67120 Implant removal Medicare reimbursement rates in Utah

An ophthalmologist, commonly a retina specialist, reports this service when surgically removing implanted material located inside the posterior segment of the eye. A familiar situation is removal of silicone oil previously placed to support the retina after retinal detachment repair. The surgeon accesses the eye and removes the material using an intraocular approach, often in an operating room or ambulatory surgery setting. This code distinguishes material removed from within the eye from material removed outside the globe, such as an encircling scleral buckle.

Select the code based on the material’s location and the operative work, not simply the patient’s history of retinal surgery. The operative report should identify the material, its intraocular posterior-segment location, the eye treated, and the removal performed. This major surgery has a 90-day global period that includes 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 other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons require supporting documentation, and team surgery is not permitted.