Medicare Reimbursement for YAG Laser Floater Treatment (Ellex)

This monograph describes reimbursement for surgical treatment of vitreous floaters with a Nd:YAG1 laser using the Ultra Q Reflex™ or Tango Reflex™ multi-modality laser system.

Much of the information in this document is taken from official publications of the Medicare program. The reader is encouraged to check with the local Medicare Administrative Contractor (MAC) for additional information and instructions. For other third party payers, we have used the coding concepts contained in CPT (Current Procedural Terminology), published by the American Medical Association; diagnosis codes are from ICD-10-CM. Documentation of laser surgery, and the medical rationale for it, is key to reimbursement so we describe the required elements in detail.

Since economic analyses are a necessary part of any capital budgeting decision, we incorporated Medicare’s payment rates for laser vitreolysis as well as recent Medicare utilization rates.

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