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CPT 66505: Iridotomy for Angle-Closure Glaucoma

CPT code 66505 represents an ophthalmic surgical procedure used to relieve acute angle-closure glaucoma by creating two puncture-like openings in the iris (iridotomy/iridectomy-type intervention) to decompress an iris bombe. This procedure is clinically significant because it provides rapid intraocular pressure reduction in settings where forward bowing of the iris obstructs aqueous outflow and threatens vision.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The summary addresses national relevance for hospital and ambulatory surgical settings where ophthalmologists deliver urgent or elective care to manage angle-closure physiology.

Readers will find concise clinical context about when CPT code 66505 is used, an overview of typical service settings, and the types of benchmarks and policy considerations commonly associated with ophthalmic surgical billing. Where specific data points are not provided in the input, the publication notes that data are not available in the input and focuses on clinical description, coding scope, and payer coverage context relevant to national stakeholders.

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Billing Code Overview

CPT code 66505 describes a surgical procedure that creates two small puncture openings in the iris to rapidly lower intraocular pressure caused by an iris bombe. The maneuver addresses anatomic obstruction of the anterior chamber angle that produces a form of angle-closure glaucoma.

Service type: Ophthalmic surgical intervention to relieve acute angle-closure physiology
Typical site of service: Hospital operating room or ambulatory surgery center where ophthalmic surgical procedures are performed

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CPT 66505: Iridotomy for Angle-Closure Glaucoma

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Billing Code Overview

Service type: Ophthalmic surgical intervention to relieve acute angle-closure physiology
Typical site of service: Hospital operating room or ambulatory surgery center where ophthalmic surgical procedures are performed

Clinical & Coding Specifications

Clinical Context

A typical patient is an older adult presenting to an ophthalmology clinic or emergency department with acute onset severe eye pain, decreased vision, halos around lights, a mid-dilated nonreactive pupil, conjunctival injection, and a markedly elevated intraocular pressure due to a pupillary block leading to an iris bombe and secondary angle-closure glaucoma. After history, slit-lamp exam, gonioscopy, tonometry, and topical or systemic pressure-lowering therapy are performed, the ophthalmologist schedules/performes an urgent laser peripheral iridotomy to create two small full-thickness puncture-like openings in the peripheral iris to immediately relieve pupillary block and re-establish aqueous flow from the posterior to anterior chamber. The procedure is commonly performed in an outpatient ophthalmic procedure room, ambulatory surgical center, or emergency department procedure area under topical anesthesia with or without a procedural sedation or retrobulbar block. Typical workflow: triage and urgent evaluation → pretreatment with intraocular pressure-lowering medications (e.g., topical beta-blocker, alpha-agonist, osmotic agent) → informed consent and documentation of laterality and indication (acute angle-closure, narrow angles, prophylactic iridotomy) → topical anesthesia, laser iridotomy performed (often two small perforations) → immediate postprocedure intraocular pressure check, gonioscopy to confirm patency, topical anti-inflammatory and IOP-lowering drops, and postprocedure discharge instructions with follow-up within 24–72 hours.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the physician's professional work separate from technical facility component (rare for laser iridotomy unless facility bills separately).
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned (e.g., inadequate visualization prevented full iridotomy).
`53`	Discontinued procedure	When the procedure is terminated due to patient instability or unforeseen complication prior to completion.
`54`	Surgical care only	When only the surgical portion is billed and another provider bills postoperative care (uncommon for office-based lasers).
`55`	Postoperative management only	When only postoperative care is billed by the surgeon and another provider performed the procedure.
`62`	Two surgeons	When two surgeons work together as primary surgeons due to unusual complexity (rare).
`63`	Procedure performed on infants less than 4 kg	Applied if patient meets weight/age criteria (rare for this procedure).
`78`	Unplanned return to OR for a related procedure during the postoperative global period	If an urgent reintervention in an OR or procedure suite is required for a complication.
`79`	Unrelated procedure or service by the same physician during the postoperative period	If an unrelated procedure is performed during the global period (note: `79` is not in the provided list; not listed further).
`73`	Discontinued outpatient hospital/ambulatory surgery center (ASC) procedure prior to anesthesia administration	If procedure cancelled after patient entered facility but before anesthesia.
`50`	Bilateral procedure	When laser iridotomy is performed on both eyes during the same operative session.
`51`	Multiple procedures	When additional procedures are performed in the same session (e.g., laser peripheral iridotomy plus yag capsulotomy).
`22`	Increased procedural services	When work required is substantially greater than typical (document rationale).

