Summary & Overview

CPT 68400: Incision and Drainage of Lacrimal Gland

Headline: CPT code 68400: Incision and Drainage of the Lacrimal Gland — what the code represents and why it matters

CPT code 68400 denotes a surgical procedure for incision and drainage of the lacrimal gland. This procedure is relevant nationally for ophthalmology and oculoplastic practices managing acute lacrimal gland infections or abscesses that require operative drainage. Proper coding affects clinical documentation, site-of-service decisions, and payment adjudication across payers.

Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service represented by the code, the typical settings where it is delivered, and what to expect in a national payer environment. The publication outlines benchmarks and coding context, summarizes common billing considerations, and highlights clinical circumstances that commonly prompt use of the code.

This summary equips billing and compliance staff, practice managers, and clinical leaders with clear identification of the procedure and its administrative implications. Data not available in the input is noted where applicable. The focus remains national in scope and intended to support accurate coding and administrative planning.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare68400CPTlacrimal glandincision and drainageophthalmologyambulatory surgerysurgical drainageoculoplastic

Billing Code Overview

CPT code 68400 describes an incision and drainage of the lacrimal gland. The procedure involves making an incision to drain an abscess or other purulent collection within the lacrimal gland.

Service type: Minor surgical drainage procedure

Typical site of service: Ophthalmology clinic procedure room, ambulatory surgery center, or hospital outpatient setting

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or pediatric patient who presents to an ophthalmology clinic, emergency department, or ambulatory surgical center with an acute, painful swelling of the upper outer eyelid consistent with a lacrimal gland abscess or infected dacryoadenitis. The patient history commonly includes rapid onset eyelid fullness, localized erythema, tenderness over the superolateral orbit, possible fever, and discharge. Initial evaluation includes focused ocular examination, assessment of visual acuity and extraocular movements, and palpation of the lacrimal gland. Imaging (orbital CT or ultrasound) may be obtained if there is concern for deeper orbital involvement or to confirm an abscess.

The clinical workflow includes informed consent, local or monitored anesthesia depending on patient factors and setting, antiseptic preparation, and placement of a small incision over the lacrimal gland to drain purulent material. Specimens may be sent for Gram stain and culture. Hemostasis is achieved, and a short course of postoperative antibiotics and follow-up are arranged. Typical sites of service are outpatient ophthalmology offices, ambulatory surgical centers, or emergency departments for urgent cases. The service type is a minor surgical procedure—incision and drainage of the lacrimal gland as defined by 68400.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

CPT Code	Description	Relationship to This Procedure
`68110`	Excision of lacrimal sac or duct (e.g., dacryocystectomy)	May be performed for chronic or refractory lacrimal sac disease after initial infection control; not typically concurrent with `68400` but part of longitudinal care.
`67700`	Removal of foreign body from conjunctiva; simple	Performed if superficial foreign body or conjunctival involvement is present during evaluation.
`67800`	Incision and drainage of eyelid; simple	Similar minor eyelid procedures; may be performed for adjacent eyelid abscesses in the same encounter.
`66140`	Incision of lacrimal passage, therapeutic	Performed for certain lacrimal duct obstructions; may be part of comprehensive lacrimal system management.
`67028`	Intravitreal injection of a pharmacologic agent (separate example)	Not directly related but listed in differential procedures for ophthalmic clinics; included here as an example of other clinic procedures.

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