Summary & Overview
CPT 67311: Strabismus Surgery, Eye Muscle Recession or Resection
CPT code 67311 denotes surgical correction of extraocular muscle imbalance through recession or resection to restore normal eye alignment and binocular function. This ophthalmic procedure is commonly performed to treat strabismus and related binocular vision disorders and has implications for both functional vision outcomes and surgical resource utilization nationwide. It is relevant to surgical departments, ophthalmologists, ambulatory surgical centers, hospitals, and payers managing surgical benefit coverage.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical intent of the code, typical sites of service, and the procedural scope. The publication summarizes common billing practices and typical modifiers used with the code, outlines typical clinical scenarios prompting the procedure, and highlights items important for claims processing and payer review. It also provides benchmarks for utilization and frequency where available, and notes recent policy or coding guidance that may affect coverage and documentation expectations.
This national overview is intended for coding professionals, revenue cycle staff, clinicians involved in ophthalmic surgery, and payer policy teams seeking a concise reference on CPT code 67311. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 67311 describes a surgical procedure to correct an imbalance of the extraocular muscles by either recession (weakening) or resection (strengthening) of the affected muscle(s). The goal of the procedure is to restore proper alignment and coordinated movement of the eyeball, improving binocular vision and reducing diplopia or strabismus.
Service type: Ophthalmic strabismus surgery
Typical site of service: Hospital operating room or ambulatory surgical center, performed by an ophthalmologist or strabismus surgeon under appropriate anesthesia.
Clinical & Coding Specifications
Clinical Context
A 9-year-old child presents with persistent horizontal strabismus (esotropia) causing diplopia and impaired stereopsis despite corrective glasses and occlusion therapy. Preoperative evaluation by the pediatric ophthalmologist includes orthoptic measurements, cycloplegic refraction, ocular motility testing, and counseling. The planned operative procedure is a unilateral medial rectus recession and lateral rectus resection under general anesthesia to realign the ocular muscles and restore binocular alignment.
On the day of surgery the patient arrives at an ambulatory surgery center. Preoperative verification and consent are confirmed, anesthesia evaluation is completed, and operative site marking is documented. Intraoperative steps include conjunctival incision, isolation of the targeted extraocular muscles, measured recession of the medial rectus and measured resection of the lateral rectus, scleral fixation of the muscle(s), and conjunctival closure. Postoperative instructions cover antibiotic and steroid drops, activity restrictions, follow‑up for suture removal if necessary, and orthoptic rehabilitation as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | Use when the same extraocular muscle procedures are performed on both eyes during the same operative session. |