CUSTOMFLEX® ARTIFICIALIRIS Reimbursement
Billing Overview
A Category 1 CPT code has been assigned for reporting surgeries with the CUSTOMFLEX® ARTIFICIALIRIS prosthesis as of 1/1/25.
66683….. Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed
(Do not report the code with anterior chamber paracentesis codes, anterior segment adhesion severing codes, anterior chamber injection codes, stab incision iridotomy codes, iridectomy codes, iris repair codes, iris cyst or lesion destruction code, retrobulbar and Tenon's capsule injection codes, or microsurgical technique with operating microscope code
Because the CUSTOMFLEX® ARTIFICIALIRIS is used in a variety of situations, often to repair serious injuries to the iris and adjacent tissues, it may be one part of a compound procedure that includes surgery of the cornea, anterior chamber angle, vitreous and retina.
In 2025, national Medicare payment rates for 66683 are:
Ambulatory surgery center (ASC) $13,886
Hospital outpatient department (HOPD) $16,416
Surgeon $749
The facility payment rates are inclusive of the artificial iris prosthetic.
HOPDs report the supply of the CUSTOMFLEX® ARTIFICIALIRIS on a claim using C1839 (Iris prosthesis). C1839 is a nonpayable code but must be present, along with 66683, for the claim to be billed correctly.
ASCs only bill 66683 for the artificial iris implantation and device cost.
Diagnosis codes in the S05‐ series describe injury of the eye and orbit. Particularly, S05.2‐ describes loss of intraocular tissue such as iris. Diagnosis code Q13.1 describes congenital aniridia.
For more information, please see the attached documents above.
