CPT® Code 21263

The procedure described by CPT® Code 21263 involves periorbital osteotomies specifically performed to address orbital hypertelorism, a condition characterized by an increased distance between the orbits (eye sockets). This surgical intervention aims to reposition the orbits closer together, enhancing the facial contours and improving aesthetic appearance. During the procedure, the physician advances the forehead forward, which is crucial for achieving a harmonious facial structure. To facilitate access to the orbits, a portion of the frontal bone is temporarily excised, allowing for intracranial cuts while ensuring that the brain is safely retracted during this phase. The use of bone grafts, which may be harvested from the patient's hip, rib, or skull, is integral to the procedure, as these grafts are utilized to fill the defects created by the repositioning of the orbits. The surgeon can access the orbits and the nasoorbital region through various incision points, including the lower eyelid, eyebrow, or maxillary vestibule, providing flexibility in surgical approach. Once the orbits are accessed, the surgeon employs drills and saws to make precise incisions into the orbital rims, and portions of the nasal and ethmoidal bones are removed to allow for proper repositioning. After the orbits are secured using wires, screws, and plates, the frontal bone is reattached in a more forward position, stabilized with additional plates or screws. Finally, the brain is returned to its original position, and all incisions are meticulously closed to promote optimal healing.