67950

👁️ CPT 67950 — Canthoplasty (Reconstruction of Canthus)

Quick Reference

wRVU: 5.84 | Global Period: 090 | Assistant Payable: No | Bilateral Indicator: 1 The 090-day global period means all related E/M visits, minor complications, and follow-up wound care within 90 days are bundled — do not separately bill these services. Bilateral indicator 1 means if performed bilaterally on the same date, report with modifier -50 and Medicare pays 150% of the single-procedure fee. Assistant surgeon is not separately payable for this code per CMS. Because this is a surgery code with a professional-only indicator (PC/TC = 0), it cannot be split into technical and professional components.

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📋 Clinical Description

CPT 67950 describes the surgical reconstruction of the canthus — the medial (inner) or lateral (outer) corner of the eye where the upper and lower eyelids meet.¹ The procedure involves tightening, repositioning, or reinforcing the canthal tendon and/or orbicularis muscle to restore proper anatomical eyelid alignment and corneal coverage.² This is commonly called a “corner eye lift” or “eye tendon surgery” in clinical settings and is distinct from simple canthotomy (division) such as 67715, which merely cuts the canthus without reconstruction.³

Canthoplasty differs significantly from lateral tarsal strip (67917) in that 67950 involves full reconstruction or reshaping of the canthus itself rather than isolated tightening of the lower eyelid retractors.⁴ Both procedures address canthal laxity but differ in complexity and indication: 67917 targets ectropion correction via the lower lid, while 67950 reconstructs the canthus as a structural unit.⁵ In complex cases involving significant lid margin involvement, coders should evaluate whether 67961 or 67966 (excision and repair of eyelid) more accurately reflects the extent of tissue involved.⁶

This procedure may be performed in the following clinical contexts:

• Post-traumatic canthal disruption — Blunt or penetrating orbital trauma may disrupt the medial or lateral canthal tendon, requiring surgical reattachment and reconstruction to restore normal eyelid closure and alignment.
• Ectropion prevention or treatment — Patients with horizontal laxity of the lower lid or a lax lateral canthal tendon may undergo canthoplasty to prevent or correct outward turning of the eyelid margin before corneal exposure develops.
• Post-oncologic reconstruction — Following excision of periocular tumors (e.g., basal cell carcinoma, sebaceous carcinoma) involving the canthal region, reconstruction of the canthus restores both function and cosmesis.
• Congenital canthal malformation — Patients with congenital abnormalities of the eyelid angle, including epicanthal folds or telecanthus, may require canthoplasty as part of a broader reconstructive surgical plan.
• Revision of prior eyelid surgery — Failed or over-corrected prior oculoplastic procedures (e.g., blepharoplasty with resultant canthal rounding or ectropion) may require canthoplasty to restore proper lid geometry and function.

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🔬 Anatomical & Procedural Considerations

Variant	Mechanism	Key Notes
Lateral Canthoplasty	The lateral canthal tendon is detached, shortened, and reattached to the periosteum of the lateral orbital rim at the internal lateral orbital tubercle (Whitnall’s tubercle). This effectively tightens the outer corner of the lid.	Most commonly performed variant; frequently done in conjunction with lower lid ectropion repair. The tendon is anchored superiorly and posteriorly to achieve appropriate vector tension. Distinguish from lateral tarsal strip (67917), which addresses only the lower lid retractors.
Medial Canthoplasty	The medial canthal tendon is reconstructed or reattached at the posterior lacrimal crest. Approach may be transcutaneous or transconjunctival depending on surgeon preference and extent of disruption.	Less common than lateral canthoplasty; frequently required following medial orbital trauma or after excision of medial canthal tumors. Lacrimal drainage system integrity must be assessed concurrently as canaliculi lie in close proximity.
Combined / Revision Canthoplasty	Combines canthal tendon reconstruction with adjacent tissue rearrangement, skin flap, or graft repair when significant tissue loss is present. May be planned as a staged procedure following tumor excision.	When adjacent tissue transfer is performed as part of the same session, evaluate whether a separate code (e.g., 14060 or 14061) is additionally reportable or already bundled into the extent of repair. Document clearly that canthal reconstruction was performed as a distinct component of the procedure.

Clinical Pearl

The most common audit trigger with CPT 67950 is unbundling it from blepharoplasty or ectropion repair codes when performed at the same anatomic site during the same session. Per CMS NCCI, 67950 is included in 67917, 67924, 67961, and 67966 — you must use modifier -59 only when the canthoplasty is performed at a clearly distinct anatomic site or as a genuinely separate procedure, and your documentation must unambiguously support that distinction.⁷

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✅ Procedure Includes

• Incision and exposure of the canthal tendon (medial or lateral) as required for the reconstruction approach.
• Detachment, shortening, and resecuring of the canthal tendon to the periosteum of the orbital rim using permanent or absorbable suture.
• Repositioning of the eyelid corner to restore proper anatomical angle, tension, and corneal coverage.
• Orbicularis muscle plication or reinforcement when performed as part of the canthal reconstruction.
• Wound closure of the conjunctival and cutaneous layers, including layered closure as appropriate to the approach.
• Standard postoperative care within the 90-day global period, including suture removal and routine wound checks.

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❌ Excludes / Do Not Report Together

Code	Description	Relationship
67917	Repair of ectropion; extensive (tarsal strip operation)	NCCI bundles 67950 into 67917 when performed at the same site in the same session; modifier -59 required only if truly distinct anatomic site and separately documented.
67924	Repair of entropion; other techniques (e.g., tarsal resection)	Per CMS NCCI policy, 67950 is bundled with entropion repair codes; may be unbundled with modifier -59 if the canthoplasty addresses a distinct canthal component not intrinsic to the entropion repair.
67961	Excision and repair of eyelid; up to one-fourth of lid margin	NCCI includes 67950 within 67961 and 67966 because full-thickness eyelid reconstruction inherently addresses the canthus; report separately only when canthoplasty is performed at a distinctly different canthal location with separate documentation.
67715	Canthotomy	Canthotomy is a simple incision/division of the canthus and does not include reconstruction; 67715 and 67950 should not be reported together for the same canthal angle in the same operative session.

Bundling Alert

CPT 67950 carries a 90-day global period, which means any E/M services, minor complications, or follow-up directly related to the canthoplasty are bundled and non-billable during that window. The NCCI bundles 67950 with multiple eyelid repair and reconstruction codes (67917, 67924, 67961, 67966, 67971, 67975) with a “1” indicator, meaning the edit is bypassable — but only with robust documentation of medical necessity and anatomic distinctness, not as a routine unbundling practice.⁷ Auditors specifically look for canthoplasty being reported alongside blepharoplasty procedures (e.g., 15820-15823) during the same session, as this combination is a known high-audit-risk pairing. Always ensure the operative note explicitly describes the canthoplasty as a separate and distinct component with its own indication.

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🌳 Code Tree — Surgery: Eye and Ocular Adnexa / Reconstruction Procedures on the Eyelids

CPT 67900-67975 Surgery: Reconstruction Procedures on the Eyelids  
│  
├── 67900-67924 Repair of Blepharoptosis and Repair of Lid Retraction  
│ ├── 67900 Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)  
│ └── 67924 Repair of entropion; other techniques (e.g., tarsal resection)  
│  
├── 67930-67938 Suture of Recent Wound, Eyelid  
│ ├── 67930 Suture of recent wound, eyelid; partial thickness  
│ └── 67938 Removal of embedded foreign body, eyelid  
│  
├── 67940-**67950** Reconstruction of Canthus  
│ ├── 67940 Repair of brow (direct excision including excessive skin)  
│ ├── 67945 Canthoplasty (tightening of lid, lateral and medial) (Global: 090)  
│ ├── ▶▶ **67950** ◀◀ Canthoplasty (reconstruction of canthus) ← YOU ARE HERE (Global: 090)  
│  
├── 67961-67966 Excision and Repair of Eyelid  
│ ├── 67961 Excision and repair of eyelid; up to one-fourth of lid margin (Global: 090)  
│ └── 67966 Excision and repair of eyelid; over one-fourth of lid margin (Global: 090)  
│  
└── 67971-67975 Reconstruction of Eyelid  
├── 67971 Reconstruction of eyelid; partial (less than 2/3 of lower lid, or less than 1/2 upper lid)  
└── 67975 Reconstruction of eyelid; total lid, upper or lower

