION AND REPORT, WITHOUT TONO$RAPHY

3.89

OPTALMOSCOPY

9%%%5 OPHTHALMOSCOPY, E!TENDED W/RETINALDRAWIN$

16.93

9%%%6 OPHTHALMOSCOPY ) SU"SE-UENT 15.0

9%%% REMOTE IMA$IN$ FOR DETECTION OF RETINALDISEASE

6.9

9%%%8REMOTE IMA$IN$ FOR MONITORIN$ ANDMANA$EMENT OF ACTIVE RETINAL DISEASE 1.9

9%%30 FLRORESCEIN AN$IOSCOPY W/INTERPRETATION

AND REPORT

40.0

9%%35%6

FLUROESCEIN AN$IO$RAPHYINTREPRETATION

83.6931.45

9%%50%6

FUNDUS PHOTOINTREPRETATION

4.0316.58

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9%%85%6

E!TERNAL OCULAR PHOTO$RAPHYINTERPRETATION

%.%8.9

9%%86

%6

ANTERIOR SE$MENT IMA$IN$

INTERPRETATION

8.%0

%5.19

CONTACT LENS FITTING

9%01FITTIN$ OF CONTACT LENS FOR TREATMENT OFOCULAR SURFACE DISEASE 19.80

9%0%INITIAL FITTIN$ OF CONTACT LENS FORMANA$EMENT OF #ERATOCONUS INITIAL FITTIN$ 8.00

9%310PRESCRIPTION OF OPTICAL AND PHYSICALCHARACTERISTICS OF AND FITTIN$ OF CONTACTLENS

69.%

9%311 CORNEAL LENS FOR APHA#IA, 1 EYE 6%.6%

9%31% CORNEAL LENS FOR APHA#IA, "OTH EYES %.%5

CPTCODE


CONTACT LENS FITTING9%313 CORNEOSCLERAL LENS 60.03

FITTING FOR GLASSES9%340 FITTIN$, SPECTACLES E!CEPT FOR APHA#IA,

MONOFOCAL%6.53

CONTACT LENS SERVICES

("% *%&'*&#* " &6& 7!&'!&"#6)

LENS SOFT ONE EYE 1%5.00

LENS HARD ONE EYE 150.00

OFFICE VISIT - MEDICAL99%01 INITIAL OFFICE VISIT E!AM %6.80

99%0% INITIAL OFFICE VISIT ) E!AM 46.53

99%03 INITIAL OFFICE VISIT ) E!AM 6.3

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99%04 LEVEL IV MEDICAL E!AM NEW PATIENT 104.69

99%05 $ENERAL MEDICAL HEMO$LO"IN * URINALYSIS 13%.41

OFFICE VISIT – ESTABLISED PATIENT99%11 LEVEL I FOLLOW UP ESTA"LISHED PATIENT 13.5%

99%1% LEVEL II FOLLOWUP ESTA"LSHED PATIENT %.05

99%13 LEVEL III FOLLOWUP ESTA"LISHED PATIENT 45.3

99%14 LEVEL V FOLLOWUP ESTA"LSIHED PATIENT 68.36

99%15 LEVEL V FOLLOWUP ESTA"LISHED PATIENT 9%.44

INITIAL CONSULTATION99%41 INITIAL OFFICE CONSULTATION 35.45

99%4% INITIAL OFFICE CONSULTATION 66.48

99%43 INITIAL OFFICE CONSULTATION 91.48


CPTCODE


AUDIOLOGICAL EVALUATION


9%550 TYMPANOMETRY AND RELFE! THRESHOLDMEASUREMENTS

1%.0

9%551 SCREENIN$ TEST, PURE TONE, AIR ONLY .

9%55% PURE TONE AUDIOMETRY &THRESHOLD' AIR ONLY 14.5%

9%553 AIR AND "ONE 19.69

9%555 SPEECH AUDIOMETRY THRESHOLD 10.69

9%55 COMPREHENSIVE AUDIOMETRY THRESHOLDEVALUATION

31.89

9%59% HEARIN$ AID CHEC#, MONAURAL 1.91

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HEARIN$ AIDS CONSULT +ERRY FRANCIS

ANESTESIAANESTHEISA ESTIMATION ONLY

&2 72 : ; <7= >?@ 2?> B@@; @?@>='

