Summary & Overview
CPT 21282: Canthopexy for Lateral Canthal Tendon Repair
CPT code 21282 represents a surgical canthopexy to repair the lateral canthal tendon, a procedure that restores lower eyelid position and support. Nationally, this code is relevant for practices in ophthalmic and facial plastic surgery, as it documents corrective reconstruction for eyelid tendon injury or laxity that can impact ocular protection and cosmesis. Payers typically engaged in coverage and payment decisions for this service include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. This publication provides clinicians, coding specialists, and revenue leaders with a concise briefing on the clinical purpose of the code, typical settings where the procedure is performed, and the payers commonly analyzed. Readers will find guidance on expected use cases for CPT code 21282, common billing modifiers included in payer interactions (data provided separately), and the clinical context that supports medical necessity for repair of the lateral canthal tendon. Where detailed payer policy language, specific ICD-10 pairings, or taxonomies are required for claims adjudication, this summary notes that those items are addressed in accompanying sections. Data not available in the input are clearly identified in supporting tables.
Billing Code Overview
CPT code 21282 describes a canthopexy to repair a damaged lateral canthal tendon, a surgical procedure intended to restore and maintain the shape and support of the lower eyelid. The procedure addresses lateral canthal tendon injury or laxity that affects eyelid position and function.
Service Type: Eyelid reconstructive surgery
Typical Site of Service: Outpatient surgical setting or ambulatory surgery center, often performed by ophthalmic plastic surgeons or facial plastic surgeons.
Clinical & Coding Specifications
Clinical Context
A 68-year-old female presents to an oculoplastic surgeon with progressive lower eyelid malposition and ocular surface irritation following prior facial trauma and age-related laxity. She reports epiphora, exposure-related dry eye, and cosmetic concern from an outwardly displaced lateral canthus. Examination shows lateral canthal tendon laxity with horizontal lower eyelid laxity and mild scleral show. The provider plans a repair of the lateral canthal tendon (canthopexy) under local anesthesia with monitored anesthesia care in an ambulatory surgical center. Preoperative steps include informed consent, preop photos, medication reconciliation, and topical ocular lubrication. Intraoperative workflow includes local anesthetic infiltration, identification and plication or suspension of the lateral canthal tendon to the orbital rim periosteum, hemostasis, and layered closure. Postoperative care includes antibiotic ointment, cold compresses, activity restrictions, and a 1-week follow-up for suture removal and assessment. The procedure preserves eyelid contour and improves lid apposition while minimizing operative time and facility resources.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the surgeon's professional services separate from technical facility charges |
50 |