Summary & Overview
CPT 67005: Anterior Vitrectomy, Vitreous Removal
CPT code 67005 denotes an anterior approach vitrectomy: removal of a portion of the vitreous humor via the limbus or cornea to access the retina or clear visually obstructive material. This ophthalmic operative procedure is clinically important for managing complications such as retained lens fragments, vitreous hemorrhage, or to facilitate retinal interventions. Nationally, the code matters for surgical billing, facility planning, and alignment of coverage policies across public and commercial payers.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a succinct overview of the clinical service, typical sites of care, and the billing context for CPT code 67005. The publication provides benchmarks and payment context where available, summarizes relevant policy considerations affecting coverage and site-of-service decisions, and outlines common modifiers used with this procedure. Clinical context explains when an anterior vitrectomy is performed and how it differs from posterior approaches.
This resource is intended for billing professionals, practice managers, and clinical leaders seeking a clear national-level summary of CPT code 67005, its clinical purpose, payer coverage landscape, and the operational implications for delivering this surgical service.
Billing Code Overview
CPT code 67005 describes a surgical procedure in which the provider removes a portion of the vitreous humor to provide access to the retina or to remove material within the vitreous that obstructs vision. The approach is anterior, meaning the surgeon accesses the vitreous from the front of the eye through the limbus or cornea.
Service type: Operative ophthalmic procedure (anterior approach vitreous removal / anterior vitrectomy)
Typical site of service: Ophthalmology operating room, ambulatory surgery center, or hospital outpatient surgical unit
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Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with decreased visual acuity and symptomatic vitreous hemorrhage following diabetic retinopathy is scheduled for an anterior approach pars plana vitrectomy via the limbus or cornea. Preoperative evaluation includes visual acuity, intraocular pressure, slit-lamp and dilated fundus exams, ocular imaging as needed (OCT, B-scan if media opaque), anesthesia assessment, and informed consent. In the operating room or ambulatory ophthalmic surgery center, the surgeon performs anterior access to the vitreous through the cornea or limbus to remove opacities and clear the visual axis or to gain access to the retina for concurrent procedures. Intraoperative steps include creation of anterior entry, controlled removal of vitreous gel, management of any retinal breaks, hemostasis, possible tamponade with gas or silicone oil, and wound closure. Postoperative workflow includes same-day monitoring for pain, intraocular pressure check, topical medications prescribed (antibiotic and steroid drops), scheduling early postoperative visits (day 1, week 1), and documenting findings and any adjunct treatments. Typical site of service is an ambulatory surgery center or hospital operating room. Service type: anterior vitrectomy (surgical ophthalmology). Typical patient scenario: pseudophakic or aphakic eye with anterior vitreous prolapse after cataract surgery, vitreous opacities obscuring the visual axis, or as an anterior approach to access the posterior segment in complex anterior segment surgery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |