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Official Description

Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 67971 refers to the surgical procedure known as the reconstruction of the eyelid, specifically involving full thickness reconstruction through the transfer of a tarsoconjunctival flap from the opposing eyelid. This procedure is applicable for reconstructing up to two-thirds of either the upper or lower eyelid and is performed in one stage or as the first stage of a two-stage reconstruction process. The tarsoconjunctival flap technique is particularly useful in cases where there is a defect in the eyelid due to trauma or extensive surgical excision of a lesion. This method, often referred to as lid-sharing reconstruction, allows for the effective restoration of eyelid integrity and function. The choice of technique may vary depending on whether the upper or lower eyelid is being addressed, with specific methods such as the tarsoconjunctival bridge flap for the lower eyelid and the Cutler-Beard procedure for the upper eyelid being commonly employed. The procedure not only aims to restore the physical appearance of the eyelid but also to ensure proper eyelid function, which is crucial for protecting the eye and maintaining ocular health.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 67971 is indicated for the reconstruction of eyelid defects resulting from various conditions. These include:

  • Trauma: Eyelid injuries that result in significant tissue loss or defects.
  • Surgical Excision: Removal of lesions or tumors that necessitate reconstruction of the eyelid.
  • Congenital Defects: Structural abnormalities present at birth that affect the eyelid.

2. Procedure

The procedure involves several detailed steps to ensure effective reconstruction of the eyelid. Each step is crucial for achieving optimal results.

  • Step 1: A traction suture is placed in the upper eyelid margin to facilitate eversion. This allows for better access to the underlying structures.
  • Step 2: The upper eyelid is everted, and an incision is made horizontally 4 mm proximal to the lid margin through the tarsus and conjunctiva. This incision is essential for creating the flap.
  • Step 3: The tarsus and conjunctiva are carefully dissected away from the levator aponeurosis and the Muller muscle. This dissection is necessary to free the flap for advancement.
  • Step 4: The tarsoconjunctival flap is then advanced to the defect in the lower eyelid. Proper alignment and positioning are critical at this stage.
  • Step 5: The edges of the flap are sutured to the medial and lateral remnants of the lower lid tarsus and conjunctiva, securing the flap in place.
  • Step 6: A skin graft is harvested from either the upper eyelid or the retroauricular region to cover the flap. Alternatively, a locally based skin flap may be advanced over the tarsoconjunctival flap.
  • Step 7: The flap is left in place for 4-6 weeks to allow for the development of blood supply to the lower lid from the flap.
  • Step 8: In the second stage of the procedure, a grooved director is inserted under the flap and anterior to the globe, and the flap is divided.
  • Step 9: The conjunctiva is sutured to the reconstructed lower lid margin, ensuring proper closure and alignment.
  • Step 10: The Muller muscle and levator aponeurosis are dissected away from the overlying skin and allowed to retract, facilitating further reconstruction.
  • Step 11: The remainder of the pedicled upper lid flap is reattached to the upper lid, completing the reconstruction process.

3. Post-Procedure

After the procedure, patients are typically monitored for any signs of complications, such as infection or flap failure. The flap is left in place for a designated period to ensure adequate blood supply and healing. Patients may be advised to avoid strenuous activities and to follow specific care instructions to promote healing. Follow-up appointments are essential to assess the healing process and to plan for any additional stages of reconstruction if necessary. The expected recovery time may vary, but patients can generally anticipate a gradual return to normal activities as healing progresses.

Short Descr RECONSTRUCTION OF EYELID
Medium Descr RCNSTJ EYELID FULL THICKNESS
Long Descr Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage
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
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).
E2 Lower left, eyelid
E4 Lower right, eyelid
RT Right side (used to identify procedures performed on the right side of the body)
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).
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.
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.
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.)
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
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
SG Ambulatory surgical center (asc) facility service
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
2024-01-01 Changed Medium Description changed.
2013-01-01 Changed Medium Descriptor changed.
2009-01-01 Changed Code description changed
Pre-1990 Added Code added.
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