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💰 RVU & Reimbursement Profile

Component	Value
Work RVU	5.84
Global Period	090
Bilateral Indicator	1
Assistant Surgeon	No
Co-Surgeon	No
Team Surgery	No
PC/TC Split	Not applicable (0)
Modifier -51 Exempt	No
Anesthesia	General or MAC; separately reportable by anesthesia provider

Bilateral Billing Rules

Bilateral indicator 1 means that when 67950 is performed on both canthal angles (e.g., bilateral lateral canthoplasty) on the same date of service, you append modifier -50 to a single line of CPT 67950, and Medicare reimburses at 150% of the single-procedure allowable.⁵ Do not report 67950-RT** and 67950-LT on two separate lines without modifier -50 on a single line — this is the required billing format for Medicare and most commercial payers following CMS guidelines. Always verify individual commercial payer policies, as some prefer the two-line format (with -RT and -LT) over the single-line -50 approach. Documentation must clearly indicate that the bilateral procedure was medically necessary for each side independently.

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🏷️ Modifier Reference

Modifier	Name	When to Apply
-RT	Right Side	Append when canthoplasty is performed on the right canthus only; required by most payers to identify laterality and prevent bilateral overpayment.
-LT	Left Side	Append when canthoplasty is performed on the left canthus only; critical for claims accuracy and audit defense.
-50	Bilateral	Use when canthoplasty is performed on both sides during the same operative session; Medicare reimburses at 150% with -50 on a single line.
-E1	Upper Left Eyelid	Use when the procedure specifically involves the upper left eyelid canthus; provides greater anatomic specificity than -LT alone.
-E2	Lower Left Eyelid	Use when the procedure specifically involves the lower left eyelid canthus; particularly relevant for lateral tarsal strip versus canthoplasty distinction.
-E3	Upper Right Eyelid	Use when the procedure specifically involves the upper right eyelid canthus.
-E4	Lower Right Eyelid	Use when the procedure specifically involves the lower right eyelid canthus.
-25	Significant E/M	Append to the E/M code (not the surgical code) when a separately identifiable evaluation and management service is performed on the same day as 67950; documentation must support a distinct, separately documented E/M.
-24	Unrelated E/M	Use when an E/M service is performed during the 90-day global period but is completely unrelated to the canthoplasty; must be clearly documented as addressing a different condition.
-51	Multiple Procedures	Append to 67950 when it is the secondary procedure performed in the same operative session; the primary (highest-value) procedure is listed without -51.
-59	Distinct Service	Required to bypass NCCI edits when 67950 is reported with bundled codes (e.g., 67917, 67924, 67961); use only when documentation clearly supports a distinct anatomic site or separate procedure.
-22	Increased Services	Append when the canthoplasty required substantially greater work than typically described (e.g., severe scarring from prior surgery, extensive tissue defect); must include documentation and a cover letter explaining the increased complexity.
-52	Reduced Services	Use when the procedure was intentionally reduced in scope — e.g., only one component of a planned bilateral canthoplasty was completed.
-53	Discontinued	Use if the procedure was begun but discontinued due to medical emergency or patient risk before completion.
-58	Staged Procedure	Append when 67950 is a planned staged component of a larger reconstructive plan initiated in a prior operative session; removes the case from the global period of the initial procedure.
-78	Return to OR	Use when the patient returns to the operating room for a related complication of 67950 during the 90-day global period; does not restart the global clock.
-79	Unrelated Procedure	Use when 67950 is performed during the global period of a completely unrelated prior surgical procedure by the same surgeon.

