67318 Eye muscle surgery Medicare reimbursement rates in Michigan

An ophthalmic surgeon uses this code for a recession or resection procedure involving the superior oblique muscle as part of strabismus surgery. The operation changes the muscle’s position or effective tension to address misalignment, such as a vertical or torsional deviation associated with superior oblique dysfunction. These procedures are typically performed in an operating room, often in a facility setting.

Select this code when the operative report identifies the superior oblique muscle and documents the procedure performed; codes for other extraocular muscles distinguish different muscles or muscle counts. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare payment for an assistant at surgery is restricted; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.