CPT® Code 21268

The procedure described by CPT® Code 21268 involves the surgical repositioning of one orbit through periorbital osteotomies, utilizing bone grafts and employing a combined intra- and extracranial approach. This complex surgical intervention is performed to correct orbital deformities or displacements. The term "periorbital osteotomies" refers to the surgical cutting of the bone surrounding the orbit, which is the bony cavity that houses the eye. The procedure necessitates the temporary removal of a portion of the frontal bone to allow access for intracranial cuts, which are essential for the repositioning of the orbit. During this phase, the brain is carefully retracted to provide the necessary space for the surgeon to work. Bone grafts, which may be harvested from the patient's hip, rib, or skull, are utilized to fill any defects created during the repositioning process. The surgeon can access the orbit through various incision points, including the lower eyelid, eyebrow, or maxillary vestibule, depending on the specific requirements of the case. Once access to the orbit is achieved, specialized instruments such as drills and saws are employed to create precise incisions in the orbital rim. After repositioning the orbit, it is secured in place using wires, screws, and plates to ensure stability. The harvested grafts are then placed into the recipient beds to address the defects resulting from the surgical adjustments. Finally, the frontal bone is reattached using plates or screws, allowing the brain to return to its original position, and all incisions are meticulously closed to promote healing.