Summary & Overview
CPT 67110: Retinal Tamponade with Intravitreous Gas Injection
CPT code 67110 represents an ophthalmologic surgical procedure in which a gas bubble is injected into the vitreous cavity to exert internal pressure on a retinal tear and promote reattachment. This targeted, minimally invasive technique is a key option for treating localized rhegmatogenous retinal breaks and can be performed in ambulatory surgical centers or hospital outpatient departments. Nationally, the procedure is significant for preserving vision and reducing progression to more extensive retinal detachment repairs.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context on what the procedure entails and where it is typically performed; benchmarking information on utilization and reimbursement patterns; common billing considerations and code-specific policy updates relevant to national payers; and implications for service-line planning in ophthalmology practices and surgical centers. The publication does not provide patient-specific clinical recommendations but offers a concise reference on coding, setting expectations for claims processing, and administrative planning for facilities that manage retinal tear interventions.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 67110 describes a procedure in which the provider injects a gas bubble into the vitreous cavity to create pressure on a retinal tear and reposition it. This service is an ocular procedure for retinal reattachment manipulation intended to close or appose a localized retinal break by internal tamponade.
Service type: Ophthalmologic surgical procedure (retinal repair technique)
Typical site of service: Ambulatory surgical center or hospital outpatient department, or other settings where ophthalmic surgical procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient presents to the ophthalmology clinic with acute onset of flashes and floaters and a confirmed retinal tear on dilated fundus exam and optical coherence tomography. The retina specialist schedules an office-based pneumatic retinopexy. In the procedure room or ambulatory surgery center under topical and/or local anesthesia, the provider performs ocular preparation, aspirates a small amount of fluid from the anterior chamber if indicated, and injects an intraocular expansile gas bubble (such as sulfur hexafluoride or perfluoropropane) into the vitreous cavity to tamponade the retinal tear, allowing the neurosensory retina to reattach. Post-procedure positioning instructions are given and follow-up visits are arranged within 24–72 hours to assess bubble position, retinal apposition, and to determine if additional treatment (laser retinopexy or cryotherapy) is required. Typical site of service is an ambulatory surgery center or ophthalmology clinic procedure room. Typical service type is minor ophthalmic surgical procedure — pneumatic retinopexy with intravitreal gas injection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable E/M service by the same physician on the day of a procedure | Use when a distinct evaluation and management visit is performed the same day as 67110 for a separate problem. |