2025 CPT code 67808
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision and Destruction Procedures on the Eyelids Surgery Feed
Excision of chalazion(s); under general anesthesia and/or requiring hospitalization.
Modifiers may be applicable depending on the circumstances.-RT (right side) and -LT (left side) may be used to specify the affected eyelid(s) if applicable. Other modifiers may be used based on the specifics of the procedure and the circumstances (e.g., -50 for bilateral procedures; other modifiers based on specific circumstances as per AMA guidelines).
Medical necessity for code 67808 is established when a patient presents with one or more symptomatic chalazia that interfere with vision, cause significant discomfort, or have failed to respond to conservative management.General anesthesia or hospitalization may be medically necessary for young children or uncooperative patients, or in cases of extensive disease.
The ophthalmologist or oculoplastic surgeon is responsible for pre-operative assessment, performing the excision under general anesthesia, ensuring hemostasis, and providing post-operative care.
In simple words: This code describes the removal of one or more small bumps (chalazia) on the eyelid(s). The surgery is done while the patient is asleep under general anesthesia and may require a hospital stay, especially for young children or patients who can't cooperate.
This CPT code, 67808, represents the surgical excision of one or more chalazia from the eyelid(s).The procedure is performed under general anesthesia and may necessitate hospitalization, particularly in young or uncooperative patients. The surgeon excises the chalazion(s), removes any associated debris or fibrous tissue, ensures hemostasis, and may administer local antibiotics. The code encompasses removal of single or multiple chalazia, regardless of their location on the eyelid(s). No additional modifiers are needed for bilateral chalazion removal.
Example 1: A 5-year-old child presents with multiple chalazia on both upper eyelids.General anesthesia is required for the excision of the chalazia, necessitating a short hospital stay. CPT code 67808 is used., An adult patient with a large chalazion on their right lower eyelid undergoes excision under general anesthesia as an outpatient. The surgeon uses CPT code 67808., A patient with multiple chalazia on both upper and lower eyelids requires general anesthesia and hospitalization for the excision procedure. CPT code 67808 is billed.
* Preoperative and postoperative assessments* Operative report detailing technique, number of chalazia excised, and any complications.* Pathology report, if applicable* Anesthesia records.* Medical necessity documentation justifying the need for general anesthesia and/or hospitalization.
** This code is specifically for excision of chalazia under general anesthesia and/or requiring hospitalization.For excision without these conditions, use codes 67800, 67801, or 67805.Always ensure that the procedure is documented completely and accurately to support the coding selection.
- Revenue Code: P4E (EYE PROCEDURE - OTHER)
- RVU: This information is not available in the provided source documents.Consult the current Medicare Physician Fee Schedule (MPFS) for relative value units and reimbursement rates.
- Global Days: The global period for this procedure is not specified in the provided data.It likely varies based on payer and facility policies.Clarification should be sought from the payer or facility.
- Payment Status: Active (Medicare reimbursable, but amount varies by location and plan specifics)
- Modifier TC rule: A technical component (TC) modifier is not typically used with this code. This code includes the entire procedure.
- Fee Schedule: Fee schedule data is not included in the provided sources. Consult the Medicare Physician Fee Schedule (MPFS) and other payer fee schedules for historical and current reimbursement information.
- Specialties:Ophthalmology, Oculoplastic Surgery
- Place of Service:Office, Ambulatory Surgical Center, Inpatient Hospital