Ophthalmology CPT Codes Reference
Overview
This note is a comprehensive, vault-indexed reference for the most commonly used CPT codes in ophthalmology practice — covering evaluation and management, diagnostic imaging, in-office procedures, laser treatments, and surgical procedures. Key billing notes and NCCI considerations are included for each section.
Evaluation and Management — Eye Exam Codes (92xxx)
These ophthalmology-specific exam codes are an alternative to standard E/M codes (99xxx) and are used when an ophthalmologist performs a structured eye examination as the primary service.
CPT Description Notes 92002 Ophthalmological services, new patient, intermediate Focused examination; one or more elements of the examination 92004 Ophthalmological services, new patient, comprehensive Complete examination including refraction 92012 Ophthalmological services, established patient, intermediate Follow-up / focused visit 92014 Ophthalmological services, established patient, comprehensive Complete exam including refraction
Key billing note: 92002 -92014 ophthalmology examinations. Providers may alternatively use standard E/M codes (99202 -99215
General E/M Codes Used in Ophthalmology
CPT Description 99202 -99205 New patient, office/outpatient E/M, levels 2-5 99212 -99215 Established patient, office/outpatient E/M, levels 2-5 99221 -99223 Initial hospital inpatient E/M 99231 -99233 Subsequent hospital inpatient E/M 99241 -99245 Office consultation (some payers; not recognized by Medicare) 99251 -99255 Inpatient consultation (some payers; not recognized by Medicare)
Diagnostic Imaging and Testing
Ocular Coherence Tomography (OCT)
CPT Description Notes 92132 Scanning computerized ophthalmic diagnostic imaging, anterior segment, unilateral or bilateral Anterior segment OCT — cornea, angle, AC assessment 92133 Scanning computerized ophthalmic diagnostic imaging, posterior segment, optic nerve OCT optic nerve / RNFL — glaucoma monitoring 92134 Scanning computerized ophthalmic diagnostic imaging, posterior segment, retina OCT retina — macula, CME, subretinal fluid, AMD monitoring
NCCI note: 92133 and 92134 can be billed together when both optic nerve and retina imaging are medically necessary and documented.NCCI note: 92250 (fundus photography) and 92133 /92134 are generally mutually exclusive per NCCI; use modifier -XU or -59 when both are medically necessary.
Fundus Photography and Extended Ophthalmoscopy
CPT Description Notes 92250 Fundus photography with interpretation and report Bilateral documentation of retinal pathology 92201 Extended ophthalmoscopy with retinal drawing, new patient Included in same-day posterior segment surgery 92202 Extended ophthalmoscopy with retinal drawing, established patient Included in same-day posterior segment surgery
Fluorescein and ICG Angiography
CPT Description Notes 92235 Fluorescein angiography with interpretation and report Unilateral or bilateral; vasculitis, CME, AMD, DR 92240 Indocyanine green angiography with interpretation and report Choroidal pathology, VKH, CSC 92242 Fluorescein and ICG angiography performed at the same session Combo code when both are done together
Visual Field Testing
CPT Description Notes 92081 Visual field exam, limited Monocular screening 92082 Visual field exam, intermediate 92083 Visual field exam, extended Full threshold Humphrey / Goldmann; glaucoma, neuro-ophthalmology
Ultrasound
CPT Description Notes 76511 Ophthalmic ultrasound, diagnostic; A-scan only Biometry 76512 Ophthalmic ultrasound; B-scan , with or without A-scan Posterior segment assessment when media opacity limits view 76513 Anterior segment ultrasound (UBM) Ciliary body, plateau iris, angle imaging 76514 Corneal pachymetry Central corneal thickness measurement
Other Diagnostic Tests
CPT Description Notes 92020 Gonioscopy Anterior chamber angle evaluation; glaucoma, uveitis 92060 Sensorimotor examination Ocular motility, strabismus workup 92100 Serial tonometry IOP monitoring over time 92285 External ocular photography Lids, cornea, conjunctiva, iris documentation 92228 Screening dark adaptation measurement (new 2026 ) Rod recovery intercept time; AMD risk screening 92025 Corneal topography Keratoconus, contact lens fitting, pre-LASIK
