CPT 67875 Tarsorrhaphy Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 67875: Temporary Eyelid Suturing (Tarsorrhaphy)

CPT code 67875 denotes temporary suturing of the eyelids (tarsorrhaphy) performed to immobilize the lids after ocular surgery or to protect and promote healing of a painful or eroded cornea. This minor ophthalmic surgical code is clinically important because it can prevent corneal exposure, reduce postoperative complications, and preserve vision, making it a procedure with clear clinical indications across diverse care settings.

The analysis covers national payer practices and benchmarks for major payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of authorization and coverage patterns, frequency benchmarks, common sites of service, and coding considerations relevant to billing and claims review. The publication summarizes typical clinical contexts in which 67875 is used, expected settings of care, and the typical service profile for temporary eyelid closure.

This resource provides clinicians, billing professionals, and policy analysts with concise guidance on the clinical role of CPT code 67875, common payer coverage scope, and the types of operational and administrative issues to anticipate when this procedure is performed nationally.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare67875CPTophthalmologytarsorrhaphyeyelid-suturingambulatory-surgeryoutpatientsurgical-procedure

Billing Code Overview

CPT code 67875 describes temporary surgical closure of the eyelids by suturing them together. This procedure is performed to immobilize the eyelids after ocular surgery to allow healing or to protect and relieve a painful or eroded cornea.

Service type: Minor ophthalmic surgical procedure for eyelid immobilization
Typical site of service: Ophthalmology clinic, ambulatory surgical center, or hospital outpatient setting

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or pediatric ophthalmology patient who presents with corneal exposure, persistent corneal epithelial defect, painful corneal erosion, or requires temporary immobilization of the eyelids following periocular surgery. For example, a 68-year-old patient with a large, nonhealing corneal epithelial defect after herpetic keratitis or a 45-year-old with severe eyelid trauma and a painful, exposed cornea may undergo temporary tarsorrhaphy. The clinical workflow includes a focused ophthalmic examination, topical or local anesthesia, placement of temporary sutures to partially or completely close the eyelids (procedure code 67875``), postoperative topical antibiotic or lubrication therapy, and scheduled follow-up visits to assess corneal healing and remove sutures when appropriate. Typical documentation includes indication, informed consent, anesthesia type, laterality, technique (temporary sutures), number and type of sutures, postoperative instructions, and follow-up plan.

Coding Specifications

The most clinically relevant modifiers for 67875 are selected based on typical perioperative and administrative scenarios.

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure

CPT 67880: Tarsorrhaphy for Corneal Healing

CPT-67882-TEMPORARY-OR-PERMANENT-TARSORRHAPHY-EYELID-CLOSURE

CPT 67882: Tarsorrhaphy for Eyelid Closure to Protect the Cornea

Taxonomy Code	Specialty	Notes
`207L00000X`	Ophthalmology	Most common specialty performing tarsorrhaphy.
`207K00000X`	Oculoplastic Surgery	Subspecialists who manage eyelid/ocular surface reconstruction.
`363L00000X`	Optometry	May perform in some jurisdictions under scope and co-management agreements; typically limited.
`2084P0800X`	Emergency Medicine	Performs temporary tarsorrhaphy in acute trauma or exposure cases in ED settings.

Related Diagnoses

Common ICD-10 codes associated with temporary tarsorrhaphy.

ICD-10 Code	Description	Clinical Relevance
`H16.221`	Central corneal ulcer, right eye	Corneal ulcers with risk of exposure or poor healing may be protected with temporary tarsorrhaphy.

| H16.222 | Central corneal ulcer, left eye | Same relevance for the left eye.

| H18.02 | Band keratopathy, right eye | Ocular surface disease causing pain or epithelial compromise that may benefit from eyelid closure.

| H18.03 | Band keratopathy, left eye | Same relevance for left eye.

| H02.00 | Entropion and trichiasis of unspecified eyelid | Eyelid malpositions causing corneal irritation sometimes managed temporarily with closure.

| S05.2XXA | Injury of eyeball and orbital tissues, initial encounter | Acute trauma with corneal exposure or epithelial injury may require temporary tarsorrhaphy for protection.

| B00.50 | Herpesviral keratitis, unspecified | Recurrent or severe viral keratitis with poor epithelial healing can be an indication for temporary eyelid closure.

| H11.123 | Exposure keratoconjunctivitis, right eye | Direct indication when exposure leads to corneal compromise addressed by tarsorrhaphy.

Related CPT Codes

Common CPT codes performed alongside or in the perioperative care of a temporary tarsorrhaphy are listed below.

CPT Code	Description	Relationship to This Procedure
`65820`	Tarsorrhaphy, permanent with or without tarsal rotation	Alternative definitive procedure when permanent eyelid closure is required; may follow or replace temporary closure.

| 67800 | Excision of lesion of eyelid (eg, chalazion); single lesion | Performed when excision of eyelid lesions is part of the same surgical episode before temporary closure for healing.

| 67850 | Closure of eyelid laceration; without repair of levator or canalicular system | Performed for traumatic eyelid repairs that may be accompanied by temporary tarsorrhaphy to protect the globe.

| 12002 | Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk; 2.5 cm or less | Generic simple repair code sometimes reported for periocular skin repairs in minor procedures accompanying tarsorrhaphy.

| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | Example E/M codes used on the same day when 25 modifier applies for a distinct visit related to the eyelid/corneal condition.

| 99070 | Supplies and materials (except spectacles), used for more than usual in the office | Used when special dressings, amniotic membrane products, or other supplies are used along with the procedure.

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