Summary & Overview
CPT 67105: Retinal Detachment Repair with Laser Photocoagulation
CPT code 67105 represents laser photocoagulation repair of a detached retina, with drainage of subretinal fluid when required. This ophthalmic surgical code is used for focal treatment of retinal breaks and reattachment procedures that employ thermal laser energy to seal retinal tears and may include concurrent drainage to remove subretinal fluid. Nationally, retinal detachment repair is a clinically important, time-sensitive intervention that affects vision outcomes and utilization patterns in surgical ophthalmology.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about when 67105 is used, typical sites of service (hospital OR or ambulatory surgical center), and the procedural elements captured by the code. The publication also presents benchmarks and comparative coverage considerations across major payers, notes any recent coding or policy updates when available, and explains how 67105 relates to other retinal surgery services.
This summary is intended for health policy analysts, coding and billing professionals, and clinical leaders seeking a concise national perspective on the use and implications of CPT code 67105 in ophthalmic surgical care. Data not available in the input is identified where applicable.
Billing Code Overview
CPT code 67105 describes a procedure to repair a detached retina using focused laser photocoagulation that heats retinal tissue. The procedure may include drainage of subretinal fluid if required.
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Service type: Retinal detachment repair using laser photocoagulation, with optional subretinal fluid drainage
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Typical site of service: Hospital operating room or ambulatory surgical center, performed by an ophthalmologist with retinal surgery expertise
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting with acute visual symptoms such as flashes, floaters, a curtain-like shadow, or sudden vision loss. Ophthalmic examination confirms a rhegmatogenous retinal detachment with one or more retinal breaks. The retinal specialist performs a pars plana vitrectomy or scleral buckle as indicated; for 67105, the primary intervention is retinal reattachment using laser photocoagulation (thermal laser) to seal retinal breaks and, when present, drainage of subretinal fluid (external drainage) to facilitate reapposition of the neurosensory retina to the retinal pigment epithelium. The clinical workflow includes preoperative evaluation (visual acuity, intraocular pressure, dilated fundus exam, ocular ultrasound if media opacity), informed consent, anesthesia evaluation (local block or monitored anesthesia care/general anesthesia depending on patient factors), intraoperative laser photocoagulation to the retinal break(s), drainage of subretinal fluid if required, and postoperative positioning and follow-up to monitor reattachment and intraocular pressure. Typical postoperative care includes topical antibiotics, steroid drops, activity and positioning instructions, and follow-up visits within 24–72 hours and weekly thereafter until stabilization. Typical site of service is an outpatient ambulatory surgery center or hospital operating room depending on patient comorbidities and anesthesia needs. Service type: surgical retinal procedure (repair of detached retina using thermal laser with possible subretinal fluid drainage).
Coding Specifications
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