CPT 67938: Removal of Embedded Eyelid Foreign Body

Medicare pays $263 on average nationally for this procedure.

CPT code 67938 describes surgical removal of an embedded foreign body from the eyelid to prevent injury to the eyeball; this procedure is an eye/orbital soft-tissue foreign body extraction performed by an ophthalmic surgeon and is typically provided as a minor surgical procedure in an office-based surgical suite, ambulatory surgical center, or hospital outpatient setting when urgent care is required to protect the globe.

For related coverage guidance, see recent payer policy updates: Evaluation of Dry Eyes, Evaluation of Dry Eyes, Ophthalmic Prostaglandin Analog Prior Authorization Criteria.

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CPT 67938: Removal of Embedded Eyelid Foreign Body

Medicare pays $263 on average nationally for this procedure.

For related coverage guidance, see recent payer policy updates: Evaluation of Dry Eyes, Evaluation of Dry Eyes, Ophthalmic Prostaglandin Analog Prior Authorization Criteria.

Customize your policy alerts

Sign up for cpt 67938 policy alerts

Get alerted when payer policies referencing 67938 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is a young adult or older child who presents to an ophthalmology clinic or emergency department after sustaining trauma to the eyelid (e.g., metal shaving, wood splinter, or glass fragment) or with an embedded insect or other foreign body lodged in the eyelid margin or tarsal plate. The patient reports localized pain, tearing, foreign-body sensation, eyelid swelling, or abrasion of the globe. Examination includes visual acuity, slit-lamp exam, eversion of the eyelid, fluorescein staining to assess corneal involvement, and palpation to localize the embedded material. Imaging (plain radiograph or CT) is reserved for radiopaque or deep objects.

Procedure workflow: the patient is consented and prepped in a procedure room or minor procedure suite. Topical anesthetic, local infiltration, or regional block is used based on patient comfort and location/depth of the foreign body. The eyelid is everted and the embedded material is exposed; sterile instruments (forceps, needle, curette) are used to remove the object. Hemostasis is achieved, and the wound is irrigated. If the eyelid laceration is present, repair may be performed during the same encounter. Post-procedure care includes topical antibiotic, tetanus assessment, and discharge instructions with return precautions. Documentation should include time, anesthetic, technique, description of the foreign body, estimated length of procedure, and patient tolerance.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12032`	Repair, intermediate, wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm	Performed when eyelid laceration accompanies embedded foreign body and requires layered repair after removal.
`92285`	External eye photography with interpretation and report	Used when photographic documentation of the eyelid or ocular surface is obtained for clinical records or medico-legal reasons.
`99024`	Postoperative follow-up visit global period services	Used for postoperative visits related to the foreign body removal when applicable during the global period of a related procedure.
`67028`	Intravitreal injection of a pharmacologic agent (separate but sometimes relevant)	Not directly related but included in periocular procedural coding sets when intraocular involvement is suspected and requires specialist intervention.
`67840`	Excision of lesion of eyelid; full thickness (e.g., chalazion)	Performed when the embedded foreign body requires excision of tissue or when concurrent eyelid lesion removal is indicated.

Related Modifiers

8 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
2251H1200X	Hand Physical Therapist	Respiratory, Developmental, Rehabilitative and Restorative Service Providers · Physical Therapist
2279G1100X	General Care Registered Respiratory Therapist	This level of care includes diagnostics testing, therapeutics, monitoring, rehabilitation of patients with disorders of the cardiopulmonary system, as…
103TP0016X	Prescribing (Medical) Psychologist	A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive p…
253J00000X	Foster Care Agency	A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for childr…
2471C1101X	Cardiovascular-Interventional Technology Radiologic Technologist	A radiologic technologist who specializes in cardiovascular interventional technology.