In-Office and Minor Procedures
Injections
CPT Description Notes 67028 Intravitreal injection of pharmacologic agent Anti-VEGF (ranibizumab, bevacizumab, aflibercept, faricimab), intravitreal steroids; most common ophthalmic procedure in retina 68200 Subconjunctival injection Periocular steroid or antibiotic delivery 67500 Retrobulbar injection Anesthetic or steroid — retrobulbar space 67505 Peribulbar injection Peribulbar anesthetic J0178 / J0179 Drug codes (HCPCS) Report appropriate J-code for the specific anti-VEGF drug administered with 67028
Anterior Segment Procedures
CPT Description Notes 65800 Paracentesis of anterior chamberAnterior chamber tap; culture/drainage of hypopyon or aqueous 65810 Paracentesis of anterior chamber with vitreous removal and/or anterior hyaloid membrane discission 65435 Removal of corneal epithelium Debridement for recurrent erosion, culture 65900 Removal of epithelial downgrowth 65855 Laser trabeculoplasty (SLT or ALT) Open-angle glaucoma; selective or argon laser
Eyelid Procedures
CPT Description Notes 67800 Excision of chalazion , single In-office or minor OR 67801 Excision of chalazion, multiple, same lid 67805 Excision of chalazion, multiple, different lids 67840 Excision of lesion of eyelid Skin tag, papilloma , benign lesion 67700 Blepharotomy , drainage of abscess , eyelid67710 Severing of tarsorrhaphy 67820 Correction of trichiasis , epilation by forceps only
Lacrimal System
CPT Description Notes 68761 Closure of lacrimal punctum by plug Punctal plug insertion for dry eye 68801 Dilation of lacrimal punctum, with or without irrigation 68810 Probing of nasolacrimal duct 68815 Probing of nasolacrimal duct with insertion of tube or stent
Laser Procedures
CPT Description Notes 66761 Iridotomy /iridectomy by laser surgery — per sessionLaser peripheral iridotomy (LPI) for angle closure glaucoma 66821 Discission of secondary membranous cataract by laser surgery (YAG capsulotomy) Posterior capsular opacification post-cataract 67210 Photocoagulation , retinal lesion (other than macular degeneration)Focal laser treatment 67228 Photocoagulation of retinal lesion, extensive — panretinal photocoagulation (PRP) Proliferative diabetic retinopathy, retinal vein occlusion 67229 Photocoagulation, retinal lesion, new vessels 67145 Prophylaxis of retinal detachment — cryotherapy or laser, 1 or more sessions Lattice degeneration treatment
Cataract Surgery
CPT Description Notes 66984 Extracapsular cataract removal with intraocular lens prosthesis, 1 stage Standard phacoemulsification with IOL — most common cataract code 66985 Insertion of intraocular lens prosthesis (secondary implant) Secondary IOL insertion 66986 Exchange of intraocular lens IOL exchange 66830 Removal of secondary membranous cataract with corneal section Open-sky posterior capsulotomy 66850 Removal of lens material, pars plana approach Combined with vitrectomy 66982 Extracapsular cataract removal — complex Use when significant comorbidity/complexity increases difficulty 66987 Extracapsular cataract removal with complex cataract + extended depth of focus or multifocal IOL 0996T Insertion/scleral fixation of capsular bag prosthesis with IOL (new 2026 Cat III) New 2026
Glaucoma Surgery
CPT Description Notes 66170 Fistulization of sclera for glaucoma — trabeculectomy Traditional bleb-forming surgery 66172 Fistulization of sclera, with scarring Trabeculectomy in scarred/previously operated eye 66174 Trabeculostomy ab interno (MIGS — minimally invasive glaucoma surgery) e.g., Kahook dual blade, trabectome 66175 Trabeculostomy ab interno, with use of illuminated microcatheter iTrack-type MIGS 0671T Insertion of anterior segment drainage device without external reservoir, internal approach iStent inject-type MIGS (Category III) 1012T Motorized ab interno trephination of scleral or trabecular meshwork (new 2026 Cat III) New 2026
Retina and Vitreous Surgery