150.00

CORNEA TISSUEV2/85 CORNEA TISSUE %,880.00

IN+ECTION +90:5 AVASTIN USE IN CON(UNCTION WITH ./028 64.6%

CPTCODE


ASSESSMENT SERVICESPSYCIATRIC SERVICES

9091 PSYCHIATRIC DIA$NOSTIC EVALUATION 115.38

909% PSYCHIATRIC DIA$NOSTIC EVALUATION WITHMEDICAL SERVICES

115.38

9083%PSYCHOTHERAPHY :0 MINUTES WITH PATIENTAND/OR FAMILY MEM"ER 33.8

90833

PSYSCHOTHERAPHY, :0 MINUTES WITH PATIENTAND/OR FAMILY MEM"ER WHEN PERFORMED WITHAN EVALUATION AND MANA$EMENT SERVICE &LISTSEPERATELY IN ADDITION TO THE CODE OFPRIMARY PROCEDURE'

%%.60

90834PSYCHOTHERAPHY, 45 MINTUES WITH PATIENTAND/OR FAMILY MEM"ER 43.95

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90836

PSYCHOTHERAPHY, 45 MINUTES WITH PATIENTAND/OR FAMILY MEM"ER WHEN PERFORMED WITHAN EVALUATION AND MANA$EMENT OF SERVICE&LIST SEPERATELY IN ADDITION TO THE CODE FOR

PRIMARY PROCEDURE'

36.3

9083PSYCHOTHERAPHY .0 MINUTES WITH PATIENTAND/OR FAMILY MEM"ER 64.3

90838

PSYCHOTHERAPHY, .0 MINUTES WITH PATIENTAND/OR FAMILY MEM"ER WHEN PERFORMED WITHAN EVALUATION AND MANA$EMENT SERVICE &LISTSEPERATELY IN ADDITION TO THE CODE FORPRIMARY PROCEDURE'

59.13

96101 PHYCHOLO$ICAL TESTIN$ – PER OUR 63.91

MOST FREGUENTLY USED OUTPATIENT

FACILITY FEES

O?>>> F@> F:

.510:E?@>2 B/I@> ?:@ 2>>>= >2 @>

1,585.3

.5105E?@>2 2 B/@>,?:@A>>= >2

1,585.3

.5420C2<, E:2 2< ><:2:>2 2P><G? B>2?> G<> 8%%.%3

.5/10 #<>2@:> &C2< T<:@>L@@<'

%,936.54

.5/:0 #<>2@:> P><>G &2) %,936.54

8/19/2019 CPT CODE LIST 2014-2015 (1)


'

.5/55 #<>2@:> P><>G &

:?=2'

%,936.54

.5850 T<;?@>2 1,339.05

.5855 T<;?@2@:> L:< ("#& "%"%& !&!!"#!)

8%%.%3

..1/0 T<;?@>2 ; ><2 ;: 2 <72?: :?<G< 1.339.05

..1/2

T<;?@>2 ; ><2

B/:<<G <2 <72?: 2?@<:?<G< 2< ><? &@?=:>2 2 >J;<2> G>:'

1,339.05

..1/4 T<:@?@ =@>2 2 K?2?:2?>2B @ B>2?> <>>2 2=7 2< :>>

1,339.05

..1/5 T<:@?@ =@>2 2 K?2?:

2?>2B @ B> <>>2 2=7 2< :>>

1,339.05

O?>>> F@> F:

..180 AK?2?: S?> >2 >< 2?@<<:<72<

1,585.3

...:0 I<=>2 :>2< 2< $@?2 1,585.3

..821 YG L:< "#& "% "%& !&!!"#! 1,339.05

..982 E>< :?@< ><> <27@ 95.00

C><> E><>2 B> P<<

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..984 I:<>2 2 I><2?@< L: 95.00

..985 I:<>2 2 I.O.L., S?;:K?> 2E><>2

95.00

./0:. V><>2, @, <: @<2

1,339.05

./0:9 V><>2, W/ 2@ =2@:<, PRP 1,339.05

./040V><>2, B> =2@:<<>@2>22G?@>2

1,339.05

./041V><>2, B> <27@ 2 <)<>@ @@?@< ;<

1,339.05

./042V><>2, B> <27@ 2 ><@@>G ;<

1,339.05

./04:

V><>2, B> <27@ 2 :?;)

<>@ ;< 1,339.05

./10/R< 2 <>@ =>> :@< ;?G B/B>2?> @>

1,339.05

O?>>> F@> F:

./108R< <>@ =>> B>7><>2 >2= 1,339.05

./110R< 2 <>@ =>> ;>2 2 < 2< 2>< G:

1,339.05

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./112R< 2 <>@ =>> ;:@< ;?@G 2< 7><>2

1,339.05

./11: R< 2 2@ <>@=>>

1,339.05

./228

;F"% U!& " L'!&% M'c<#& ;O@ ?: B PRP @:< : =2 2:>@ 2< 2?>>> @>

NOT B > : =2 > =2>2<:2

1%5.00

CPT CODE LIST 2014-2015 (1)

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