Related ICD-10-CM Codes

16 rows

ICD-10-CM Code	Description
H01.001	Unspecified blepharitis right upper eyelid
H02.831	Dermatochalasis of right upper eyelid
H02.832	Dermatochalasis of right lower eyelid
H02.839	Dermatochalasis of unspecified eye, unspecified eyelid
H05.89	Other disorders of orbit
H10.9	Unspecified conjunctivitis
H16.9	Unspecified keratitis
H57.89	Other specified disorders of eye and adnexa
S00.11XA	Contusion of right eyelid and periocular area, initial encounter
S00.12XA	Contusion of left eyelid and periocular area, initial encounter

Showing 1–10 of 16

Related Payer Policy Updates

Specialty: Ophthalmology/Optometry1 / 3

10 rows

Policy	Payer	Effective Date
Evaluation of Dry Eyes	Oscar Health	2026-10-01
Evaluation of Dry Eyes	Blue Cross Blue Shield - New Mexico	2026-09-04
Ophthalmic Prostaglandin Analog Prior Authorization Criteria	medimpact	2026-09-01
revakinagene taroretcel-lwey (Encelto) coverage for idiopathic macular telangiectasia (MacTel) type 2	blue cross blue shield - louisiana	2026-09-01
Glaucoma Prostaglandins	Cigna	2026-08-15
Corneal Cross‑linking (CXL) Procedure	husky_health	2026-08-01
Corneal surgical procedures (excluding corneal collagen cross-linking)	husky_health	2026-08-01
Intracanalicular and Intravitreal Corticosteroid Implants	UnitedHealthcare	2026-08-01
Eye Optical Coherence Tomography	Premera Bluecross	2026-08-01
Encelto (Revakinagene Taroretcel-Lwey) implant — coverage criteria	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 67930: Eyelid Laceration Repair, Direct Closure

CPT-67935-EYELID-LACERATION-DIRECT-CLOSURE

CPT 67935: Simple Closure of Penetrating Eyelid Wound

CPT-67950-CANTHOPLASTY-CORNER-EYE-LIFT

CPT 67950: Canthoplasty (Median or Lateral)

CPT-67961-EYELID-EXCISION-REPAIR-SKIN-GRAFT-UP-TO-25-PERCENT

CPT 67961: Excision of Eyelid Tissue with Local Skin Graft

CPT-67966-EYELID-EXCISION-WITH-GRAFT-RECONSTRUCTION

CPT 67966: Excision and Reconstruction of Eyelid Defect

CPT-67971-EYELID-RECONSTRUCTION-FULL-THICKNESS-FLAP

CPT 67971: Full-Thickness Eyelid Reconstruction with Opposing Eyelid Flap

CPT-67973-LOWER-EYELID-FULL-THICKNESS-RECONSTRUCTION-FLAP

CPT 67973: Full-Thickness Lower Eyelid Reconstruction

CPT-67974-UPPER-EYELID-FULL-THICKNESS-RECONSTRUCTION-EYELID-FLAP

CPT 67974: Upper Eyelid Full-Thickness Reconstruction with Flap

CPT-67975-STAGED-FULL-THICKNESS-EYELID-RECONSTRUCTION-FLAP-TRANSFER

CPT 67975: Staged Full-Thickness Eyelid Reconstruction with Flap Transfer

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12032`	Repair, intermediate, wounds of face, ears, eyelids, nose, lips; 2.6 cm to 7.5 cm	Performed when eyelid laceration accompanies embedded foreign body and requires layered repair after removal.
`92285`	External eye photography with interpretation and report	Used when photographic documentation of the eyelid or ocular surface is obtained for clinical records or medico-legal reasons.
`99024`	Postoperative follow-up visit global period services	Used for postoperative visits related to the foreign body removal when applicable during the global period of a related procedure.
`67028`	Intravitreal injection of a pharmacologic agent (separate but sometimes relevant)	Not directly related but included in periocular procedural coding sets when intraocular involvement is suspected and requires specialist intervention.
`67840`	Excision of lesion of eyelid; full thickness (e.g., chalazion)	Performed when the embedded foreign body requires excision of tissue or when concurrent eyelid lesion removal is indicated.

Related Modifiers

8 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
2251H1200X	Hand Physical Therapist	Respiratory, Developmental, Rehabilitative and Restorative Service Providers · Physical Therapist
2279G1100X	General Care Registered Respiratory Therapist	This level of care includes diagnostics testing, therapeutics, monitoring, rehabilitation of patients with disorders of the cardiopulmonary system, as…
103TP0016X	Prescribing (Medical) Psychologist	A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive p…
253J00000X	Foster Care Agency	A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for childr…
2471C1101X	Cardiovascular-Interventional Technology Radiologic Technologist	A radiologic technologist who specializes in cardiovascular interventional technology.

