Summary & Overview
CPT 68335: Symblepharon Repair with Conjunctival or Buccal Graft
CPT code 68335 represents surgical repair of a symblepharon using a free graft of conjunctiva or buccal mucous membrane. The procedure restores eyelid–globe anatomy and ocular surface function when adhesions impede movement or cause persistent irritation. Nationally, this code is relevant to ophthalmic reconstructive surgery billing and coverage policies for specialty care and outpatient surgical settings. Primary payers commonly engaged for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of clinical context for 68335, typical sites of service, and the payer landscape. The publication offers benchmarks and policy-oriented details such as coverage considerations, coding context, and common billing modifiers where available. It also outlines clinical indications and how the procedure fits within ophthalmic reconstructive and oculoplastic service lines. This material supports revenue cycle, clinical coding, and policy teams in understanding how 68335 is described, where it is performed, and which national payers are most commonly involved.
Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 68335 describes a surgical repair of a symblepharon using a free graft of the conjunctiva or buccal mucous membrane. The procedure involves excision or release of adhesions between the eyelid and the globe followed by placement of a free mucosal or conjunctival graft to restore anatomy and ocular surface function.
Service Type: Ophthalmic reconstructive surgery
Typical Site of Service: Hospital outpatient department or ambulatory surgery center; may also be performed in an ophthalmic specialty surgical suite depending on facility capabilities.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents to an ophthalmic plastic surgery clinic with progressive symblepharon formation following chemical injury to the eye. Symptoms include restricted extraocular movement, diplopia in extreme gaze, conjunctival scarring, and discomfort. After evaluation including slit-lamp exam and assessment of fornix depth, the ophthalmic surgeon plans surgical release of the symblepharon with reconstruction of the conjunctival surface using a free graft of either autologous conjunctiva or buccal mucous membrane. The procedure is performed in an ambulatory surgical center or hospital outpatient department under local with sedation or general anesthesia depending on patient factors. Intraoperative steps include excision of scar tissue, measurement of the defect, harvest of a conjunctival or buccal mucosal graft, graft placement and suturing, possible use of amniotic membrane or tissue adhesive, and placement of a conformer or temporary tarsorrhaphy to maintain fornix depth. Postoperative care involves topical antibiotics and steroids, pain control, wound checks in clinic, and instructions to avoid eye rubbing and to return for staged revisions if needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or technical difficulty substantially exceeds usual for 68335. |