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    OpenPayerBilling CodesInsertion of Aqueous Drainage DeviceCPT cpt-0450t-glaucoma-subconjunctival-drainage-device-implantation
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    CPT 0450T: Insertion of Subconjunctival Aqueous Drainage Device

    CPT code 0450T describes insertion of an additional aqueous drainage device into the interior of the eye with the distal end positioned in the subconjunctival space; the device, which has no reservoir, facilitates drainage of aqueous fluid to lower intraocular pressure in patients with glaucoma. Service type: implantation of an ocular drainage device. Typical site of service: ophthalmology clinic, ambulatory surgery center, or hospital outpatient department for glaucoma management procedures involving implantable drainage devices aimed at reducing intraocular pressure.

    For related coverage guidance, see recent payer policy updates: Corneal Remodeling for Refractive Errors and Corneal Grafting and Transplantation, Glaucoma Agents iDose TR (travoprost intracameral implant), Topical Treatments for Dry Eye Disease.

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    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with medically uncontrolled primary open-angle glaucoma presents to an ophthalmology ambulatory surgical center after progressive visual field loss and elevated intraocular pressure despite maximal tolerated topical and/or oral therapy. The surgeon performs implantation of a subconjunctival aqueous drainage device to lower intraocular pressure. Typical workflow: preoperative evaluation by the glaucoma specialist including visual acuity, slit-lamp exam, gonioscopy, optic nerve assessment, visual field testing, and medication review; informed consent and preoperative anesthetic assessment; the procedure performed in an operating room or procedure suite under monitored anesthesia care or regional/local anesthesia; placement of the device with its distal end in the subconjunctival space to drain aqueous humor; intraoperative confirmation of flow and conjunctival closure; postoperative recovery with topical antibiotics and steroids, and follow-up visits for IOP checks and bleb evaluation. Typical site of service: outpatient ambulatory surgery center or hospital outpatient department. Service type: ophthalmic surgical supply and implant procedure for glaucoma (minimally invasive glaucoma surgery with subconjunctival drainage device). Typical patient scenario: adult with uncontrolled glaucoma despite medications and/or previous trabeculectomy or tube shunt failure who requires an additional subconjunctival drainage device to lower intraocular pressure.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    65820Trabeculectomy ab externo with or without intraoperative antimetabolite (eg, mitomycin)Alternative or prior filtering procedure; may be performed before or instead of subconjunctival device placement
    66180Implantation of internal drainage device (aqueous shunt) without external reservoir (eg, nonvalved tube)Similar category of glaucoma drainage implants; may be performed in cases requiring a traditional tube shunt rather than a minimally invasive subconjunctival device
    66984Extracapsular cataract removal with insertion of intraocular lens (IOL)Often performed concurrently or staged with glaucoma surgery in patients with coexisting visually significant cataract
    67028Intravitreal injection of a pharmacologic agentPostoperative intervention that may be used if intraocular inflammation or other retinal issues arise (not routine for glaucoma implant but performed in some combined cases)
    0100TInsertion of aqueous drainage device, internal, without reservoir, with distal subconjunctival implantation (example related Category III codes exist for emerging devices)Procedures for similar devices or device-specific temporary codes that may be reported when applicable

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207W00000X
    363A00000X
    363L00000X
    374J00000X
    207T00000X
    261QR0800X
    261QM1102X
    146L00000X

    Related ICD-10-CM Codes

    3 rows

    ICD-10-CM CodeDescription
    H40.10X0Unspecified open-angle glaucoma, stage unspecified
    H40.10X1Unspecified open-angle glaucoma, mild stage
    H40.10X2Unspecified open-angle glaucoma, moderate stage

    Related Payer Policy Updates

    Specialty: Ophthalmology/Optometry1 / 2

    10 rows

    PolicyPayerEffective Date
    Corneal Remodeling for Refractive Errors and Corneal Grafting and TransplantationHealth-New-England2027-02-01
    Glaucoma Agents iDose TR (travoprost intracameral implant)Mass General Brigham Health Plan2027-01-04
    Topical Treatments for Dry Eye Diseaseblue cross blue shield - louisiana2027-01-01
    Corneal Collagen Cross-LinkingMass General Brigham Health Plan2026-11-01
    VizzCigna2026-11-01
    Intraocular Lens ImplantCigna2026-11-01
    Travoprost Intracameral ImplantBluecross Idaho2026-11-01
    Ophthalmology - Pilocarpine 1.25%Cigna2026-10-15
    Intravitreal and PunctumBlue Cross Blue Shield - Rhode Island2026-10-01
    Cataract Removal Surgery for AdultsAnthem2026-10-01

    Related Codes

    CPT-0449T-AQUEOUS-DRAINAGE-DEVICE-INSERTION-SUBCONJUNCTIVAL

    CPT 0449T: Aqueous Drainage Device Inserted Subconjunctivally

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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