Summary & Overview
CPT 65750: Keratoplasty (Corneal Transplant) in Aphakic Patients
CPT code 65750 denotes keratoplasty (corneal transplant) specifically performed in aphakic patients—those without a natural lens due to congenital absence or prior cataract extraction. As the most common method of corneal tissue transplantation, this procedure has national relevance for vision-restorative surgery and for surgical specialties in ophthalmology. Payers commonly involved in coverage and reimbursement for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find an overview of clinical context for corneal transplant in aphakia, the typical sites of service, and the types of coverage considerations relevant to major national payers. The publication summarizes common billing modifiers and service line context when available, highlights where input data are incomplete, and provides benchmarking and policy-oriented discussion to inform billing, coding, and payer communication. It is intended for healthcare administrators, coding professionals, and clinicians seeking a concise briefing on how CPT code 65750 is used and interpreted within the current national payer environment.
Billing Code Overview
CPT code 65750 describes a keratoplasty (corneal transplant) performed in aphakic patients, meaning patients who lack a natural lens in the eye either from congenital absence or following cataract removal. This procedure involves replacing damaged or diseased corneal tissue with donor cornea to restore ocular anatomy and improve vision.
Service Type
- Ophthalmic surgical procedure — corneal transplant
Typical Site of Service
- Ambulatory surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of complicated cataract surgery several years earlier presents with progressive corneal decompensation, glare, and reduced vision in the right eye. On examination the patient has corneal edema, scarring, and aniridia remnants; slit-lamp and endothelial evaluation confirm endothelial failure and absence of the crystalline lens (aphakia) in the affected eye. The ophthalmic surgeon schedules a penetrating keratoplasty to replace the diseased cornea and restore optical clarity. The clinical workflow includes preoperative evaluation (ocular history, corneal imaging, endothelial cell counts, systemic assessment for anesthesia), procurement and sizing of donor corneal tissue, intraoperative removal of the diseased cornea and placement of the donor button with sutures, immediate postoperative management in the ambulatory surgery center or hospital outpatient department, and scheduled postoperative visits for suture adjustment, graft monitoring, and management of rejection or infection. The procedure is reported with 65750 for keratoplasty in an aphakic or congenitally aphakic eye, with appropriate modifiers appended to indicate laterality, surgeon status, or unusual circumstances as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT / LT | Right or Left side designation | Append to indicate the operated eye laterality when required by payer or facility. |
50 | Bilateral procedure | Use when bilateral keratoplasties are performed during the same operative session. |
59 | Distinct procedural service | Not in provided modifier list; Data not available in the input. |
62 | Two surgeons | Use when two surgeons work together as co-surgeons and each performs distinct portions of 65750. |
66 | Surgical team or multiple surgeons | Use when a surgical team approach is required for the procedure. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances. |
78 | Return to OR for related procedure during global period | Use when the patient returns to the operating room for a complication related to the original keratoplasty during the global period. |
79 | Unrelated procedure or service during global period | Use when an unrelated procedure is performed during the global period. |
22 | Increased procedural services | Use when the work required to perform 65750 is substantially greater than typically required. |
26 | Professional component | Use when reporting only the surgeon’s professional component separate from the facility technical component. |
TC | Technical component | Use when reporting only the facility/technical component of the service (facility reporting of supplies, OR, anesthesia separate from surgeon). |
23 | Unusual anesthesia | Use when general anesthesia is required for a procedure normally performed under local anesthesia due to unusual circumstances. |
58 | Staged or related procedure during postoperative period | Use when 65750 is planned as a staged procedure or a more extensive procedure follows during the postoperative period. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207P00000X | Ophthalmology | Corneal surgeons and general ophthalmologists commonly perform keratoplasty. |
207RK0000X | Retina/Vitreous Specialist | May be involved for complex anterior segment cases with posterior pathology; consultative role. |
207XS0112X | Corneal and External Disease Specialist | Subspecialists who frequently perform corneal transplantation and manage postoperative graft care. |
2080S0003X | Ophthalmic Plastic and Reconstructive Surgery | In cases with combined anterior segment reconstruction or ocular surface reconstruction. |
363A00000X | Eye Bank Specialist / Tissue Procurement | Providers involved in donor tissue procurement and coordination (administrative/technical role). |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
H18.50 | Corneal edema, unspecified | Corneal decompensation with edema is a common indication for keratoplasty. |
H18.443 | Other corneal opacity, right eye | Dense corneal scarring and opacities impair vision and may prompt transplant. |
H18.49 | Other corneal dystrophies | Endothelial dystrophies (e.g., Fuchs) lead to grafting in advanced cases. |
H59.139 | Surgical complication of other intraocular lens prosthesis, unspecified eye | Complications after cataract surgery can result in aphakia and corneal failure necessitating keratoplasty. |
H15.103 | Conjunctival scarring involving the cornea, unspecified eye | Ocular surface disease that can compromise graft survival and require additional management. |
T83.098A | Other mechanical complication of intraocular lens, initial encounter | Lens-related complications leading to aphakia and corneal compromise. |
Z98.89 | Other specified postprocedural states | History of prior ocular surgery (e.g., prior cataract extraction) relevant to surgical planning. |
H16.233 | Peripheral corneal ulcer, bilateral | Peripheral ulcers and melts can lead to corneal perforation and need for transplantation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
65750 | Keratoplasty for aphakia (penetrating corneal transplant in aphakic eye) | Primary procedure for corneal transplantation in an eye lacking a lens; the code in focus. |
65730 | Keratoplasty, corneal transplant (penetrating) | Alternative penetrating keratoplasty code used for eyes with an intact lens; may be used when aphakia is not present. |
65710 | Corneal transplant, anterior lamellar keratoplasty | Used for selective anterior lamellar procedures when only anterior corneal layers are replaced instead of full-thickness keratoplasty. |
66984 | Removal of lens by extracapsular cataract extraction with insertion of intraocular lens prosthesis | May precede or be performed in staged fashion in patients undergoing lens extraction-related management in the same eye or contralateral eye. |
65785 | Amniotic membrane transplantation, ocular (when applicable) | Performed adjunctively for ocular surface disease that may complicate keratoplasty healing. |
92134 | Scanning computerized ophthalmic diagnostic imaging, posterior segment, with interpretation and report; ocular coherence tomography (OCT) of retina | Preoperative imaging often performed for comprehensive ocular assessment; documented in the perioperative workup. |