2025 CPT code 67904
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Eye and Ocular Adnexa Feed
Repair of blepharoptosis; (tarso)levator resection or advancement, external approach.
Modifiers may be applicable. E1 (Upper left, eyelid), E3 (Upper right, eyelid) can be used to specify which eyelid the procedure was performed on, though these do not affect payment. Other modifiers like 22 (Increased Procedural Services), 50 (Bilateral Procedure), 52 (Reduced Services), etc., may apply based on circumstances.
Medical necessity must be established for this procedure. It is typically justified by documenting the functional impairment caused by the ptosis, such as visual field obstruction impacting daily activities.If the procedure is performed for cosmetic reasons, this should be clearly documented.
The surgeon performs the procedure under appropriate anesthesia.They make an incision in the upper eyelid crease, dissect to the levator tendon, isolate the levator muscle, and adjust the tendon length or aponeurosis position to correct the ptosis.The incision is then closed with sutures.
In simple words: This procedure fixes a droopy eyelid by tightening the muscle that lifts it. The surgeon makes a small cut on the outside of the eyelid to access and adjust the muscle.
This code describes a surgical procedure to correct blepharoptosis (drooping eyelid) by tightening the levator muscle, which controls eyelid movement.The procedure involves an external approach, meaning the incision is made on the outside of the eyelid. The surgeon shortens the levator muscle or advances the levator aponeurosis to improve the eyelid's position.
Example 1: A 65-year-old patient has ptosis of the right upper eyelid obstructing their superior visual field, causing difficulty with reading and driving.The ophthalmologist performs a tarsolevator resection using an external approach (67904) to correct the drooping eyelid., Following trauma to the face, a 30-year-old patient develops ptosis of the left upper eyelid. The surgeon performs 67904 to repair the damaged levator muscle and restore normal eyelid function., A 50-year-old patient with a congenital ptosis of their left upper eyelid undergoes 67904 to improve their appearance and visual field.
Documentation should include the diagnosis (e.g., blepharoptosis), severity of the ptosis (e.g., degree of visual field obstruction), operative technique used (external approach), any complications encountered, and the postoperative result.
- Revenue Code: P4E - EYE PROCEDURE - OTHER
- Payment Status: Active
- Specialties:Ophthalmology, Oculoplastic Surgery
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient Department, Physician's Office