Summary & Overview

CPT 68505: Partial Lacrimal Gland Excision for Excessive Tearing

CPT code 68505 denotes a surgical ophthalmologic procedure involving partial excision of the lacrimal gland to address excessive tearing that contributes to dry eye. This procedure is clinically significant because it directly alters tear production and is used when conservative therapies fail, affecting both vision comfort and ocular surface health. Nationally, the code is relevant to specialty ophthalmic practices and facilities that manage complex tear disorders.

Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, typical sites of service, and the common billing modifiers associated with the procedure. The publication summarizes benchmark payment patterns, coverage considerations, and coding nuances that affect claim adjudication and facility reporting.

This summary provides clinicians, billing professionals, and policy analysts with a concise reference on how CPT code 68505 is used, where the service is typically performed, and what aspects of the service drive coding and payment variability. Data not available in the input will be identified in relevant sections of the full publication.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 68505lacrimal gland surgeryophthalmologyepiphora treatmentdry eye managementambulatory surgerysurgical codingophthalmic procedurefacility billing

Billing Code Overview

CPT code 68505 describes a surgical procedure in which the provider removes a portion of the lacrimal gland to reduce excessive tearing (epiphora) that results in dry eye. The procedure is an operative ophthalmologic service aimed at modifying tear production by partial excision of the lacrimal gland.

Service type: Surgical, ophthalmic lacrimal gland procedure
Typical site of service: Ambulatory surgical center or hospital outpatient department

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with symptomatic epiphora (excess tearing) due to lacrimal gland hypersecretion or structural gland pathology where conservative measures (lubricating drops, topical anti-inflammatory therapy) have failed. The ophthalmic oculoplastic surgeon evaluates the patient with history, external and slit-lamp exam, assessment of tear film and ocular surface, and imaging or dye testing when indicated to confirm lacrimal gland contribution to tearing. The provider obtains informed consent and performs a partial lacrimal gland excision under monitored anesthesia care or general anesthesia in an ambulatory surgical center or hospital outpatient setting. Intraoperative steps include exposure of the lacrimal gland via an eyelid crease or lateral canthal approach, careful removal of gland tissue to reduce tear production while preserving lacrimal drainage and eyelid function, hemostasis, and layered wound closure. Postoperative care includes topical antibiotics and steroids, ocular lubrication, activity restrictions, and follow-up visits to monitor for dry eye, scarring, ptosis, or persistent epiphora. Typical site of service: outpatient surgical center or hospital outpatient department. Service type: minor ophthalmic surgical procedure (oculoplastic lacrimal gland procedure). Typical patient scenario: a 52-year-old patient with chronic reflex tearing from a hypertrophic lacrimal gland refractory to medical therapy presenting for partial excision to reduce tear production and improve ocular surface comfort.

Coding Specifications

Modifier	Description	When to Use
`26`

Taxonomy Code	Specialty	Notes
`252S00000X`	Ophthalmology	Oculoplastic surgeons commonly perform lacrimal gland procedures.
`207K00000X`	Ophthalmic Plastic and Reconstructive Surgery	Subspecialty focused on eyelid, lacrimal, and orbital surgery.
`2080S0122X`	Oculoplastic Surgery	Surgeons specializing in lacrimal and eyelid procedures.
`362E00000X`	Anesthesiology	Provides monitored anesthesia care or general anesthesia for the procedure.
`2080P0105X`	General Ophthalmology	General ophthalmologists may perform minor lacrimal gland surgeries.

CPT Code	Description	Relationship to This Procedure
`68710`	Excision of lacrimal sac	Performed when lacrimal drainage system pathology coexists and requires sac excision.
`68760`	Dacryocystorhinostomy (external or endoscopic)	Related when epiphora is due to nasolacrimal duct obstruction rather than gland hypersecretion; may be performed in the same episode if indicated.
`67820`	Repair of lacrimal gland by incision or excision of lesion	May be used for limited excisional procedures of lacrimal gland lesions or biopsies.
`66840`	Removal of foreign body from external eye; cornea, conjunctiva, and/or sclera	Not directly related but commonly performed by the same ophthalmic teams in the ambulatory setting.
`99152`	Moderate sedation services provided by the same physician performing the procedure	Billed when moderate sedation/monitored anesthesia care is provided by the surgeon during the lacrimal gland excision.

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