Summary & Overview

CPT 67840: Excision of Diseased or Damaged Eyelid, Excluding Chalazion

CPT code 67840 covers surgical excision of diseased or damaged eyelid tissue, excluding chalazion removal, and includes wound closure when required. This procedure is commonly performed to remove neoplastic, degenerative, or traumatic lesions of the eyelid and is clinically significant for preserving ocular function and cosmesis. Nationally, accurate coding of eyelid excisions affects surgical case classification, facility billing, and appropriate allocation of resources for ophthalmologic and oculoplastic services.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, common billing modifiers and coding considerations provided in ancillary sections, and references to related procedure groupings. The publication outlines benchmarking approaches and common payer coverage patterns where available, highlights policy and documentation points that influence claim acceptance, and summarizes coding relationships relevant to eyelid surgical services.

Intended for billing managers, surgical providers, and policy analysts, this summary provides a practical national-level reference for CPT code 67840 including what the code represents, where it is typically performed, and which major payers are commonly involved. Data not available in the input is identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 67840eyelid excisionophthalmic surgeryoculoplasticoutpatient surgeryprocedure codingsurgical pathologyoperative procedurewound closure

Billing Code Overview

CPT code 67840 describes the surgical excision of a diseased or damaged portion of the eyelid, excluding removal of a chalazion. The procedure includes necessary closure of the wound with sutures when indicated.

Service type: Eyelid excision (operative procedure)
Typical site of service: Ambulatory surgical center or hospital outpatient department; may also be performed in an office-based surgical suite depending on clinical setting and facility capabilities.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 67-year-old patient presents to an ophthalmology clinic with a slowly enlarging, irregular, crusting lesion on the lower eyelid margin that intermittently bleeds and causes discomfort. Examination by the oculoplastic surgeon demonstrates a suspicious full-thickness eyelid lesion consistent with a possible malignancy (for example, basal cell carcinoma) or a severely scarred/necrotic area from prior trauma. After counseling and obtaining informed consent, the provider schedules excision of the diseased eyelid tissue under local anesthesia with intraoperative frozen section or standard histopathology. The procedure includes excision of the lesion with margin control and, if needed, layered closure with sutures to restore eyelid function and contour. Typical workflow includes preoperative evaluation, local anesthesia, excision of the lesion, hemostasis, possible tissue submission to pathology, wound closure, postoperative instructions, and short-term follow-up to assess healing and suture removal. Typical site of service is an outpatient ophthalmology clinic, ambulatory surgical center, or hospital outpatient department. Service type is minor surgical excision of eyelid tissue (non-chalazion eyelid lesion excision) with possible closure.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work or time substantially exceeds usual for `67840` (document reason and additional work).
`23`	Unusual anesthesia	Use if general anesthesia is used for reasons unrelated to the procedure complexity (document medical necessity).
`24`	Unrelated evaluation and management (E/M) service during postoperative period	Use when an E/M visit unrelated to the excision is provided during the global period.
`26`	Professional component	Use when billing only the physician professional component separate from technical facility services.
`50`	Bilateral procedure	Use if bilateral eyelid excisions are performed (confirm payer rules for bilateral coding).
`51`	Multiple procedures	Use when `67840` is one of multiple distinct procedures performed in the same session.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the procedure is started but discontinued due to extenuating circumstances.
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure when needed to bypass same-day bundling edits (use sparingly and justify).
`76`	Repeat procedure by same physician	Use if the exact procedure is repeated later the same day by the same provider.
`RT`	Right side	Use to indicate the right eyelid when laterality is reported.
`LT`	Left side	Use to indicate the left eyelid when laterality is reported.
`AJ`	Not listed in provided modifiers	Data not available in the input.

Taxonomy Code	Specialty	Notes
207W00000X	Ophthalmology	Oculoplastic and general ophthalmologists commonly perform eyelid lesion excisions.
363L00000X	Oculoplastic Surgery	Subspecialists in oculoplastics perform complex eyelid reconstructions and excisions.
208800000X	Dermatology	Dermatologic surgeons perform eyelid skin lesion excisions and reconstructions.
207P00000X	Family Medicine	Family physicians with procedural skillsets may perform simple eyelid excisions in outpatient settings.
208000000X	General Surgery	General surgeons with experience in skin/soft tissue excisions may perform periocular lesion excisions in some settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C44.111`	Basal cell carcinoma of right eyelid, including canthus	Common malignant eyelid lesion requiring excision of affected tissue with margin control.
`C44.112`	Basal cell carcinoma of left eyelid, including canthus	As above, for left-sided lesions requiring surgical excision.
`C44.119`	Basal cell carcinoma of unspecified eyelid, including canthus	Use when laterality not specified; indicates malignant lesion of eyelid requiring excision.
`D04.1`	Carcinoma in situ of eyelid, including canthus	Intraepithelial malignancy often treated with surgical excision to prevent progression.
`H02.831`	Other specified disorders of right eyelid	Non-specific eyelid lesions or scarring that may require excision for symptom relief or diagnosis.
`H02.832`	Other specified disorders of left eyelid	As above, left-sided presentations needing excision.
`S01.101A`	Laceration without foreign body of right eyelid, initial encounter	Traumatic eyelid injuries with devitalized tissue may require debridement/excision and closure.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12041`	Repair of wound(s) of face, ears, eyelids, nose, lips; 2.5 cm or less	May be used when layered primary closure of the eyelid defect requires an adjacent tissue repair technique for small defects following excision.
`13131`	Complex repair, eyelids, nose, ears, and/or fingers; 1.1 cm to 2.5 cm	Used when reconstruction after excision requires complex layered repair or multiple layers and undermining beyond simple closure.
`17110`	Destruction, premalignant lesion (e.g., actinic keratoses), 4 cm or less	May be performed for small superficial lesions when destruction rather than excision is chosen instead of `67840`.
`88305`	Level IV surgical pathology, gross and microscopic examination	Used when the excised eyelid specimen is submitted for standard histopathologic evaluation.
`15730`	Composite graft to face, nose, eyelids; first 3.0 sq cm or less	Used when reconstruction after excision requires grafting techniques for larger eyelid defects.