Summary & Overview
CPT 67950: Canthoplasty (Corner Eye Lift)
CPT code 67950 represents a canthoplasty (median or lateral), an ophthalmic reconstructive procedure used to tighten the lateral canthal tendon or orbicularis muscle to reshape the outer corner of the eyelids and help prevent or correct ectropion. Nationally, this code matters for surgical ophthalmology billing and coverage decisions because it captures procedures performed for both functional eyelid support and cosmetic reshaping. Payment policies and coding guidance for 67950 influence practice revenue and documentation requirements for eye surgeons and surgical centers.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical places of service, and the common modifiers associated with surgical billing. The publication summarizes national benchmarks and payer coverage considerations, highlights clinical scenarios where the procedure is used (e.g., eyelid laxity, risk of ectropion), and outlines documentation and coding points that affect reimbursement and claim processing. Where specific data elements were not provided in the source, the text notes their absence. This summary is designed for clinicians, coding professionals, and policy analysts seeking a clear, national-level briefing on CPT code 67950 and its role in ophthalmic surgical billing.
Billing Code Overview
CPT code 67950 describes canthoplasty (median or lateral), a surgical procedure commonly called a corner eye lift or eye tendon surgery. The operation is performed by an ophthalmologist to strengthen the lateral canthal tendon or orbicularis muscle at the outer corner of the eyelids, providing support to the outer canthal region and reshaping the eye. The procedure is sometimes used to prevent or correct ectropion and other lateral eyelid laxity problems.
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Service type: Eyelid reconstructive/ophthalmic surgical procedure
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Typical site of service: Outpatient surgical suite, ambulatory surgery center, or hospital operating room
Data not available in the input for associated taxonomies, ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A 68-year-old female presents to the ophthalmic plastic surgery clinic with chronic lateral eyelid laxity and early lateral canthal tendon attenuation causing lateral lower eyelid malposition and intermittent tearing. Conservative measures including lubrication and eyelid taping failed. The surgeon discusses canthoplasty to tighten the lateral canthal tendon and restore eyelid apposition. Preoperative evaluation includes visual acuity, external and slit-lamp exam, measurement of lateral canthal tendon laxity (snap-back and distraction tests), photography, and medical clearance as needed. The procedure is scheduled in an ambulatory surgery center under monitored anesthesia care or local anesthesia with sedation. Intraoperatively, the lateral canthal tendon is shortened and reanchored to the lateral orbital rim, with adjustment of orbicularis oculi tension as needed. Postoperative workflow includes short PACU recovery, instructions for cold compresses, topical antibiotics, follow-up at 1 week and 4–6 weeks for suture removal and assessment of eyelid position, and documentation of functional improvement (reduction in tearing and resolution of malposition). Common clinical indications include eyelid laxity, horizontal eyelid malposition, prevention or correction of ectropion or lateral canthal deformity after trauma or tumor excision, and cosmetic corner-lift procedures when performed by an ophthalmic plastic surgeon.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when only the physician interpretation or professional portion is billed separate from technical facility services (rare for this operative procedure). |