CPT® Code 21256

Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)

The CPT® Code 21256 refers to the surgical procedure known as reconstruction of the orbit, which involves the use of osteotomies and bone grafts. This procedure is typically performed to address conditions such as micro-ophthalmia, where the eye socket (orbit) may be underdeveloped or malformed. During the surgery, the physician may harvest bone grafts from the patient's own body, commonly from areas such as the hip, rib, or skull. The choice of graft site depends on the specific needs of the reconstruction and the availability of suitable bone. Access to the orbit can be achieved through various incision points, including the lower eyelid, eyebrow, or maxillary vestibule, allowing the surgeon to reach the orbital area effectively. Once access is obtained, specialized instruments such as drills and saws are utilized to create precise incisions in the orbital rims. The repositioning of the bone is a critical step, as it ensures that the orbit is shaped correctly to support the eye and its functions. The repositioned bone is then secured in place using wires, screws, and plates, which provide stability during the healing process. Finally, the harvested grafts are placed into the designated recipient beds within the orbit, and all incisions are meticulously closed to promote optimal healing and minimize scarring.