CPT 67914 Ectropion Repair Reimbursement

CPT code 67914 represents surgical repair of lower eyelid ectropion using sutures to correct outward turning of the eyelid and lashes. This ophthalmic reconstructive procedure is performed to reduce ocular surface exposure, improve tear drainage, and relieve irritation. Nationally, eyelid malposition procedures are clinically significant because they address functional vision risks and quality-of-life concerns in aging and surgically complex populations.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise synthesis of clinical context, common sites of service, and payer coverage patterns. The publication outlines expected billing and coding considerations tied to the procedure's clinical indications and typical care settings.

The report provides benchmarks where available, notes common modifiers used with this service, and highlights policy and coverage factors that affect reimbursement and prior authorization. Clinical context explains when ectropion repair is indicated and what outcomes the procedure seeks to achieve. Data gaps in the input are noted as "Data not available in the input." This summary is intended for clinicians, billing professionals, and policy analysts seeking an authoritative, national-level view of CPT code 67914 and its clinical and administrative implications.

Billing Code Overview

CPT code 67914 describes surgical repair of an ectropion of the lower eyelid using sutures to correct outward turning of the eyelid and eyelashes. The goal of the procedure is to restore proper eyelid position, reduce exposure and irritation of the ocular surface, and improve tear distribution.

Service Type: Ophthalmic reconstructive eyelid surgery

Typical Site of Service: Hospital outpatient surgical center or ambulatory surgical center; ophthalmology clinic with procedure capability

Clinical Context

A 72-year-old female presents to the ophthalmology clinic with progressive outward turning of the left lower eyelid causing chronic epiphora, conjunctival irritation, and exposure-related keratopathy. Conservative measures including lubricating drops and eyelid taping provided temporary relief. Examination demonstrates horizontal eyelid laxity and malposition consistent with involutional ectropion. The patient is scheduled for an operative repair under monitored anesthesia care. In the preoperative workflow, informed consent is obtained, photographs are taken, and local anesthesia with sedation is planned. Intraoperatively, the surgeon places sutures and performs eyelid tightening and reattachment techniques to restore normal eyelid apposition; hemostasis is confirmed and a topical antibiotic ointment is applied. Postoperative workflow includes discharge instructions, topical antibiotics and lubricants, a follow-up visit at 1 week for suture check, and an ophthalmology clinic visit at 4–6 weeks to confirm eyelid position and healing.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use when the procedure is performed on the left lower eyelid.
`RT`	Right side

Taxonomy Code	Specialty	Notes
`207K00000X`	Ophthalmology	Most common specialty performing eyelid malposition repairs.
`207K00000X`	Ophthalmic Plastic and Reconstructive Surgery (Oculoplastic)	Subspecialists who frequently perform ectropion repairs.
`208VP0000X`	Plastic Surgery	Facial plastic surgeons also perform eyelid reconstruction and ectropion repair.
`207L00000X`	Optometry	May perform pre- and postoperative evaluation but not the surgical repair in most jurisdictions.
`2083P0002X`	Otolaryngology (ENT)	May be involved when adjacent facial procedures are required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H02.13`	Ectropion of left lower eyelid	Direct indication for `67914` when the left lower eyelid is affected.
`H02.12`	Ectropion of right lower eyelid	Direct indication for `67914` when the right lower eyelid is affected.
`H02.10`	Ectropion of unspecified eyelid	Use when side is not specified in documentation.
`H02.831`	Lagophthalmos	May coexist with ectropion and contribute to exposure keratopathy prompting repair.
`H16.22`	Keratoconjunctivitis due to exposure, bilateral	Represents corneal irritation from poor lid apposition; supports medical necessity for repair.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`67914`	Repair of ectropion; with sutures	Primary procedure: direct suture repair of lower eyelid ectropion to restore lid apposition.
`67916`	Repair of ectropion; with tendon or ligament repair (e.g., lateral tarsal strip)	Often performed for horizontal laxity or when greater tightening is required; may be performed instead of or in addition to `67914`.
`67840`	Canthoplasty	Can be performed concurrently to tighten the lateral canthal tendon for better eyelid support.
`12032`	Repair, intermediate, wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm	May be used if there is concurrent skin repair or scar revision adjacent to the eyelid during the same operative session.
`99024`	Postoperative follow-up visit global period	Used to report routine postoperative visit in the global period when payer requires separate reporting (payer-specific).

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Summary & Overview

CPT 67914: Repair of Lower Eyelid Ectropion with Sutures