Summary & Overview
CPT 67801: Removal of Multiple Chalazia, Same Eyelid
CPT code 67801 denotes the surgical removal of multiple chalazia from the same eyelid, a common minor ophthalmic procedure to treat persistent eyelid masses that do not respond to conservative therapy. Nationally, this code matters because it captures discrete procedural care for eyelid pathology, affects outpatient ophthalmology billing patterns, and factors into utilization and coverage determinations for eyelid procedures. Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what clinical service CPT code 67801 represents, typical settings where the procedure is performed, and which major payers cover the service. The publication provides benchmarks and operational context relevant to coding and billing for minor eyelid surgeries, summarizes common payer considerations, and outlines how this code fits into ophthalmic procedural reporting. Data limitations: specific ICD-10 pairings, detailed payer policy language, and internal taxonomy mappings are not provided in the input and are noted as unavailable where applicable.
Billing Code Overview
CPT code 67801 describes the removal of multiple chalazia from the same eyelid. Chalazia are small, localized masses within the eyelid caused by obstruction and inflammation of meibomian glands. This procedure involves incision and drainage or excision of several chalazia during a single operative session.
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Service type: Minor surgical procedure on the eyelid
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Typical site of service: Office or ambulatory surgical center (outpatient ophthalmic procedure)
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or adolescent presenting to an ophthalmology clinic with multiple chalazia clustered on the same eyelid that have persisted despite conservative management (warm compresses, lid hygiene, topical antibiotics or steroid ointments) for several weeks. The patient reports localized eyelid swelling, tenderness, and occasional blurred vision from mechanical ptosis or ocular surface irritation. After clinical evaluation including slit-lamp exam and confirmation that lesions are chalazia (not hordeola, tumor, or skin infection requiring systemic therapy), the ophthalmologist schedules an in-office procedure under local anesthetic. The workflow includes pre-procedure consent, topical and local infiltration anesthesia, sterile field setup, incision and curettage of multiple chalazia through conjunctival or cutaneous approach as clinically appropriate, hemostasis, and post-procedure instructions with short-term topical antibiotic or steroid regimen. Typical documentation includes indication, number and location of lesions, approach (internal vs external), anesthesia type, complications (if any), and postoperative care instructions. The typical site of service is an ambulatory ophthalmology clinic procedure room or ambulatory surgical center for patients requiring monitored sedation or additional services. Payers commonly billed include commercial plans such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Data not available in the input. |