Summary & Overview
CPT 65760: Corneal Refractive Surgery to Improve Vision
CPT code 65760 represents a corneal refractive procedure in which a provider uses a laser or other device to reshape the cornea to improve a patient’s vision. As a commonly performed ophthalmic procedure, this code is important for payers and providers managing coverage, prior authorization, and coding accuracy for elective and corrective vision surgeries performed in outpatient settings. Nationally, use of this code reflects demand for surgical vision correction and has implications for benefit design and medical necessity policies.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent of the procedure, typical sites of service, and payer presence. The publication also outlines common modifiers associated with surgical procedures and notes where input data is not available.
This report provides: clinical context for 65760, a summary of payer coverage presence, and pointers to areas where benchmarks or policy updates are typically relevant for this service line. Data not available in the input is clearly identified so readers understand which elements require supplemental sources for a full reimbursement or policy assessment.
Billing Code Overview
CPT code 65760 describes a corneal refractive procedure in which the provider uses a laser or other device to change the shape of the cornea to improve a patient’s vision. This procedure is a refractive corneal surgery intended to correct common vision errors such as myopia, hyperopia, and astigmatism.
Service Type: Refractive corneal surgery (laser or device-assisted corneal reshaping)
Typical Site of Service: Outpatient surgical center or ophthalmology ambulatory clinic with appropriate laser equipment
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient with stable refractive error and no active ocular disease presents seeking decreased dependence on glasses and contact lenses. After a comprehensive refractive evaluation including manifest and cycloplegic refraction, corneal topography, pachymetry, wavefront aberrometry, and a slit-lamp exam, the ophthalmologist determines the patient is a candidate for laser corneal refractive surgery. On the day of service, the patient undergoes a laser corneal reshaping procedure to alter corneal curvature and improve uncorrected visual acuity. Typical workflow steps include preoperative counseling and consents, preoperative markings and topical anesthesia, creation of a flap or surface ablation as applicable, laser ablation of the corneal stroma to achieve the planned refractive correction, intraoperative assessments, and immediate postoperative checks with instructions for topical medications and follow-up visits. The procedure is most commonly performed in an ambulatory surgical center or hospital outpatient department under local/topical anesthesia and monitored by an ophthalmic surgeon and perioperative nursing staff. Billing and documentation should include the specific laser technique performed, preoperative measurements and candidacy documentation, informed consent, intraoperative findings and any complications, and postoperative discharge instructions and follow-up plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician’s professional interpretation component separate from the technical component of a diagnostic test related to the procedure. |