Summary & Overview
CPT 66625: Iris Full-Thickness Resection for Glaucoma
CPT code 66625 denotes an ophthalmic surgical procedure in which a full-thickness piece of the iris is excised by creating a hole in the peripheral iris to treat glaucoma. This anterior segment procedure is used to address mechanisms such as pupillary block or other anatomic contributors to elevated intraocular pressure and can be performed in ambulatory surgical centers or hospital outpatient departments. Nationally, accurate coding for this procedure matters for clinical documentation, appropriate reimbursement, and tracking surgical trends in glaucoma care.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical intent of the code, expected sites of service, and common billing considerations. The publication also provides benchmarks and payer coverage context where available, highlights coding relationships to other anterior segment procedures, and summarizes policy and documentation points relevant to payers and health systems. Data not available in the input is noted where applicable, and the write-up focuses on the national policy and clinical context rather than jurisdiction-specific rules.
Billing Code Overview
CPT code 66625 describes a surgical procedure in which the provider removes a full-thickness piece of the iris by creating a hole in the outer part of the iris. The procedure is performed as a targeted surgical intervention to treat glaucoma by improving aqueous outflow or relieving pupillary block.
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Service type: An ophthalmic surgical procedure (anterior segment iris surgery)
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Typical site of service: Ambulatory surgical center or hospital outpatient surgical department
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old with medically uncontrolled narrow-angle glaucoma or chronic angle-closure glaucoma presenting with progressive peripheral anterior synechiae, elevated intraocular pressure (IOP) despite maximally tolerated topical therapy, and symptomatic visual field threat. The ophthalmic surgeon evaluates the patient in an ambulatory surgical center or hospital outpatient department, documents indications, informed consent, and performs preoperative measurements and topical/systemic perioperative medications. Under monitored anesthesia care or local/regional anesthesia with sedation, the surgeon creates a full-thickness surgical iridectomy by excising a small piece of the peripheral iris to create an alternate drainage pathway, relieve pupillary block, or allow aqueous flow. Intraoperative documentation includes operative eye, technique (site and size of iridectomy), use of adjunctive procedures (e.g., cataract extraction, goniosynechialysis), complications, and specimens if any. Postoperative workflow includes recovery monitoring of vision and IOP, topical antibiotic and steroid regimen, follow-up visits with IOP checks, and documentation of postoperative instructions and any additional interventions if IOP remains elevated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician’s professional component separate from the technical facility component in limited reporting structures. |