Summary & Overview
CPT 21275: Secondary Orbitocraniofacial Reconstruction Revision
CPT code 21275 represents a secondary revision of prior orbitocraniofacial reconstruction to repair persistent or new facial deformities commonly resulting from trauma or congenital anomalies. This CPT surgical code captures procedures intended to restore form and function after an initial reconstructive operation and is relevant to plastic and craniofacial surgeons, hospital administrators, and payers involved in complex reconstructive care. Nationally, secondary craniofacial revision procedures carry implications for surgical resource utilization, facility setting selection, and post-operative care coordination.
Key payers included in the scope of this publication are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused overview of the code, typical sites of service, common modifiers (listed separately), and context about when secondary revision is performed. The publication outlines benchmarks and coverage considerations where available, highlights clinical scenarios that commonly lead to use of this code, and summarizes documentation elements that typically accompany complex reconstructive claims. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 21275 describes a secondary revision of orbitocraniofacial reconstruction performed to correct residual deformities of the face following an initial reconstructive procedure. This procedure typically addresses functional and cosmetic sequelae that arise from trauma or congenital craniofacial abnormalities.
Service Type: Surgical — Reconstructive/Plastic Surgery
Typical Site of Service: Hospital operating room or ambulatory surgical center, depending on patient complexity and facility resources.
Clinical & Coding Specifications
Clinical Context
A 38-year-old patient presents for a planned secondary orbitocraniofacial revision following prior reconstructive surgery after a motor vehicle collision two years earlier. The patient has persistent facial contour deformity with malpositioned orbital rim and residual facial asymmetry, malaligned zygomatic complex, and areas of scar contracture causing functional eyelid malposition and diplopia on upward gaze. Preoperative workup includes facial CT imaging with 3D reconstruction, ophthalmology evaluation for globe position and extraocular muscle function, and discussion of goals with the multidisciplinary craniofacial and maxillofacial team. In the operating room under general anesthesia, the reconstructive surgeon performs exposure of the previous fixation, removal or adjustment of plates and screws as needed, osteotomies to reposition bony segments, bone grafting or implant placement for contour restoration, soft tissue release and scar revision, and meticulous layered closure to restore form and function. Intraoperative documentation notes the prior surgical sites, any hardware removed, graft or implant materials used, estimated blood loss, and neurovascular structures protected. Postoperative care includes ophthalmic checks, pain control, wound care, and outpatient visits for suture removal and functional and aesthetic reassessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | When two surgeons work together as primary surgeons on separate portions of the procedure |