Summary & Overview
CPT 67413: Incision of Orbit for Removal of Foreign Body
CPT code 67413 denotes an operative procedure to incise the orbit via an eyelid or conjunctival approach to remove a foreign body without creating a bone flap. This code captures a specific ophthalmic orbital surgery that addresses retained intraorbital foreign material and is used in billing for surgical services in hospital and ambulatory surgical settings. Nationally, accurate coding for orbital foreign body removal matters because it affects surgical case classification, resource use, and longitudinal tracking of ocular trauma and surgical outcomes.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, guidance on typical sites of service, and an overview of common billing modifiers and payer considerations where provided. The publication highlights benchmark elements and coding context useful for providers, billing staff, and policy analysts seeking clarity on when and how this specific surgical code is applied. Data not available in the input are noted where applicable, and readers will receive a focused summary of code intent, service type, and operational settings relevant to national billing practices.
Billing Code Overview
CPT code 67413 describes an operative procedure in which the provider incises the orbit — the bony cavity that holds the eye — through an eyelid incision or through the conjunctival membrane to remove a foreign body. The procedure is performed without creating a bone flap (no temporary removal of a bone segment).
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Service type: Surgical operative procedure for removal of orbital foreign body
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Typical site of service: Hospital operating room or ambulatory surgical center, often performed by ophthalmic or orbital surgeons under sterile operative conditions
Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents to the emergency department after a workplace injury in which a metal fragment penetrated the left orbital area. The patient reports pain, decreased extraocular motility, and a sensation of a foreign body. Initial evaluation includes visual acuity testing, pupillary exam, ocular motility assessment, and bedside slit-lamp and funduscopic exams. Non-contrast orbital CT imaging confirms a small intraorbital foreign body located inferior to the globe without evidence of globe rupture or intracranial extension. Ophthalmology (oculoplastics/orbital surgeon) is consulted. After informed consent, the patient is taken to the operating room where the surgeon makes an eyelid (transcutaneous) or conjunctival (transconjunctival) incision into the orbit, dissects to the foreign body, and removes it without creating a bone flap. Hemostasis is achieved and the incision closed. Postoperative care includes topical and/or systemic antibiotics, tetanus prophylaxis as indicated, ocular motility monitoring, and follow-up visits to assess wound healing and visual function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typical for 67413, documented with supporting operative report and time. |