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🩺 Common ICD-10-CM Pairings

Primary Diagnosis Group

ICD-10	Description	HCC?	Notes
H02.101	Unspecified ectropion of right upper eyelid	No	Most common indication for lateral canthoplasty; document specific eyelid and laterality to code to highest specificity.
H02.105	Unspecified ectropion of left lower eyelid	No	Lower eyelid ectropion is the predominant functional indication; ensure laterality is specified in the operative report.
H02.001	Unspecified entropion of right upper eyelid	No	Entropion may accompany canthal laxity requiring canthoplasty; if canthoplasty is performed alongside entropion repair, evaluate NCCI bundling rules.
H02.401	Unspecified ptosis of right eyelid	No	Canthal laxity contributing to eyelid ptosis may be addressed with canthoplasty; confirm surgeon’s documentation identifies canthus as the primary site of correction.
H02.209	Unspecified lagophthalmos, unspecified eye, unspecified eyelid	No	Lagophthalmos may result from prior facial nerve palsy or scarring; canthoplasty may be performed to improve lid closure and prevent corneal exposure.

Secondary Group

ICD-10	Description	HCC?	Notes
H18.891	Other specified disorders of right cornea	No	Document as secondary when canthal laxity has resulted in corneal exposure or punctate keratopathy requiring concurrent management.
Q10.3	Other congenital malformations of eyelid	No	Used for congenital canthal malformations requiring canthoplasty; confirms medical necessity over cosmetic intent.

Etiology / Complication

ICD-10	Description	HCC?	Notes
S01.101A	Unspecified open wound of right eyelid and periocular area, initial encounter	No	Use for post-traumatic canthoplasty at initial encounter; confirms reconstructive rather than cosmetic indication.
Z98.89	Other specified postprocedural states	No	May be used as secondary code when canthoplasty is a revision of a prior surgical procedure; supports medical necessity for revision surgery.

Coding Specificity Reminder

ICD-10-CM codes for eyelid conditions are highly laterality- and position-specific — always code to the specific eyelid (upper/lower) and side (right/left) as documented by the surgeon. Unspecified codes (e.g., H02.109) are audit red flags and should only be used when the operative note genuinely fails to specify. Cosmetic canthoplasty (i.e., performed solely for appearance without functional impairment) is not covered by Medicare or most commercial payers — diagnosis coding must reflect a documented functional deficit such as ectropion, lagophthalmos, or corneal exposure. If the claim is payer-denied as cosmetic, the supporting diagnosis codes and operative note language are your primary appeal tools, so documentation quality is paramount.

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🏥 MS-DRG Considerations

CPT 67950 is an outpatient or ASC procedure in the vast majority of clinical scenarios and does not have a dedicated inpatient MS-DRG assignment as a standalone code.⁵ When performed in the inpatient setting (uncommon and typically limited to complex trauma or oncologic reconstruction cases), it would group under the Major and Other Eye Procedures DRG family (DRGs 124-125), where the principal diagnosis, any CCs or MCCs, and the full operative complexity drive DRG assignment and relative weight. Profee coders working inpatient should note that the physician professional fee is still reported with CPT 67950 regardless of setting, but the facility claim will use ICD-10-PCS procedure coding — not CPT — for inpatient stays. Because this procedure rarely meets inpatient admission criteria under Two-Midnight Rule guidelines, utilization review and medical necessity documentation are critical if the patient is kept overnight following canthoplasty.⁷

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🔧 ICD-10-PCS Equivalents

PCS Code	Full Description	Modality
08QQXZZ	Repair of Right Lower Eyelid, External Approach	Repair
08QPXZZ	Repair of Right Upper Eyelid, External Approach	Repair
08SRXZZ	Reposition of Right Lower Eyelid, External Approach	Reposition
08SQXZZ	Reposition of Right Upper Eyelid, External Approach	Reposition

PCS Character Analysis (using 08QQXZZ as the primary example)

Position	Character	Value	Definition
1	Section	0	Medical and Surgical section — used for all operative procedures on body structures.
2	Body System	8	Eye — encompasses eyelids, conjunctiva, cornea, iris, lens, and ocular adnexa.
3	Root Operation	Q	Repair — restoring, to the extent possible, a body part to its normal anatomic structure and function; appropriate when the intent is reconstruction of the canthus.
4	Body Part	Q	Right Lower Eyelid — specifies the anatomical location; select P (Right Upper), N (Left Upper), or R (Left Lower) as appropriate to the operative site.
5	Approach	X	External — canthoplasty is performed through the skin surface without endoscopic instrumentation; this is the standard approach for open oculoplastic procedures.
6	Device	Z	No Device — no implant, drain, or hardware is left in place following canthoplasty under this code.
7	Qualifier	Z	No Qualifier — no additional specification is required.

