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Official Description

Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 67413 involves an orbitotomy performed without the creation of a bone flap, utilizing either a frontal or transconjunctival approach. This surgical intervention is primarily aimed at exploring the orbit, which is the bony cavity that houses the eye, and addressing specific issues such as the presence of foreign bodies or lesions. The transconjunctival approach is characterized by an incision made in the conjunctival fornix, which is the fold of tissue that connects the eyelid to the eyeball. This method allows for direct access to the orbit while minimizing external scarring. During the procedure, the surgeon dissects the soft tissues to expose the area of interest, which may involve locating and removing a foreign body or lesion. The removal process is meticulous, ensuring that all abnormal tissue is excised along with a margin of healthy tissue when necessary. The procedure concludes with the careful closure of the soft tissues and conjunctiva in layers, ensuring proper healing and minimizing complications. This approach is particularly beneficial for patients with orbital foreign bodies, as it allows for effective removal while preserving surrounding structures.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The orbitotomy procedure described by CPT® Code 67413 is indicated for specific conditions that necessitate exploration and intervention within the orbit. These indications include:

  • Foreign Body Presence The procedure is performed when a foreign body is located within the orbit, which may cause discomfort, injury, or potential complications if not removed.
  • Lesion Removal The procedure is indicated for the removal of lesions, which may be cystic or solid tumors, that are present in the orbital area and require surgical intervention for diagnosis or treatment.

2. Procedure

The orbitotomy procedure involves several critical steps to ensure effective exploration and removal of foreign bodies or lesions. The procedural steps are as follows:

  • Step 1: Anesthesia Administration The procedure begins with the administration of appropriate anesthesia to ensure patient comfort and pain management during the surgery. This may involve local anesthesia or sedation, depending on the complexity of the case and the patient's needs.
  • Step 2: Incision Creation A transconjunctival incision is made in the upper or lower conjunctival fornix. This approach allows the surgeon to access the orbit without creating an external scar, providing a cosmetic advantage while facilitating direct access to the orbital contents.
  • Step 3: Soft Tissue Dissection The surgeon carefully dissects the soft tissues surrounding the orbit to expose the area of interest. This dissection is performed with precision to avoid damaging surrounding structures, such as nerves and blood vessels.
  • Step 4: Foreign Body or Lesion Identification Once the area is adequately exposed, the surgeon locates the foreign body or lesion. If a foreign body is present, it is grasped with forceps for removal. In cases of lesions, the surgeon identifies the cystic or solid tumor for further dissection.
  • Step 5: Removal of Foreign Body or Lesion The foreign body is either removed directly or carefully dissected from the surrounding tissue to minimize trauma. If a lesion is being removed, the surgeon excises the tumor along with a margin of normal tissue to ensure complete removal and facilitate pathology evaluation.
  • Step 6: Wound Irrigation After the removal of the foreign body or lesion, the surgical site is flushed with sterile saline or an antibiotic solution as needed to reduce the risk of infection and promote healing.
  • Step 7: Closure of Incision The final step involves the layered closure of the soft tissues and conjunctiva. This meticulous closure technique helps to ensure proper healing and minimizes the risk of complications such as scarring or infection.

3. Post-Procedure

Following the orbitotomy procedure, patients are typically monitored for any immediate complications. Post-procedure care may include instructions for wound care, the use of prescribed medications such as antibiotics or analgesics, and follow-up appointments to assess healing and recovery. Patients are advised to avoid strenuous activities and to report any signs of infection or unusual symptoms to their healthcare provider. The expected recovery period may vary depending on the individual case and the extent of the procedure performed.

Short Descr EXPLORE/TREAT EYE SOCKET
Medium Descr ORBITOTOMY W/O BONE FLAP W/RMVL FOREIGN BODY
Long Descr Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body
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) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
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 21 - Other extraocular muscle and orbit therapeutic procedures
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
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).
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.
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.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
E3 Upper right, eyelid
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
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