CPT Description Notes 67005 Removal of vitreous , anterior approach 67010 Removal of vitreous, pars plana approac h — subtotal 67015 Aspiration or release of vitreous, subretinal or choroidal space 67025 Injection of vitreous substitute, pars plana or limbal approach 67036 Vitrectomy , mechanical, pars plana approach67039 Vitrectomy + focal endolaser photocoagulation 67040 Vitrectomy + endolaser photocoagulation , panretinal 67107 Repair of retinal detachment — scleral buckling 67108 Repair of retinal detachment — vitrectomy 67113 Repair of complex retinal detachment 67115 Release of encircling material (scleral buckle removal) 67120 Removal of implanted material, posterior segment — anterior approach 67121 Removal of implanted material, posterior segment — pars plana 67218 Radiation by implantation of source, retina/choroid 67220 Destruction of localized lesion of choroid — photocoagulation 67225 Photocoagulation, age-related macular degeneration, subfoveal
Strabismus Surgery
CPT Description Notes 67311 Strabismus surgery — resection or recession, one horizontal muscle67312 Strabismus surgery — two horizontal muscles 67314 Strabismus surgery — one vertical muscle 67316 Strabismus surgery — two or more vertical muscles 67320 Transposition procedure 67331 Strabismus surgery on patient with previous surgery or injury
Common Modifiers in Ophthalmology
Modifier Description Ophthalmology Use -RT Right eye Laterality for unilateral procedures -LT Left eye Laterality for unilateral procedures -50 Bilateral procedure Bilateral procedures billed on one claim line -25 Significant separately identifiable E/M same day as procedure E/M + injection (e.g., 67028 + 92012 -25 ) on same day -24 Unrelated E/M during post-op period E/M during global period for unrelated condition -57 Decision for surgery E/M visit where surgery was decided, day of or before 90-day surgery -58 Staged/related procedure during post-op period Planned second-stage ocular procedure within global period -78 Unplanned return to OR for complication Return for post-op complication (e.g., post-cataract endophthalmitis requiring vitrectomy) -79 Unrelated procedure during post-op period Unrelated ocular or non-ocular procedure during global period -22 Increased procedural services Complex surgical case requiring substantially more work than typical
NCCI Bundling Watchpoints (Ophthalmology-Specific)
92250 + 92133 /92134 :-XU or -59 only when both are independently medically necessary and fully documented.92201/92202 + posterior segment surgery: Extended ophthalmoscopy is bundled into posterior segment surgical procedures (67005 -67229 ) when performed same-day. Extended ophthalmoscopy would normally not be reported pre-operatively same-day as an elective posterior segment procedure.67028 (intravitreal injection) + E/M same day:-25 on the E/M is required to separately bill E/M on the same day as an intravitreal injection when the E/M represents a significant, separately identifiable service beyond the pre-injection evaluation.Bilateral eye procedures: When the same procedure is performed bilaterally at the same session, use modifier -50 or bill separately with RT/LT per payer instructions.
Common ICD-10-CM Codes Cross-Reference for Ophthalmology
ICD-10-CM Description H20.051 Hypopyon, right eye H20.011 Primary iridocyclitis, right eye H20.013 Primary iridocyclitis, bilateral H25.13 Age-related nuclear cataract, bilateral H26.001 Unspecified infantile and juvenile cataract, right eye H40.1110 Primary open-angle glaucoma, right eye, mild stage H40.1130 Primary open-angle glaucoma, right eye, severe stage H35.31- Nonexudative (dry) AMD, right eyeH35.32- Exudative (wet) AMD, right eyeH35.81 Retinal edema H43.391 Vitreous degeneration, right eyeH52.13 Myopia , bilateralH53.003 Unspecified amblyopia, bilateral H10.9 Unspecified conjunctivitis H11.001 Unspecified pterygium , right eye H16.009 Unspecified corneal ulcer, right eye H30.91 Unspecified chorioretinal inflammation, right eye H44.001 Unspecified purulent endophthalmitis, right eye B00.51 Herpesviral iridocyclitis B02.32 Zoster iridocyclitis D86.83 Sarcoid iridocyclitis
Crystal's Coder Hub