Ophthalmology Surgical Billing Outsourcing
Outsource ophthalmology surgical billing to remote AAPC-credentialed BPO coders. Cataract, retina, glaucoma, cornea, and oculoplastics surgical billing. Modifier 24, 25, 57, 78, 79, and 58 applied correctly. Global period management. ASC plus professional split billing. AAPC-credentialed surgical coders.
Ophthalmology Surgical Billing, handled by a dedicated remote team
Trained specialists handle it inside your existing software, so your team stays on patient care.
With Staffingly, ophthalmology surgical billing outsourcing means a dedicated team of trained specialists running this part of your back office. They are named to your account and work remotely as an extension of your staff, not a shared offshore pool. As a HIPAA-compliant healthcare BPO, we bill a flat weekly fee per specialist, never a percentage of your collections.
Surgical billing across every eye care subspecialty
Cataract. Retina. Glaucoma. Cornea. Oculoplastics. We handle the modifier, the global period, and the ASC split. Charges are reviewed by AAPC-credentialed surgical coders who know the difference between modifier 78 and modifier 79.
Surgical ophthalmology billing fails on modifier discipline more than anything else. Modifier 25 for the same-day E/M plus minor procedure. Modifier 57 for the same-day decision-for-surgery E/M plus major procedure. Modifier 78 for a return to the OR during a global. Modifier 79 for an unrelated procedure during a global. Modifier 58 for a staged or related procedure. Modifier 24 for an unrelated E/M during a global. Each one has audit risk. We get them right.
We also coordinate ASC plus professional split billing. The facility fee bills under the ASC's tax ID and the professional component bills under the surgeon. Both sides need to use the same CPT for the procedure. We confirm alignment before either side submits.
For surgical PA before the OR, see the cataract surgery PA spoke and the anti-VEGF PA spoke . For aged AR see the AR calling spoke .
Tell us about your practice.
Send us your situation and our team will scope the right setup, usually within one business day. No obligation.
Surgical codes we bill weekly
CPT codes verified against AAPC ophthalmology coding and AMA CPT 2026. Global periods reflect current CMS guidance.
| CPT | Procedure | Global Period |
|---|---|---|
| 66984 | Cataract extraction with IOL | 90-day |
| 66982 | Complex cataract extraction with IOL | 90-day |
| 66821 | YAG laser capsulotomy | 90-day |
| 65855 | Selective laser trabeculoplasty (SLT) | 10-day |
| 66174 / 66175 | Canaloplasty (with / without retention device) | 90-day |
| 67028 | Intravitreal injection administration | 0-day |
| 67210 | Focal laser retinal photocoagulation | 10-day |
| 67228 | Panretinal photocoagulation | 10-day |
| 65730 | Penetrating keratoplasty | 90-day |
| 67900-67924 | Oculoplastic ptosis repair / blepharoplasty | 90-day |
Three things that protect surgical revenue
Modifier discipline
Modifier 24, 25, 57, 58, 78, 79 applied per documentation, not per habit. Audit trail in every chart.
Global period tracking
90-day, 10-day, and 0-day globals tracked in the EMR. Front desk knows the window before re-billing.
ASC + pro fee coordination
Facility and professional CPT alignment confirmed before either side submits. Underpayment audits run when ASC EOBs post.
Surgical encounter to payment
Surgical chart pull
OR note, op report, anesthesia record, post-op note pulled from EMR.
CPT + modifier review
AAPC-credentialed coder. Primary procedure, additional procedures, modifiers, ICD-10 specificity.
Global period flag
Window logged in EMR. Future encounters during global flagged for modifier evaluation.
ASC alignment
Facility CPT confirmed with ASC billing. Both sides submit aligned codes.
Submission + ERA
Submitted through Waystar or Trizetto. ERA posted within 24 hours of receipt.
Underpayment audit
Anti-VEGF underpayment audit by J-code. Surgical underpayment audit by CPT. Refile within 30 days.