Taxonomy Code	Specialty	Notes
207W00000X	Ophthalmology	Majority of laser peripheral iridotomies are performed by ophthalmologists, particularly glaucoma specialists.
207WH0002X	Ophthalmic Plastic and Reconstructive Surgery	May perform related anterior segment procedures in conjunction with iris or angle issues.
363LA2200X	Optometry	Optometrists with appropriate licensure in some jurisdictions may perform laser procedures or be involved in diagnosis and referral; scope varies by state.
207WI0002X	Pediatric Ophthalmology & Strabismus	Performs iridotomies for pediatric narrow angle or secondary pupillary block cases.
207W00000X-GS	Glaucoma subspecialist (use of general ophthalmology taxonomy as primary)	Glaucoma specialists most commonly manage angle-closure glaucoma and perform iridotomy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H40.21X1`	Acute angle-closure glaucoma, right eye	Direct indication for urgent laser peripheral iridotomy to relieve pupillary block in the right eye.
`H40.21X2`	Acute angle-closure glaucoma, left eye	Direct indication for urgent laser peripheral iridotomy to relieve pupillary block in the left eye.
`H40.21X3`	Acute angle-closure glaucoma, bilateral	Indicates bilateral acute angle-closure requiring treatment in both eyes; may prompt bilateral iridotomies.
`H40.20`	Angle-closure glaucoma, unspecified	General angle-closure diagnosis that may require iridotomy based on clinical findings.
`H21.13`	Iridocorneal endothelial syndrome	Associated anterior segment abnormalities that can contribute to secondary angle closure; may influence procedural approach.
`H40.22`	Chronic angle-closure glaucoma	May be treated prophylactically or therapeutically with iridotomy to prevent progression.
`H21.10`	Iridocyclitis, unspecified	Inflammation affecting iris may complicate or contraindicate immediate iridotomy; relevant to pre/postprocedure management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`66761`	Laser iridotomy (separate CPT for some laser approaches)	Alternative or related laser procedure code used for certain types of iridotomy or when different laser modality is billed; relates as an equivalent or supplement depending on payer policy.
`99284`	Emergency department visit, intermediate complexity	Often used when a patient presents to the ED with acute angle-closure glaucoma prior to iridotomy; documents initial ED evaluation and management.
`92015`	Determination of refractive state, supplemental; for diagnostic consultation	Pre- or post-procedure diagnostic evaluation in ophthalmology clinics; may be used for comprehensive ophthalmologic assessment.
`65855`	Iridotomy/iridectomy, surgical (incisional)	Incisional surgical iridectomy may be performed when laser iridotomy is ineffective or not feasible; represents an alternate definitive intervention.
`99152`	Moderate sedation services provided by the same physician performing the procedure (initial 15 minutes)	If conscious sedation is administered in addition to topical anesthesia during the iridotomy, sedation time may be reported as appropriate.
`99024`	Postoperative follow-up visit included in global period	Postoperative visits are commonly included within the global period; used for billing postoperative care when separate reporting is required by payer.

CPT 66500: Iris Puncture for Angle-Closure Glaucoma

Frequently Asked Questions

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the physician's professional work separate from technical facility component (rare for laser iridotomy unless facility bills separately).
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned (e.g., inadequate visualization prevented full iridotomy).
`53`	Discontinued procedure	When the procedure is terminated due to patient instability or unforeseen complication prior to completion.
`54`	Surgical care only	When only the surgical portion is billed and another provider bills postoperative care (uncommon for office-based lasers).
`55`	Postoperative management only	When only postoperative care is billed by the surgeon and another provider performed the procedure.
`62`	Two surgeons	When two surgeons work together as primary surgeons due to unusual complexity (rare).
`63`	Procedure performed on infants less than 4 kg	Applied if patient meets weight/age criteria (rare for this procedure).
`78`	Unplanned return to OR for a related procedure during the postoperative global period	If an urgent reintervention in an OR or procedure suite is required for a complication.
`79`	Unrelated procedure or service by the same physician during the postoperative period	If an unrelated procedure is performed during the global period (note: `79` is not in the provided list; not listed further).
`73`	Discontinued outpatient hospital/ambulatory surgery center (ASC) procedure prior to anesthesia administration	If procedure cancelled after patient entered facility but before anesthesia.
`50`	Bilateral procedure	When laser iridotomy is performed on both eyes during the same operative session.
`51`	Multiple procedures	When additional procedures are performed in the same session (e.g., laser peripheral iridotomy plus yag capsulotomy).
`22`	Increased procedural services	When work required is substantially greater than typical (document rationale).

