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    v1.0.30
    OpenPayerBilling CodesOutpatient PPSHCPCS hcpcs-c1818-integrated-keratoprosthesis
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    HCPCS Level II C1818: Integrated Keratoprosthesis

    HCPCS Level II code C1818 denotes an integrated keratoprosthesis, a surgical ophthalmology implant procedure that replaces or augments the cornea with a prosthetic device; the service is an implantation of an integrated corneal prosthesis typically performed in an operating room or ambulatory surgery center by an ophthalmic surgeon, and the code is used for billing and documentation of that specific keratoprosthetic implant service.

    For related coverage guidance, see recent payer policy updates: Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood Pressure, Cardiology - Ivabradine, Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA).

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    Clinical & Coding Specifications

    Clinical Context

    An adult patient with severe corneal disease not amenable to conventional penetrating or lamellar keratoplasty undergoes placement of an integrated keratoprosthesis (C1818). Typical indications include end-stage corneal opacity from multiple failed grafts, severe ocular surface disease (for example, Stevens-Johnson syndrome or ocular cicatricial pemphigoid), chemical injury with loss of corneal clarity, or severe limbal stem cell deficiency with visual axis compromise. The clinical workflow begins with a comprehensive ophthalmic evaluation including best-corrected visual acuity, slit-lamp exam, corneal imaging, and assessment of eyelid and ocular surface health. Preoperative counseling and medical optimization (control of surface inflammation, treatment of ocular surface disease, systemic immunosuppression if indicated) are completed prior to scheduling.

    On the day of service, the procedure is performed in an operating room or ambulatory surgery center under general or monitored anesthesia care. The integrated keratoprosthesis is implanted either as a primary reconstruction or as a revision after failed grafts. Postoperative care includes topical antimicrobials, anti-inflammatory agents, frequent follow-up visits to monitor device position, corneal-tissue interface, intraocular pressure, and management of complications (retroprosthetic membrane, device extrusion, endophthalmitis). Long-term surveillance and possible further procedures (membrane removal, glaucoma procedures) are part of care coordination.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    65730Corneal transplant, penetrating; full thicknessAlternative or prior procedure in patients with failed penetrating keratoplasty considered before keratoprosthesis.
    65785Keratolimbal allograft (eg, for limbal stem cell deficiency), with or without amniotic membranePerformed in patients with severe limbal stem cell deficiency who may require ocular surface stabilization prior to or in conjunction with keratoprosthesis.
    65778Keratoprosthesis, donor corneal graft with artificial corneal device (eg, Boston type I), implantationDirectly related implantation code for certain keratoprosthesis procedures often performed alongside integrated keratoprosthesis workflows.
    66170Anterior vitrectomy, with or without irrigation/aspirationPerformed intraoperatively if vitreous prolapse or anterior vitreous needs removal during keratoprosthesis implantation.
    66761Removal of implanted device (prosthesis), anterior segment; for retained membranes or revisionsUsed when membrane removal, device revision, or explantation is required after keratoprosthesis placement.
    66183Excision or drainage of lesion of orbit or eyelid when requiredPeriocular or orbital procedures performed concurrently when adnexal reconstruction is needed in the same operative setting.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207W00000X
    207K00000X
    363L00000X
    367500000X
    333600000X
    207RA0401X
    2278S1500X
    364ST0500X

    Related Payer Policy Updates

    Specialty: Cardiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Automated Ambulatory Blood Pressure Monitoring for Diagnosis of Hypertension in Patients with Elevated Office Blood PressureBluecross Idaho2026-11-01
    Cardiology - IvabradineCigna2026-10-15
    Cardiac Computed Tomography (CCT)/Coronary Computed Tomographic Angiography (CCTA)univerahealthcare2026-10-15
    Percutaneous Ventricular Assist DeviceUnitedHealthcare2026-10-01
    Cardiovascular Disease Risk AssessmentOscar Health2026-10-01
    Biomarkers for Myocardial Infarction and Chronic Heart FailureOscar Health2026-10-01
    Multiple Procedure Payment Reduction for Diagnostic Cardiovascular ProceduresBlue Cross Blue Shield - Maine2026-10-01
    Left Atrial Appendage Closure Devicesexcellus_health_plan_inc2026-09-17
    Left Atrial Appendage Closure Devicesuniverahealthcare2026-09-17
    Cardiac Omnibus CodesCigna2026-09-15

    Related Codes

    HCPCS-C1713-IMPLANTABLE-ANCHOR-SCREW-BONE-FIXATION

    HCPCS C1713: Anchor/Screw for Bone or Soft Tissue Fixation (Implantable)

    HCPCS-C1714-TRANSLUMINAL-DIRECTIONAL-ATHERECTOMY-CATHETER

    HCPCS C1714: Catheter, transluminal atherectomy, directional

    HCPCS-C1715-BRACHYTHERAPY-NEEDLE

    HCPCS C1715: Brachytherapy Needle

    HCPCS-C1716-BRACHYTHERAPY-GOLD-198-SOURCE

    HCPCS C1716: Brachytherapy Source, Gold-198, Per Source

    HCPCS-C1717-HDR-BRACHYTHERAPY-IRIDIUM-192-SOURCE

    HCPCS C1717: HDR Iridium-192 Brachytherapy Source, Per Source

    HCPCS-C1719-BRACHYTHERAPY-IRIDIUM-192-SOURCE-NON-STRANDED

    HCPCS C1719: Brachytherapy Source, Iridium-192, Non-Stranded

    HCPCS-C1721-IMPLANTABLE-DUAL-CHAMBER-CARDIOVERTER-DEFIBRILLATOR

    HCPCS C1721: Cardioverter-Defibrillator, Dual Chamber (Implantable)

    HCPCS-C1724-ROTATIONAL-TRANSLUMINAL-ATHERECTOMY-CATHETER

    HCPCS Level II C1724: Rotational Transluminal Atherectomy Catheter

    HCPCS-C1725-TRANSLUMINAL-ANGIOPLASTY-CATHETER-NON-LASER

    HCPCS Level II C1725: Transluminal Angioplasty Catheter, Non-Laser

    HCPCS-C1726-NON-VASCULAR-BALLOON-DILATATION-CATHETER

    HCPCS C1726: Catheter, Balloon Dilatation, Non-Vascular

    Showing 1–10 of 603

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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