AI + AAPC-Credentialed Coders = Cleaner Claims, Faster AR
Staffingly AI and workflow automation handle the repetitive parts of optometry and ophthalmology billing. Modifier suggestion, NCCI edits, global period tracking, anti-VEGF J-code units. Every claim still touched by an AAPC-credentialed coder before submission.
AI Coding Assistant
Suggests CPT 92002-92014 element matches, modifier 25/24/57/78/79 placement, and ICD-10 medical-necessity links. Coder confirms; AI never auto-submits.
NCCI Edit Engine
Automated NCCI edits apply the current-quarter ruleset and CCI bundling rules before the claim leaves your EMR. First-pass clean rate climbs.
Global Period Tracker
Automated global-period tracking watches every 90-day CPT 66984 cataracts and 67028 IVT injections. Modifier 24/79 placement happens automatically when post-op visits are unrelated.
AR Auto-Recall Engine
Automation categorizes aged AR by payer, denial reason, and dollar tier. High-yield denials get worked first. Nothing sits in the 90+ bucket without a touch.
- HIPAA Compliant
- SOC 2 Type II
- ISO 27001
- End-to-End Encryption
- BAA Before Pilot
How Staffingly works, in practice
Inside the work A trained Staffingly specialist handles the workflow inside your existing practice software, with clear escalation back to your team.
One Flat Weekly Rate. No Surprises.
Dedicated specialists at a fixed weekly cost. Per specialist FTE, per week. No contracts, no minimums, no hidden fees.
Want to compare against an in-house hire? Use the savings calculator.
Frequently asked questions
How do you handle modifier 25 for an exam plus same-day minor surgery?
When the documentation supports a significant separately identifiable E/M service on the same day as a minor procedure such as 67028 intravitreal injection or 65855 SLT, we append modifier 25 to the E/M code. We pull the documentation to confirm chief complaint, history, exam, and medical decision making are clearly separated from the procedure note. Modifier 25 is one of the top audit triggers in eye care so we document the rationale in the chart.
How do you manage the 90-day global period after cataract surgery (66984)?
CPT 66984 carries a 90-day global. We document the global period in the EMR. Any post-op exam in that window is included unless it is unrelated (modifier 24) or staged (modifier 58). Routine post-op visits do not generate a separate charge. We track the global window end date and prompt the front desk before re-billing.
Do you handle ASC + professional component split billing?
Yes. For surgical procedures performed at an ambulatory surgery center, the facility component is billed by the ASC and the professional component is billed by the surgeon. We coordinate with the ASC's billing team, confirm CPT alignment on both sides, and handle any underpayment audit when the ASC payment posts.
Can you audit anti-VEGF underpayments?
Yes. Anti-VEGF J-codes (J0178 Eylea, J0177 Eylea HD, J2778 Lucentis, J2777 Vabysmo) have specific unit billing rules. We audit ERAs against billed units and contracted rates. When a payer underpays, we file the corrected claim or appeal within 30 days of the original posting.
Should I outsource ophthalmology surgical billing?
For most surgical practices the answer is yes. Modifier 25 is one of the top audit triggers in eye care, the 90-day global period after CPT 66984 requires disciplined tracking, and ASC plus professional split billing needs CPT alignment between both sides. A remote AAPC-credentialed surgical coder priced as an outsourced specialist applies the right modifier per chart, tracks every global window, and runs the anti-VEGF J-code unit-level audit that catches underpayments.
How much does ophthalmology surgical billing outsourcing cost?
Staffingly surgical billing is a flat weekly rate: $399 per AAPC coder per week single, $349 at 5+ coders, $299 at 10+ resources. Each coder works 45 hours per week, fully managed, no long-term contract. The 2-Week Free Pilot is included so you see real operative-report coding go out on your real EMR before any invoice.
President and CEO, Staffingly, Inc. 25+ years in IT consulting and healthcare BPO operations. One of the earliest US operators to set up an RPO/BPO delivery network in India. Leads AI-driven optometry and ophthalmology workflows that help vision practices and multi-location groups cut admin cost without compromising care.
