Summary & Overview
CPT 67314: Strabismus Repair (Extraocular Muscle Surgery)
CPT code 67314 designates surgical repair for strabismus involving recession or resection of extraocular muscles to realign the eye. This procedure matters nationally because strabismus surgery addresses functional vision impairment, reduces diplopia, and can improve binocular vision and quality of life across pediatric and adult populations. It is commonly performed in ambulatory surgical centers and hospital outpatient departments, and it has implications for surgical resource use, preoperative evaluation, and postoperative follow-up care.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the procedure’s clinical intent and service context, payer coverage considerations, and benchmarks where available. The publication summarizes coding specifics for billing and claims submission, typical sites of service, and the clinical scenarios in which a recession or resection is performed. It also outlines common modifiers associated with surgical services and notes when additional documentation or global period rules may be relevant.
This resource is intended for billing managers, ophthalmology practice administrators, coding specialists, and policy analysts seeking a national-level summary of CPT code 67314, its clinical application, and the payer landscape affecting reimbursement and coverage policies.
Billing Code Overview
CPT code 67314 describes a surgical procedure to correct strabismus by realigning extraocular muscles. The physician performs either a recession (weakening) or resection (strengthening) of one or more eye muscles to improve ocular alignment and binocular vision.
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Service type: Strabismus repair (extraocular muscle surgery)
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Typical site of service: Ambulatory surgical center or hospital outpatient surgical suite
Clinical & Coding Specifications
Clinical Context
A typical patient is a child or adult with symptomatic strabismus (ocular misalignment) presenting to an ophthalmology clinic for evaluation. The patient undergoes a preoperative assessment including history (onset, diplopia, amblyopia risk), full ophthalmic exam, ocular motility testing, measurement of deviation (prism cover test), and identification of restrictive or paretic components. Conservative measures (glasses, patching, prisms, orthoptics) are reviewed; when surgical realignment is indicated, the patient is scheduled for a strabismus muscle procedure such as recession (weakening) or resection (strengthening) of one or more extraocular muscles.
On the day of surgery the procedure is typically performed in an ambulatory surgery center or hospital outpatient operating room under general anesthesia for children or monitored anesthesia care/local for cooperative adults. The surgeon performs conjunctival incision, isolation of the target muscle, and either recession or resection with scleral suturing to adjust muscle tension and alignment. Postoperative follow-up includes immediate assessment for alignment, pain control, topical antibiotics and steroids, and scheduled visits to monitor alignment, diplopia, and healing. Rehabilitation may include prism prescription or additional surgery if under- or over-correction occurs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician’s professional component for a service split between professional and technical components. |