Summary & Overview
CPT 66605: Excision of Ciliary Body Lesion with Iris/Cornea/Sclera
CPT code 66605 denotes surgical excision of a lesion on the ciliary body of the eye that requires removal of part of the iris, cornea, and/or sclera. This procedure is clinically significant because it addresses intraocular or juxtaocular lesions that may threaten vision or indicate malignancy; appropriate coding ensures accurate classification of complex ophthalmic surgery and supports consistent national reporting of surgical ophthalmology services. 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 code's clinical intent and typical service setting, benchmarks for utilization and reimbursement where available, and relevant policy or billing considerations that affect national coverage and claims processing. The publication summarizes clinical context for when excision of ciliary body lesions is performed, common operative settings, and the implications for documentation and coding specificity. Data not available in the input is noted where applicable. The content is intended to inform billing professionals, clinical coders, and policy analysts about the role of CPT code 66605 in surgical ophthalmology practice and payer interactions at a national level.
Billing Code Overview
CPT code 66605 describes a surgical procedure in which the provider excises a lesion on the ciliary body of the eye by removing part of the iris, cornea, and/or sclera. The service is an ophthalmic excision procedure involving intraocular structures and adjacent ocular surface tissues.
Service type: Surgical excision of an ocular ciliary body lesion.
Typical site of service: Operative suite or ambulatory surgery center with ophthalmic surgical capability; procedure performed under appropriate intraoperative anesthesia in a sterile surgical setting.
Clinical & Coding Specifications
Clinical Context
A patient in their mid-60s presents with a suspicious pigmented or nonpigmented mass of the ciliary body detected on slit-lamp biomicroscopy and ultrasound biomicroscopy. The lesion is associated with progressive visual disturbance, localized iris distortion, or secondary glaucoma. After ophthalmic oncology evaluation, the decision is made to perform an excisional procedure removing the lesion with partial resection of adjacent iris, cornea, and/or sclera to obtain clear margins while preserving globe integrity. The preoperative workflow includes informed consent, ocular imaging (ultrasound biomicroscopy, anterior segment OCT), visual acuity and intraocular pressure documentation, medical clearance if indicated, and discussion of anesthesia (local retrobulbar block or general anesthesia). Intraoperatively, the surgeon performs careful exposure of the anterior segment, resects the tumor with margins, repairs the scleral/corneal defect, and may place an intraoperative specimen for pathology. Postoperative care includes topical antibiotics and steroids, intraocular pressure monitoring, visual rehabilitation, and scheduled oncology follow-up with serial imaging and pathology review.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician's professional component if the facility bills the technical component separately. |