Medicare Reimbursement for CUSTOMFLEX® ARTIFICIALIRIS

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Topic: Artificial Iris

Sponsor: VEO Ophthalmics

Updated: 12/01/2024

This FAQ addresses the following:

What is the CUSTOMFLEX® ARTIFICIALIRIS?
What is the FDA status of the device?
What are the indications for use?
How is the artificial iris implanted?
Will Medicare cover the artificial iris and its implantation?
What HCPCS code describes this prosthetic device?
What CPT codes are used to report implantation?
What is the Medicare payment to the surgeon?
What is the Medicare payment to the facility?

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The reimbursement information is provided by Corcoran Consulting Group based on publicly available information from CMS, the AMA, and other sources. The reader is strongly encouraged to review federal and state laws, regulations, code sets, and official instructions promulgated by Medicare and other payers. This document is not an official source nor is it a complete guide on reimbursement. Although we believe this information is accurate at the time of publication, the reader is reminded that this information, including references and hyperlinks, changes over time, and may be incorrect at any time following publication.

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