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The procedure described by CPT® Code 67908 involves the surgical repair of blepharoptosis, which is characterized by the drooping or sagging of the upper eyelid. This condition typically arises due to weakness in the levator palpebrae muscle, which is responsible for elevating the eyelid. The surgical technique employed in this procedure is known as conjunctivo-tarso-Muller's muscle levator resection, commonly referred to as Muller muscle conjunctiva repair (MMCR) or the Fasanella-Servat repair. During the operation, the upper eyelid is everted, allowing the surgeon to expose the tarsal plate, which is the dense connective tissue that provides structure to the eyelid. To facilitate the repair, three temporary traction sutures are strategically placed near the superior margin of the tarsal plate—one positioned medially, one laterally, and one centrally. These sutures serve to lift and hold the section of the tarsal plate that is to be excised. The ends of these sutures are clamped with artery forceps to maintain tension. Additionally, three more temporary traction sutures are placed near the margin of the everted eyelid, emerging close to the superior fornix and aligned with the first set of sutures. This arrangement supports the conjunctival and tarsal wedge for subsequent suturing. The surgeon then marks the planned incision lines based on previously obtained measurements and uses a blade breaker knife to create a groove incision. Scissor tips are inserted into this groove to excise the tarsal plate. Following the excision, the wound is repaired using a continuous buried suture, which is temporarily tied at both ends. The shape of the eyelid is assessed, and adjustments are made to achieve the desired contour. Once the ideal lid shape is confirmed, the sutures are permanently tied with small knots that are buried at each end. After the removal of the temporary traction sutures, the incision on the lid crease skin is closed. In cases where a modified or sutureless Fasanella-Servat repair is performed, hemostat forceps are utilized to grasp the tarsoconjunctival Muller complex along the marked lines, remaining in place for 60 seconds. Upon removal of the hemostat, a broad ischemic groove of tissue is left behind, which is subsequently excised. This technique eliminates the need for suture repair, as the compressed groove at the site of the forceps functions as a mechanical suture, effectively securing the eyelid in its new position.
© Copyright 2026 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 67908 is indicated for the surgical correction of blepharoptosis, which is the abnormal drooping of the upper eyelid. This condition may result from various underlying issues, including weakness of the levator palpebrae muscle, which is essential for eyelid elevation. The surgery aims to restore normal eyelid position and function, thereby improving visual field and aesthetic appearance.
The surgical procedure for CPT® Code 67908 involves several detailed steps to effectively repair blepharoptosis. Initially, the upper eyelid is everted to expose the tarsal plate, which is the fibrous structure that provides support to the eyelid. The surgeon places three temporary traction sutures close to the superior margin of the tarsal plate—one medially, one laterally, and one centrally. These sutures are crucial as they lift and hold the portion of the tarsal plate that is to be excised, allowing for better access and visibility during the procedure. The ends of these sutures are clamped with artery forceps to maintain tension and stability. Next, three additional temporary traction sutures are placed near the margin of the everted eyelid, emerging close to the superior fornix and aligned with the first three sutures. This arrangement supports the conjunctival and tarsal wedge, which will be sutured later in the procedure. The surgeon then marks the planned incision lines based on previously obtained measurements to ensure precision in the excision. Using a blade breaker knife, the surgeon makes an incision in the form of a groove along the marked lines. Scissor tips are then inserted into this groove to facilitate the excision of the tarsal plate. Once the tarsal plate is excised, the wound is repaired with a continuous buried suture, which is temporarily tied at both ends to secure the tissue. The surgeon assesses the shape of the eyelid and makes any necessary adjustments to achieve the desired contour. After confirming the ideal lid shape, the sutures are permanently tied with small knots that are buried at each end to minimize scarring. Finally, the temporary traction sutures are removed, and the incision on the lid crease skin is closed. In cases where a modified or sutureless Fasanella-Servat repair is performed, hemostat forceps are used to grasp the tarsoconjunctival Muller complex along the marked lines, remaining in place for 60 seconds. Upon removal of the hemostat, a broad ischemic groove of tissue is left behind, which is then excised. This technique eliminates the need for suture repair, as the compressed groove at the site of the forceps acts as a mechanical suture, effectively securing the eyelid in its new position.
Post-procedure care following the repair of blepharoptosis with CPT® Code 67908 involves monitoring the surgical site for any signs of complications, such as infection or excessive swelling. Patients are typically advised to avoid strenuous activities and to keep the head elevated to reduce swelling during the initial recovery period. Follow-up appointments are essential to assess the healing process and to ensure that the eyelid is maintaining its corrected position. Patients may also receive instructions on how to care for the incision site, including keeping it clean and dry. Any sutures that are not buried will be removed during follow-up visits, and the overall aesthetic and functional outcomes of the procedure will be evaluated to ensure patient satisfaction.
| Short Descr | REPAIR EYELID DEFECT | Medium Descr | RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ | Long Descr | Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, Fasanella-Servat type) | 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) | 0 - Co-surgeons not permitted for this procedure. | 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 |
| 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). | 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). | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | E1 | Upper left, eyelid | E3 | Upper right, eyelid | GA | Waiver of liability statement issued as required by payer policy, individual case | 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 | SG | Ambulatory surgical center (asc) facility 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). | 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. | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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. | 74 | Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. 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. | 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.) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | E2 | Lower left, eyelid | E4 | Lower right, eyelid | FA | Left hand, thumb | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | UA | Medicaid level of care 10, as defined by each state | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | 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 |
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