CPT 67915 Thermocauterization Reimbursement | OpenPayer

Summary & Overview

CPT 67915: Thermocauterization Repair of Lower Eyelid Ectropion

CPT code 67915 describes thermocauterization repair of an ectropion of the lower eyelid, a minor oculoplastic procedure used to correct outward turning of the lid and lashes that can cause tearing and ocular irritation. Nationally, this code is relevant to ophthalmology practices, ambulatory surgical centers, and payers managing coverage of outpatient eyelid repairs.

Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers commonly encounter claims for this service. The publication also outlines benchmark considerations, common modifier usage patterns when available, and policy or coverage themes affecting payment for minor eyelid procedures.

This summary equips billing and revenue teams, clinical leaders, and policy analysts with a clear understanding of what CPT code 67915 represents, why it matters in outpatient ophthalmic care, and the areas to examine further when reviewing reimbursement, prior authorization requirements, and claims documentation for eyelid thermocauterization.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 67915oculoplasticseyelid repairthermocauterizationoutpatient surgeryophthalmologyambulatory surgical centersurgical procedureeyelid ectropion

Billing Code Overview

CPT code 67915 describes a surgical procedure that uses thermocauterization to repair an ectropion, an outward turning of the lower eyelid and eyelashes. The technique aims to reduce excessive tearing and ocular surface irritation by tightening or reshaping the lower eyelid margin through cauterization.

Service type: Minor oculoplastic surgical repair of the lower eyelid using thermocautery
Typical site of service: Outpatient ophthalmology or ambulatory surgical center setting where minor eyelid procedures are performed

Clinical & Coding Specifications

Clinical Context

A 72-year-old patient presents to the ophthalmology clinic with chronic tearing, ocular irritation, and outward turning of the lower eyelid margin. Examination confirms involutional lower eyelid ectropion with lash malposition causing exposure and secondary conjunctival injection. Conservative measures (lubricating drops, ointment) provided partial relief. The provider schedules an in-office or ambulatory surgical center procedure using thermocauterization to tighten the lower eyelid and restore lid apposition. The clinical workflow includes preoperative evaluation (history, medication review, consent), topical or local anesthesia, application of controlled thermocautery to the eyelid margin/incision site, immediate assessment of lid position and hemostasis, postoperative instructions, and brief follow-up to monitor healing and symptom improvement. Typical site of service is an ophthalmology clinic procedure room or ambulatory surgery center for a minor eyelid surgical procedure.

Coding Specifications

Modifier	Description	When to Use
`25`	Data not available in the input.	Data not available in the input.

Modifier

CPT 67908: Eyelid Ptosis Repair (Fasanella–Servat Procedure)

CPT-67906-PTOSIS-REPAIR-SUPERIOR-RECTUS-SUSPENSION-WITH-GRAFT

CPT 67906: Ptosis Repair with Superior Rectus Suspension and Graft

CPT-67902-FRONTALIS-SLING-EYELID-PTOSIS-REPAIR-WITH-GRAFT

CPT 67902: Frontalis Sling Repair of Eyelid Ptosis with Graft

CPT-67909-PTOSIS-REVISION-REPAIR-LEVATOR-TENSION-REDUCTION

CPT 67909: Revision of Ptosis Repair, Levator Tension Reduction

CPT-67917-ECTROPION-REPAIR-EXTENSIVE-LOWER-EYELID

CPT 67917: Extensive Repair of Lower Eyelid Ectropion

CPT-67900-BROW-REPAIR-FOR-PTOSIS

CPT 67900: Repair of Drooping Eyebrow (Brow Ptosis)

CPT-67911-EYELID-RETRACTION-CORRECTION

CPT 67911: Surgical Correction of Eyelid Retraction

CPT-67914-ECTROPION-REPAIR-LOWER-EYELID-SUTURE-REPAIR

CPT 67914: Repair of Lower Eyelid Ectropion with Sutures

CPT-67912-LID-LOAD-FOR-LAGOPHTHALMOS-UPPER-EYELID

CPT 67912: Upper Eyelid Lid Load for Lagophthalmos Correction

CPT-67916-TARSAL-WEDGE-EXCISION-ECTROPION-REPAIR

CPT 67916: Tarsal Wedge Excision for Ectropion Repair

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Taxonomy Code	Specialty	Notes
207K00000X	Ophthalmology	Primary specialty performing eyelid procedures including thermocauterization for ectropion.
207LA0402X	Oculoplastic Surgery	Subspecialty focus on eyelid and periorbital reconstructive procedures.
207R00000X	Optometry	May perform pre- and post-procedure evaluation; does not perform surgery in most jurisdictions.
363L00000X	Plastic Surgery	Performs eyelid reconstructive procedures in some clinical settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H02.103`	Involutional ectropion of right lower eyelid	Age-related laxity causing outward turning; common indication for thermocauterization.
`H02.104`	Involutional ectropion of left lower eyelid	Same as above for the left side.
`H02.109`	Involutional ectropion of unspecified lower eyelid	General code when laterality not specified.
`H02.201`	Cicatricial ectropion of right lower eyelid	Scarring-induced ectropion that may require surgical correction; thermocautery sometimes used adjunctively.
`H02.202`	Cicatricial ectropion of left lower eyelid	As above for left side.
`H02.209`	Cicatricial ectropion of unspecified lower eyelid	As above without specified laterality.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`67915`	Repair of ectropion, using thermocauterization	This is the index procedure used to tighten the lower eyelid margin and correct outward rotation.
`67901`	Repair of entropion, medial/lateral canthal sutures (repair of entropion)	May be performed when eyelid malposition requires suture repair rather than thermocautery; alternative surgical approach.
`67800`	Electrocauterization of lesion of eyelid, single lesion	Related technique using cautery for small eyelid lesions; sometimes used adjunctively for hemostasis.
`67900`	Repair of lid malposition (ectropion/entropion), simple (eg, tarsorrhaphy is separate)	Alternative or adjunctive surgical procedures for eyelid malposition in less complex cases.
`12001`	Simple repair of superficial wounds (2.5 cm or less)	Used for closure of small skin incisions if incision closure is required after eyelid procedure.

`22`	Increased procedural services	When the thermocauterization required substantially greater work or operative time than usual.
`52`	Reduced services	When the procedure is partially reduced or not completed as described.
`53`	Discontinued procedure	If the procedure was started but terminated due to unforeseen circumstances.
`59`	Data not available in the input.	Data not available in the input.
`62`	Two surgeons	When two surgeons of different specialties work together as primary surgeons.
`63`	Procedure performed on infants less than 4 kg	When patient meets the infant weight criteria (rare for ectropion).
`73`	Discontinued outpatient procedure prior to anesthesia	If the outpatient procedure is stopped before anesthesia is given.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	For unplanned reintervention related to the index procedure.
`80`	Assistant surgeon	When an assistant surgeon is required.
`81`	Minimum assistant surgeon	When a minimal-assist surgeon is used.
`82`	Assistant surgeon (when qualified resident surgeon not available)	When a qualified resident is unavailable and an assistant is used.
`26`	Professional component	If reporting only the physician’s professional component separate from technical component.
`TC`	Technical component	If reporting only the technical component (facility resources, equipment).

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