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Official Description

Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 67903 involves the surgical repair of blepharoptosis, which refers to the drooping or sagging of the upper eyelid. This condition is typically caused by weakness in the levator palpebrae muscle, which is responsible for elevating the eyelid. The surgical approach utilized in this procedure is an internal method, specifically through tarso levator resection or advancement. During the operation, a local anesthetic is administered to the upper eyelid to ensure patient comfort. The surgeon takes precise measurements to determine the necessary amount of tissue resection or advancement required to correct the eyelid position. In this internal approach, the eyelid is everted, meaning it is turned inside out, and traction sutures are placed to facilitate the procedure. The planned incision lines are marked based on the previously obtained measurements, and an incision is made in the conjunctiva to access the underlying structures. This method contrasts with the external approach, which is described under CPT® Code 67904, where a skin incision is made on the upper eyelid fold. The internal approach aims to restore the normal contour and function of the eyelid while minimizing visible scarring. Overall, this procedure is essential for improving both the aesthetic appearance and functional capabilities of the eyelid in patients suffering from blepharoptosis.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 67903 is indicated for patients experiencing blepharoptosis, which is characterized by the following conditions:

  • Sagging of the Upper Eyelid - This condition can lead to visual impairment or obstruction of the visual field due to the drooping eyelid.
  • Weakness of the Levator Palpebrae Muscle - The underlying cause of blepharoptosis, where the muscle responsible for lifting the eyelid is not functioning adequately.
  • Cosmetic Concerns - Patients may seek this procedure for aesthetic reasons, desiring to improve the appearance of their eyelids.

2. Procedure

The surgical procedure for CPT® Code 67903 involves several detailed steps to effectively repair blepharoptosis:

  • Step 1: Anesthesia Administration - A local anesthetic is injected into the upper eyelid to ensure that the patient remains comfortable and pain-free during the procedure.
  • Step 2: Measurement and Planning - The surgeon takes precise measurements of the eyelid to determine the necessary amount of resection or advancement required for optimal correction.
  • Step 3: Eversion of the Eyelid - The eyelid is everted, or turned inside out, to provide access to the underlying structures. Traction sutures are placed in the upper eyelid to facilitate the procedure.
  • Step 4: Incision Marking - The planned incision lines are marked based on the previously obtained measurements to ensure accuracy during the surgical intervention.
  • Step 5: Conjunctival Incision - An incision is made in the conjunctiva to access the levator aponeurosis and tarsal plate, which are critical for the repair process.
  • Step 6: Tarsal Plate Incision - The tarsal plate is incised, and a spindle-shaped section of the tarsus and aponeurosis is excised based on the measurements taken earlier.
  • Step 7: Suture Placement - A suture is placed anteriorly through the tarsus along the central portion of the superior edge and then passed through the superior edge of the levator aponeurosis. Two additional sutures are placed medially and laterally using the same technique.
  • Step 8: Contour Assessment - The sutures are temporarily tied, and the lid contour is assessed to ensure that the desired eyelid shape is achieved.
  • Step 9: Final Suture Tying - The sutures are adjusted as necessary until the ideal lid shape is attained, and then they are permanently tied to secure the position.
  • Step 10: Closure - The lid crease skin incision or conjunctival incision is closed to complete the procedure.

3. Post-Procedure

After the completion of the procedure, patients may require specific post-operative care to ensure proper healing and recovery. This may include instructions on eyelid care, the use of prescribed medications to manage pain or prevent infection, and follow-up appointments to monitor the healing process. Patients should be advised to avoid strenuous activities and to keep the surgical area clean and dry. The expected recovery time may vary, but patients can generally anticipate some swelling and bruising in the initial days following surgery, which should gradually subside. It is important for patients to adhere to their surgeon's post-operative instructions to achieve the best possible outcome.

Short Descr REPAIR EYELID DEFECT
Medium Descr RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL
Long Descr Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P4E - Eye procedure - other
MUE 1
CCS Clinical Classification 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
E1 Upper left, eyelid
E3 Upper right, eyelid
SG Ambulatory surgical center (asc) facility service
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
GC This service has been performed in part by a resident under the direction of a teaching physician
GA Waiver of liability statement issued as required by payer policy, individual case
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
KX Requirements specified in the medical policy have been met
55 Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number.
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
73 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure prior to the administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient's surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but prior to the administration of anesthesia (local, regional block(s) or general). under these circumstances, the intended service that is prepared for but cancelled can be reported by its usual procedure number and the addition of modifier 73. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AG Primary physician
CR Catastrophe/disaster related
E2 Lower left, eyelid
E4 Lower right, eyelid
GW Service not related to the hospice patient's terminal condition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2001-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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