Coding Ahead
CasePilot
Medical Coding Assistant
CaseConsultant
Instant Email Coding Consultant
Case2Code
Search and Code Lookup Tool
CareerCenter
Medical Coding Job Board
Log in Register free account

Need help choosing the right code?

Ask CasePilot about procedures, modifiers, bundling, and coding guidance.

Try CasePilot

Official Description

Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 67966 refers to a surgical procedure involving the excision and repair of the eyelid, specifically when the procedure encompasses the lid margin, tarsus, conjunctiva, canthus, or the full thickness of the eyelid. This procedure is typically performed to remove a lesion that may be malignant, such as basal cell carcinoma, squamous cell carcinoma, sebaceous carcinoma, or melanoma. The excision is conducted with the intent to remove not only the lesion but also a margin of healthy tissue surrounding it to ensure complete removal of cancerous cells. Following the excision, the surgical defect is repaired, which may involve the use of a skin graft or a pedicle flap, as well as adjacent tissue transfer or rearrangement. The extent of the excision is significant, as it involves over one-fourth of the lid margin, necessitating careful planning and execution to achieve optimal cosmetic and functional outcomes. The procedure may also require a pathological examination of the excised tissue to confirm that the margins are clear of malignancy; if they are not, further excision may be necessary. The reconstruction technique varies depending on whether the upper or lower eyelid is being addressed and the specific location of the defect on the eyelid itself, whether it be medial, central, or lateral. This complexity underscores the importance of skilled surgical intervention in managing eyelid lesions effectively.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 67966 is indicated for the excision and repair of eyelid lesions that involve significant structures of the eyelid. The following conditions may warrant this surgical intervention:

  • Malignant Lesions Lesions such as basal cell carcinoma, squamous cell carcinoma, sebaceous carcinoma, and melanoma that require excision due to their potential for invasion and spread.
  • Lesions Involving Lid Margin Lesions that are located at or near the lid margin, necessitating careful removal to preserve eyelid function and appearance.
  • Full Thickness Involvement Conditions where the lesion penetrates through the full thickness of the eyelid, requiring more extensive surgical intervention for complete removal and repair.
  • Pathological Concerns Situations where a pathological examination is needed to ensure that the excised margins are free of malignancy, which may necessitate further excision if clean margins are not achieved.

2. Procedure

The procedure for CPT® Code 67966 involves several critical steps to ensure the effective excision and repair of the eyelid lesion. Each step is detailed as follows:

  • Step 1: Preparation The patient is positioned appropriately, and the surgical area is prepared and draped in a sterile manner. Local anesthesia is administered to ensure patient comfort during the procedure.
  • Step 2: Excision of the Lesion The surgeon carefully excises the lesion along with a margin of healthy tissue surrounding it. This is crucial for ensuring that any malignant cells are completely removed. The excision may involve deeper structures such as the tarsus or conjunctiva, depending on the lesion's extent.
  • Step 3: Pathological Examination The excised tissue is sent for pathological examination to confirm that the margins are clear of malignancy. If the margins are not clean, further excision is performed until clear margins are obtained.
  • Step 4: Reconstruction Once the lesion is excised and clean margins are confirmed, the surgical defect is reconstructed. If a skin graft is indicated, an appropriate donor site is selected, and the graft is harvested, prepared, and sutured in place over the defect. Alternatively, if a pedicle flap is used, the flap is elevated, rotated over the defect, and secured with sutures. The defect created by the flap is then closed in layers to ensure proper healing and cosmetic appearance.

3. Post-Procedure

After the procedure, the patient is monitored for any immediate complications. Post-operative care includes instructions for wound care, signs of infection to watch for, and follow-up appointments to assess healing. Patients may experience swelling, bruising, or discomfort in the surgical area, which can be managed with prescribed pain relief. The surgeon will provide specific guidelines on activity restrictions and when normal activities can be resumed. Follow-up visits are essential to ensure proper healing and to evaluate the success of the reconstruction, as well as to discuss the results of the pathological examination.

Short Descr REVISION OF EYELID
Medium Descr EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN
Long Descr Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin
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 2
CCS Clinical Classification 19 - Other therapeutic procedures on eyelids, conjunctiva, cornea
E2 Lower left, eyelid
E4 Lower right, eyelid
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).
SG Ambulatory surgical center (asc) facility service
E3 Upper right, eyelid
E1 Upper left, eyelid
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.)
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
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.
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.
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.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
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
GA Waiver of liability statement issued as required by payer policy, individual case
GW Service not related to the hospice patient's terminal condition
PT Colorectal cancer screening test; converted to diagnostic test or other procedure
TL Early intervention/individualized family service plan (ifsp)
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
2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
Code
Description
Code
Description
Code
Description
Code
Description
Code
Description
CasePilot

Get instant expert-level medical coding assistance.

Ask about:
CPT Codes Guidelines Modifiers Crosswalks NCCI Edits Compliance Medicare Coverage
Example: "What is CPT code 99213?" or "Guidelines for E/M services"