Summary & Overview
CPT 67108: Retinal Detachment Repair with Laser or Cryotherapy
CPT code 67108 represents surgical repair of rhegmatogenous retinal detachment using laser photocoagulation or cryotherapy, with optional scleral buckle, vitrectomy, subretinal fluid drainage, and intraocular gas or air tamponade. This procedure is a cornerstone of vitreoretinal surgery and has significant implications for vision preservation and postoperative resource use nationwide. Payers commonly covering or adjudicating claims for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication provides a concise national overview of CPT code 67108, including clinical context for the procedure, procedural components typically billed under the code, and the service settings where it is performed. Readers will find benchmarks and policy-relevant information related to coding and payer coverage practices, along with clinical context that clarifies when the code applies. The summary highlights common billing considerations and areas where payer policies and prior authorization requirements can affect access and reimbursement. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 67108 describes surgical repair of a detached retina using laser photocoagulation or cryotherapy. The procedure may include placement of a scleral buckle to alter fluid dynamics, intravitreal gas injection to tamponade a retinal break, partial or complete vitrectomy (removal of vitreous), drainage of subretinal fluid, and use of intraocular air to reattach and level the retina.
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Service type: Surgical retinal detachment repair involving laser or cryotherapy, which may include scleral buckle placement, pars plana vitrectomy, fluid drainage, and intraocular gas or air tamponade.
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Typical site of service: Hospital operating room or ambulatory surgery center where ophthalmic vitreoretinal surgery is performed.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient presents with sudden onset of floaters, flashes, and a curtain-like loss of vision in the affected eye. Ophthalmic examination and dilated fundus exam confirm a rhegmatogenous retinal detachment with one or more full-thickness retinal breaks. The retina specialist schedules a surgical repair using pars plana vitrectomy with fluid–air exchange, endolaser photocoagulation, possible cryopexy, and placement of an intraocular tamponade (gas or silicone oil) as indicated. The clinical workflow includes preoperative evaluation (history, visual acuity, intraocular pressure, B-scan ultrasound if media opacity), informed consent addressing risks (infection, increased intraocular pressure, cataract progression), anesthesia planning (local monitored anesthesia care or general anesthesia), intraoperative repair using laser or cryotherapy to seal breaks and drainage of subretinal fluid with or without scleral buckle placement, and postoperative positioning and follow-up visits to monitor retinal reattachment and intraocular pressure. Typical expected sites of service are an ambulatory surgery center or hospital outpatient surgery department. The service type is ophthalmic surgical retinal repair (retinal detachment repair) that may include vitrectomy and tamponade maneuvers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician’s professional component separate from a facility or technical component for imaging or diagnostic elements of the service. |