Root Operation Comparison

• Repair (Q) is the correct root operation when the surgeon is reconstructing the canthus to restore normal anatomy — this is the standard selection for canthoplasty and maps most directly to CPT 67950.
• Reposition (S) is appropriate when the primary objective is moving the canthal tendon to a new, more anatomically correct position (e.g., reattachment after traumatic avulsion), rather than simply restoring the existing structure — select this root operation when the operative note emphasizes relocation over repair.
• Supplement (U) would be selected if the surgeon uses a graft or augmentation material (e.g., fascia lata, synthetic mesh) to augment the canthal reconstruction — rare in isolated canthoplasty but may apply in revision or complex oncologic cases.

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📝 Coding Examples

Example 1

Clinical Scenario: A 72-year-old male presents with progressive right lower eyelid ectropion causing constant epiphora and corneal irritation. The ophthalmologist documents horizontal canthal tendon laxity on exam. The patient is taken to the ASC, and under MAC anesthesia, a lateral canthoplasty is performed on the right lower eyelid by detaching the lateral canthal tendon, shortening it, and reattaching it to the periosteum of the lateral orbital rim. No entropion repair or blepharoplasty is performed. The procedure is completed without complication.

Field	Code	Rationale
CPT	67950-RT	67950 is the correct code for canthoplasty; -RT specifies right side and is required by most payers for laterality.
PDx	H02.101	Unspecified ectropion of right upper eyelid — code to the specific eyelid and side as documented; confirms functional (non-cosmetic) medical necessity.

Note

The 90-day global period begins on the date of service; do not separately bill the preoperative evaluation performed on the same day unless it was a significant, separately identifiable E/M with modifier -25 on the E/M code. Routine postoperative follow-up visits within 90 days are bundled.

Example 2

Clinical Scenario: A 65-year-old female undergoes bilateral lateral canthoplasty for bilateral canthal tendon laxity resulting in bilateral lower lid laxity and lagophthalmos with documented corneal exposure. The surgeon performs the identical canthoplasty procedure on both the right and left lateral canthi during the same operative session in an outpatient hospital setting. The operative note documents both sides independently and confirms medical necessity for each.

Field	Code	Rationale
CPT 1	67950-50	Bilateral indicator 1 — report as a single line with modifier -50; Medicare reimburses at 150% of the single-procedure fee.
PDx	H02.209	Unspecified lagophthalmos, unspecified eye — code to highest specificity available; if the note specifies right and left, code each side separately as secondary diagnoses for completeness.

Warning

Do NOT report 67950-RT and 67950-LT on two separate lines for Medicare without confirming the payer’s bilateral billing preference — Medicare requires the -50 modifier on a single line. Reporting two lines without -50 may result in one line being denied as duplicate. Verify commercial payer contracts individually, as preferences vary.

Example 3

Clinical Scenario: A 58-year-old male with a history of Mohs surgery for basal cell carcinoma of the right medial canthus three months prior presents with post-excision canthal webbing and functional ectropion. The surgeon plans a medial canthoplasty for reconstruction of the medial canthal angle. Because this was performed during the global period of a prior surgical procedure by the same surgeon, modifier -58 is required to indicate a staged, related procedure. The procedure is completed under general anesthesia in the outpatient hospital setting.

Field	Code	Rationale
CPT	67950-58-RT	-58 identifies this as a staged/related procedure within the global period of the prior surgery; -RT specifies laterality.
PDx	Z98.89	Postprocedural state used as secondary; primary diagnosis should reflect the functional ectropion (H02.101) driving medical necessity for the reconstruction.

