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Official Description

Evisceration of ocular contents; without implant

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Evisceration of the eye, as described by CPT® Code 65091, is a surgical procedure that involves the removal of the ocular contents while leaving the scleral shell intact. This procedure is typically indicated for patients suffering from severe eye infections that do not respond to antibiotic treatment, as well as for those experiencing significant pain or discomfort in a blind eye. The goal of evisceration is to alleviate pain and improve the cosmetic appearance of the affected eye. During the procedure, the cornea is excised, allowing access to the internal structures of the eye. An ocular curette is then utilized to carefully scrape away the internal ocular contents, which include the retina, uveal tract, vitreous body, and lens, from the scleral shell. To manage any bleeding that may occur from the vortex veins and central retinal artery during this process, electrocautery and/or pressure techniques are employed. After the ocular contents have been removed, the scleral shell is meticulously inspected, and any residual uveal tissue is cleared using a swab. It is important to note that in this specific code, no implant is placed within the scleral shell, distinguishing it from related procedures such as CPT® Code 65093, where an implant is inserted to provide structural support.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The evisceration of ocular contents is performed under specific clinical circumstances. The following indications are explicitly recognized for this procedure:

  • Severe Eye Infections - Evisceration may be indicated for patients with eye infections that are unresponsive to antibiotic therapy, necessitating surgical intervention to prevent further complications.
  • Pain Control - This procedure is also performed to alleviate significant pain associated with a blind eye, providing relief to patients who may be suffering from chronic discomfort.
  • Cosmetic Improvement - Evisceration can improve the appearance of a blind eye, addressing aesthetic concerns for patients who may be self-conscious about the condition of their eye.

2. Procedure

The evisceration procedure involves several critical steps to ensure the safe and effective removal of ocular contents. The following procedural steps are outlined:

  • Step 1: Corneal Excision - The procedure begins with the excision of the cornea, which allows access to the internal structures of the eye. This step is crucial for facilitating the subsequent removal of ocular contents.
  • Step 2: Insertion of Ocular Curette - An ocular curette is then inserted into the space between the uveal tract and the sclera. This instrument is specifically designed to aid in the careful scraping away of the internal ocular contents.
  • Step 3: Removal of Ocular Contents - The ocular contents, including the retina, uveal tract, vitreous body, and lens, are meticulously scraped away from the scleral shell. This step requires precision to ensure that all internal structures are removed effectively.
  • Step 4: Control of Bleeding - During the removal process, bleeding may occur from the vortex veins and central retinal artery. To manage this, electrocautery and/or pressure techniques are employed to control any hemorrhage and maintain hemostasis.
  • Step 5: Inspection and Cleaning - After the ocular contents have been removed, the scleral shell is carefully inspected for any remaining uveal tissue. A swab is used to remove any residual tissue, ensuring that the area is clean and free of debris.

3. Post-Procedure

Post-procedure care following evisceration of ocular contents is essential for optimal recovery. Patients may experience some discomfort and swelling in the area, which can be managed with prescribed pain relief medications. It is important for patients to follow their healthcare provider's instructions regarding wound care and any prescribed medications to prevent infection. Regular follow-up appointments may be necessary to monitor the healing process and address any complications that may arise. Since no implant is placed in this procedure, the focus will be on ensuring the scleral shell heals properly and that the patient adjusts to the changes in their ocular structure.

Short Descr REVISE EYE
Medium Descr EVISCERATION OCULAR CONTENTS W/O IMPLANT
Long Descr Evisceration of ocular contents; without implant
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P4E - Eye procedure - other
MUE 1
CCS Clinical Classification 21 - Other extraocular muscle and orbit therapeutic procedures
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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