CPT® Code 21267

The procedure described by CPT® Code 21267 involves orbital repositioning through periorbital osteotomies, specifically performed on one side (unilateral) and utilizing bone grafts. This surgical intervention is conducted via an extracranial approach, meaning that the access to the orbit is achieved from outside the cranial cavity. The term "orbital repositioning" refers to the adjustment of the position of the eye socket (orbit) to correct deformities or misalignments that may affect vision or facial aesthetics. The use of periorbital osteotomies indicates that the surgeon makes precise cuts in the bone surrounding the orbit to facilitate this repositioning. Bone grafts are integral to this procedure, as they are used to fill in any voids or defects created during the repositioning process. These grafts can be harvested from various donor sites on the patient's body, including the hip, rib, or skull, ensuring that the graft material is biocompatible and conducive to healing. The surgical access points for this procedure can vary, with common incisions made through the lower eyelid, eyebrow, or maxillary vestibule, allowing the surgeon to reach the orbital area effectively. Once the orbit is accessed, specialized instruments such as drills and saws are employed to create the necessary incisions in the orbital rim. After repositioning the orbit, the surgeon secures it in place using various fixation devices, including wires, screws, and plates. Finally, the incisions made during the procedure are meticulously closed to promote optimal healing and minimize scarring.