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CPT 65270: Conjunctival Laceration Repair
CPT code 65270 designates surgical repair of a conjunctival laceration with direct closure, and includes closure of any associated nonperforating scleral laceration. This code captures a common ophthalmic minor surgical procedure performed to restore ocular surface integrity and prevent complications such as persistent wound gape, infection, or scarring that can affect vision.
Key national payers relevant to this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and payment policies for 65270 vary by payer and setting, with differences in site-of-service allowances, prior authorization requirements for outpatient procedures, and bundling or global period rules.
Readers will learn the clinical context of the procedure, typical sites of service, and which major payers commonly adjudicate claims for this repair. The publication provides benchmarks and policy-relevant notes about coding capture, common modifier usage, and documentation elements payers often review. Where payer-specific policy details are not available in the input, the text notes: Data not available in the input.
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Billing Code Overview
CPT code 65270 describes the surgical repair of a laceration of the conjunctiva, the transparent membrane covering the eye. The procedure brings wound edges together with direct suture closure and includes closure of any nonperforating scleral laceration present.
Service Type: Ophthalmic minor surgical repair of ocular surface laceration
Typical Site of Service: Ambulatory surgical center or hospital outpatient department; may also be performed in an emergency department when indicated.