Taxonomy Code	Specialty	Notes
207W00000X	Ophthalmology	Majority of laser peripheral iridotomies are performed by ophthalmologists, particularly glaucoma specialists.
207WH0002X	Ophthalmic Plastic and Reconstructive Surgery	May perform related anterior segment procedures in conjunction with iris or angle issues.
363LA2200X	Optometry	Optometrists with appropriate licensure in some jurisdictions may perform laser procedures or be involved in diagnosis and referral; scope varies by state.
207WI0002X	Pediatric Ophthalmology & Strabismus	Performs iridotomies for pediatric narrow angle or secondary pupillary block cases.
207W00000X-GS	Glaucoma subspecialist (use of general ophthalmology taxonomy as primary)	Glaucoma specialists most commonly manage angle-closure glaucoma and perform iridotomy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H40.21X1`	Acute angle-closure glaucoma, right eye	Direct indication for urgent laser peripheral iridotomy to relieve pupillary block in the right eye.
`H40.21X2`	Acute angle-closure glaucoma, left eye	Direct indication for urgent laser peripheral iridotomy to relieve pupillary block in the left eye.
`H40.21X3`	Acute angle-closure glaucoma, bilateral	Indicates bilateral acute angle-closure requiring treatment in both eyes; may prompt bilateral iridotomies.
`H40.20`	Angle-closure glaucoma, unspecified	General angle-closure diagnosis that may require iridotomy based on clinical findings.
`H21.13`	Iridocorneal endothelial syndrome	Associated anterior segment abnormalities that can contribute to secondary angle closure; may influence procedural approach.
`H40.22`	Chronic angle-closure glaucoma	May be treated prophylactically or therapeutically with iridotomy to prevent progression.
`H21.10`	Iridocyclitis, unspecified	Inflammation affecting iris may complicate or contraindicate immediate iridotomy; relevant to pre/postprocedure management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`66761`	Laser iridotomy (separate CPT for some laser approaches)	Alternative or related laser procedure code used for certain types of iridotomy or when different laser modality is billed; relates as an equivalent or supplement depending on payer policy.
`99284`	Emergency department visit, intermediate complexity	Often used when a patient presents to the ED with acute angle-closure glaucoma prior to iridotomy; documents initial ED evaluation and management.
`92015`	Determination of refractive state, supplemental; for diagnostic consultation	Pre- or post-procedure diagnostic evaluation in ophthalmology clinics; may be used for comprehensive ophthalmologic assessment.
`65855`	Iridotomy/iridectomy, surgical (incisional)	Incisional surgical iridectomy may be performed when laser iridotomy is ineffective or not feasible; represents an alternate definitive intervention.
`99152`	Moderate sedation services provided by the same physician performing the procedure (initial 15 minutes)	If conscious sedation is administered in addition to topical anesthesia during the iridotomy, sedation time may be reported as appropriate.
`99024`	Postoperative follow-up visit included in global period	Postoperative visits are commonly included within the global period; used for billing postoperative care when separate reporting is required by payer.

CPT 66500: Iris Puncture for Angle-Closure Glaucoma

Frequently Asked Questions

References

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.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.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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CPT 66505: Iridotomy for Angle-Closure Glaucoma

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Billing Code Overview

OpenPayer

CPT 66505: Iridotomy for Angle-Closure Glaucoma

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 66505: Iridotomy for Angle-Closure Glaucoma

Sign up for cpt 66505 policy alerts

Billing Code Overview

CPT 66505: Iridotomy for Angle-Closure Glaucoma

Sign up for cpt 66505 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 66505 represent and where is it typically performed?

What are the typical clinical indications for using CPT 66505?

Which CPT modifiers are relevant when billing CPT 66505?

What other CPT codes are commonly reported in association with CPT 66505?

Which payers are listed as covering CPT 66505 and are reimbursement rates provided?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 66505 represent and where is it typically performed?

What are the typical clinical indications for using CPT 66505?

Which CPT modifiers are relevant when billing CPT 66505?

What other CPT codes are commonly reported in association with CPT 66505?

Which payers are listed as covering CPT 66505 and are reimbursement rates provided?

References