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Official Description

Canthoplasty (reconstruction of canthus)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Canthoplasty is a surgical procedure aimed at reconstructing the canthus, which is the anatomical junction where the upper and lower eyelids meet. This procedure can involve either the medial canthus, located at the inner corner of the eye, or the lateral canthus, found at the outer corner. The medial canthus is significant as it houses the medial canthal ligament, which connects to the orbit and plays a crucial role in the structural integrity of the eyelids and the lacrimal drainage system. Conversely, the lateral canthus comprises several key structures, including the lateral canthal tendon, Lockwood's ligament, and the cheek ligaments associated with the lateral rectus muscle, as well as the lateral horn of the levator aponeurosis. The choice of surgical technique for canthoplasty is determined by the specific canthus affected and the nature of the injury sustained. For instance, injuries to the medial canthus may necessitate the use of a full-thickness skin graft or various types of flaps, such as an upper eyelid transposition flap or a rotation flap from the glabella. In cases where the lateral canthus is involved, a cheek rotation flap is typically employed. The procedure is intricate, requiring careful planning and execution to ensure that the reconstructed canthus not only restores the eyelid's appearance but also maintains its functional integrity, allowing for proper eyelid closure and support of the ocular globe.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The indications for canthoplasty primarily involve reconstructive needs due to trauma, congenital defects, or other conditions affecting the canthus. The following are specific indications for performing this procedure:

  • Medial Canthus Injury Reconstruction is necessary when there is damage to the medial canthus, which may involve the medial canthal ligament and surrounding structures.
  • Lateral Canthus Injury Repair is indicated for injuries to the lateral canthus, which may compromise the structural integrity of the eyelid and its associated ligaments.
  • Congenital Defects Canthoplasty may be performed to correct congenital anomalies affecting the canthus, ensuring proper eyelid function and aesthetics.
  • Post-Trauma Reconstruction Following trauma to the eyelid area, canthoplasty is indicated to restore normal anatomy and function.

2. Procedure

The canthoplasty procedure involves several detailed steps, which vary depending on whether the medial or lateral canthus is being reconstructed. The following outlines the procedural steps:

  • Step 1: Assessment and Planning The surgeon begins by assessing the extent of the injury or defect at the canthus. This includes evaluating the surrounding structures and determining the appropriate surgical approach based on the specific characteristics of the defect.
  • Step 2: Graft or Flap Selection Depending on the location of the injury, the surgeon selects either a full-thickness skin graft or a flap for reconstruction. For medial canthus injuries, options include an upper eyelid transposition flap or a rotation flap from the glabella. For lateral canthus injuries, a cheek rotation flap is typically chosen.
  • Step 3: Harvesting the Graft or Flap If a skin graft is selected, it is harvested from a suitable donor site, prepared for grafting, and sutured over the defect. In the case of a flap, the surgeon incises the skin according to the predetermined flap configuration, ensuring that the incision extends to the subcutaneous tissues.
  • Step 4: Flap Development The flap is carefully developed, with glabellar flaps requiring thinning to achieve the desired contour and skin thickness around the eye. This step is crucial for ensuring that the flap integrates well with the surrounding tissues.
  • Step 5: Reconstruction of Supporting Structures If the medial canthal supports, such as ligaments and tendons, are damaged, they are reconstructed to ensure proper eyelid opposition to the globe. This step is vital for restoring functional integrity.
  • Step 6: Flap Positioning and Suturing The flap is then rotated or transferred to cover the defect and is sutured securely to the surrounding tissue. The configuration of the flap must allow for effective reconstruction of the canthus.
  • Step 7: Repair of Donor Site Finally, the donor site from which the graft or flap was taken is repaired, ensuring that the overall aesthetic and functional outcomes are optimized.

3. Post-Procedure

After the canthoplasty procedure, patients are typically monitored for any immediate complications. Post-operative care may include instructions for wound care, management of swelling, and pain control. Patients are advised to avoid strenuous activities and to follow up with their surgeon for assessment of healing and flap viability. The expected recovery period can vary based on the extent of the procedure and individual healing responses. It is essential to monitor for signs of infection or complications at both the surgical site and the donor site. Long-term follow-up may be necessary to evaluate the functional and aesthetic outcomes of the reconstruction.

Short Descr REVISION OF EYELID
Medium Descr CANTHOPLASTY
Long Descr Canthoplasty (reconstruction of canthus)
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 2
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).
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)
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).
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.
E2 Lower left, eyelid
E4 Lower right, eyelid
GC This service has been performed in part by a resident under the direction of a teaching physician
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
SG Ambulatory surgical center (asc) facility service
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.
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.
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.
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
E1 Upper left, eyelid
E3 Upper right, eyelid
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
KX Requirements specified in the medical policy have been met
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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