Global period reminder

Modifier -58 does NOT restart the global period of the prior procedure — it simply removes 67950 from being bundled into the prior surgery’s global window so it can be separately billed. A new 90-day global period begins for CPT 67950 itself from this new date of service. Ensure the operative note explicitly references the prior procedure and links the canthal reconstruction as a planned staged component.

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⚠️ Common Coding Pitfalls

• Pitfall 1 — Cosmetic vs. Functional: Reporting 67950 without a functional diagnosis is the fastest path to denial and post-payment audit. If the operative note uses language like “improve appearance” or “cosmetic improvement” without a co-existing functional impairment (ectropion, lagophthalmos, corneal exposure), payers will deny as cosmetic. Always verify that the diagnosis coding reflects the functional indication and that the note explicitly documents the functional deficit.
• Pitfall 2 — NCCI Bundling Ignored: Billing 67950 alongside 67917, 67924, 67961, or 67966 without modifier -59 will trigger an NCCI edit denial. Even with -59 appended, documentation must unambiguously support anatomic distinctness — the canthoplasty must have been performed at a different canthal site or as a genuinely distinct procedure, not just as an incidental component of the ectropion/entropion repair.⁷
• Pitfall 3 — Wrong Laterality Modifier: Omitting -RT or -LT (or appending the wrong side) on a unilateral canthoplasty claim is a common data entry error that triggers payer queries and can look like upcoding on audit. Always verify laterality against the operative report before submission.
• Pitfall 4 — Global Period Violations: Separately billing a related E/M visit during the 90-day global period without modifier --24 (unrelated service) is a global period violation. Remind the billing team that all related postoperative care — including suture removal, wound checks, and minor complication management — is bundled into 67950’s global fee.
• Pitfall 5 — Bilateral Billing Format Error: Reporting bilateral canthoplasty as two separate lines (67950-RT and 67950-LT) for Medicare instead of the required single-line -50 format frequently results in one claim line being denied as a duplicate. Know your payer’s bilateral format preference before submission.
• Pitfall 6 — Confusing 67950 with 67945 or 67715: CPT 67945 (canthoplasty — tightening of lid) and 67715 (canthotomy) are distinct codes that describe less complex or different canthal procedures. Assigning 67950 when only a simple canthotomy or tightening was performed — without true reconstruction — is upcoding. Closely review the operative note’s description of what was actually done to the canthal tendon structure before assigning 67950.¹²

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📎 Sources

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Footnotes

1. AAPC. CPT Code 67950 — Reconstruction Procedures on the Eyelids. Codify by AAPC. Accessed June 2026. https://www.aapc.com/codes/cpt-codes/67950 ↩ ↩² ↩³

2. MDClarity. CPT Code 67950: What It Is, Modifiers, Reimbursement. Accessed June 2026. https://www.mdclarity.com/cpt-code/67950 ↩ ↩² ↩³

3. University of Arizona Health Sciences. Oculoplastics CPT Codes Reference. Accessed June 2026. https://eyes.arizona.edu/sites/default/files/cpt_codes.pdf ↩ ↩²

4. AAPC Ophthalmology Coding Alert. NCCI Bundles 67924 and 67950. April 2003. https://www.aapc.com/codes/coding-newsletters/my-ophthalmology-coding-alert/reader-question-ncci-bundles-67924-and-67950-article ↩ ↩²

5. FastRVU. CPT 67950: Revision of Eyelid — RVU Values & Medicare Reimbursement 2026. Accessed June 2026. https://fastrvu.com/cpt/67950 ↩ ↩² ↩³ ↩⁴

6. GenHealth.ai. 67950 — Canthoplasty (Reconstruction of Canthus). Accessed June 2026. https://genhealth.ai/code/cpt4/67950-canthoplasty-reconstruction-of-canthus ↩ ↩²

7. CMS. Medicare NCCI Coding Policy Manual, Chapter 8. 2024. https://www.cms.gov/files/document/medicare-ncci-policy-manual-2024-chapter-8.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