Related ICD-10-CM Codes

16 rows

ICD-10-CM Code	Description
H01.001	Unspecified blepharitis right upper eyelid
H02.831	Dermatochalasis of right upper eyelid
H02.832	Dermatochalasis of right lower eyelid
H02.839	Dermatochalasis of unspecified eye, unspecified eyelid
H05.89	Other disorders of orbit
H10.9	Unspecified conjunctivitis
H16.9	Unspecified keratitis
H57.89	Other specified disorders of eye and adnexa
S00.11XA	Contusion of right eyelid and periocular area, initial encounter
S00.12XA	Contusion of left eyelid and periocular area, initial encounter

Showing 1–10 of 16

Related Payer Policy Updates

Specialty: Ophthalmology/Optometry1 / 3

10 rows

Policy	Payer	Effective Date
Evaluation of Dry Eyes	Oscar Health	2026-10-01
Evaluation of Dry Eyes	Blue Cross Blue Shield - New Mexico	2026-09-04
Ophthalmic Prostaglandin Analog Prior Authorization Criteria	medimpact	2026-09-01
revakinagene taroretcel-lwey (Encelto) coverage for idiopathic macular telangiectasia (MacTel) type 2	blue cross blue shield - louisiana	2026-09-01
Glaucoma Prostaglandins	Cigna	2026-08-15
Corneal Cross‑linking (CXL) Procedure	husky_health	2026-08-01
Corneal surgical procedures (excluding corneal collagen cross-linking)	husky_health	2026-08-01
Intracanalicular and Intravitreal Corticosteroid Implants	UnitedHealthcare	2026-08-01
Eye Optical Coherence Tomography	Premera Bluecross	2026-08-01
Encelto (Revakinagene Taroretcel-Lwey) implant — coverage criteria	Colorado Rocky Mountain Health Plans	2026-08-01

CPT 67930: Eyelid Laceration Repair, Direct Closure

CPT-67935-EYELID-LACERATION-DIRECT-CLOSURE

CPT 67935: Simple Closure of Penetrating Eyelid Wound

CPT-67950-CANTHOPLASTY-CORNER-EYE-LIFT

CPT 67950: Canthoplasty (Median or Lateral)

CPT-67961-EYELID-EXCISION-REPAIR-SKIN-GRAFT-UP-TO-25-PERCENT

CPT 67961: Excision of Eyelid Tissue with Local Skin Graft

CPT-67966-EYELID-EXCISION-WITH-GRAFT-RECONSTRUCTION

CPT 67966: Excision and Reconstruction of Eyelid Defect

CPT-67971-EYELID-RECONSTRUCTION-FULL-THICKNESS-FLAP

CPT 67971: Full-Thickness Eyelid Reconstruction with Opposing Eyelid Flap

CPT-67973-LOWER-EYELID-FULL-THICKNESS-RECONSTRUCTION-FLAP

CPT 67973: Full-Thickness Lower Eyelid Reconstruction

CPT-67974-UPPER-EYELID-FULL-THICKNESS-RECONSTRUCTION-EYELID-FLAP

CPT 67974: Upper Eyelid Full-Thickness Reconstruction with Flap

CPT-67975-STAGED-FULL-THICKNESS-EYELID-RECONSTRUCTION-FLAP-TRANSFER

CPT 67975: Staged Full-Thickness Eyelid Reconstruction with Flap Transfer

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 67938: Removal of Embedded Eyelid Foreign Body

Sign up for cpt 67938 policy alerts

OpenPayer

CPT 67938: Removal of Embedded Eyelid Foreign Body

Sign up for cpt 67938 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

CPT 67938: Removal of Embedded Eyelid Foreign Body

Sign up for cpt 67938 policy alerts

CPT 67938: Removal of Embedded Eyelid Foreign Body

Sign up for cpt 67938 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT 67938 represent and where is this procedure typically performed?

What procedural details and documentation are expected for a 67938 encounter?

Which CPT codes are commonly billed in conjunction with CPT 67938?

What ICD-10 diagnosis codes are relevant for cases billed with CPT 67938?

Does the page specify imaging use, other potentially relevant procedures, or payer coverage details for CPT 67938?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does CPT 67938 represent and where is this procedure typically performed?

What procedural details and documentation are expected for a 67938 encounter?

Which CPT codes are commonly billed in conjunction with CPT 67938?

What ICD-10 diagnosis codes are relevant for cases billed with CPT 67938?

Does the page specify imaging use, other potentially relevant procedures, or payer coverage details for CPT 67938?

References