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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the HeadCPT cpt-00103-anesthesia-reconstructive-eyelid-surgery
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    CPT 00103: Anesthesia for Reconstructive Eyelid Procedures

    Commercial payers pay $82 on average nationally for this procedure.

    CPT code 00103 describes anesthesia services provided for reconstructive eyelid procedures such as blepharoplasty or ptosis repair; this represents an anesthesia service typically delivered in an ambulatory surgical center or hospital operating room for perioperative management of patients undergoing eyelid reconstruction.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    National Reimbursement Benchmarks

    National commercial rates for CPT 00103 cluster around the BUCA average commercial rate of $81.70, with payers showing distinct central tendencies. Blue Cross Blue Shield centers lower near its median of $65.20 while Aetna and Cigna skew higher with medians of $95.30 and $86.00 respectively; UnitedHealth Group sits closer to BCBS with a median of $64.00. These central values highlight that BUCA’s average sits between the lower cluster (Blue Cross Blue Shield, UnitedHealth Group) and the higher cluster (Aetna, Cigna).

    Dispersion measured by the interquartile range (P75–P25) is widest for Aetna at $73.40 ($138.60–$65.20) and narrowest for UnitedHealth Group at $30.90 ($81.10–$52.00). Cigna shows a wide spread of $58.40 ($125.00–$68.40), Blue Cross Blue Shield a moderate spread of $38.90 ($94.10–$51.60), and BUCA’s spread is $36.70 ($104.50–$56.80). These differences indicate varied variability in contract rates across payers for this code.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with symptomatic dermatochalasis and unilateral mechanical ptosis (H02.411) presents for elective upper eyelid reconstructive surgery (e.g., blepharoplasty with levator advancement). Preoperative assessment by the anesthesiology team documents history of myasthenia gravis without exacerbation (G70.00), controlled hypertension, and routine labs. The procedure is scheduled in an ambulatory surgery center; anesthesia plan is local with monitored anesthesia care (MAC) or general anesthesia depending on surgeon preference and patient comorbidities. On the day of surgery the anesthesiologist documents airway assessment, obtains informed consent for anesthesia services, administers monitored sedation and local infiltration, titrates medications for hemodynamic stability, provides intraoperative monitoring (ECG, pulse oximetry, blood pressure, capnography if sedated), and manages emergence and PACU handoff. Postoperative documentation includes anesthesia start and stop times, agents used, airway device if any, intraoperative events, and a focused note at PACU discharge. Billing uses anesthesia code 00103 to report anesthesia care for reconstructive eyelid procedures such as blepharoplasty or ptosis repair.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    15820

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    207LC0200XCritical Care Medicine (Anesthesiology) PhysicianAn anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
    367A00000XAdvanced Practice MidwifeAdvanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproduc…
    207N00000XDermatology PhysicianA dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genital…
    207XS0106XOrthopaedic Hand Surgery PhysicianAn orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of t…
    207RE0101XEndocrinology, Diabetes & Metabolism PhysicianAn internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with …
    246YC3302XPhysician Office Based Coding SpecialistNone

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    G24.5Blepharospasm
    G51.2Melkersson's syndrome
    G51.31Clonic hemifacial spasm, right
    G51.32Clonic hemifacial spasm, left
    G51.4Facial myokymia
    G70.00Myasthenia gravis without (acute) exacerbation
    G70.80Lambert-Eaton syndrome, unspecified
    G70.81Lambert-Eaton syndrome in disease classified elsewhere
    G73.1Lambert-Eaton syndrome in neoplastic disease
    H02.31Blepharochalasis right upper eyelid

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 2

    7 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-00100-ANESTHESIA-FOR-SALIVARY-GLAND-PROCEDURES

    CPT 00100: Anesthesia for Salivary Gland Procedures

    CPT-00102-ANESTHESIA-CLEFT-LIP-REPAIR

    CPT 00102: Anesthesia for Plastic Repair of Cleft Lip

    CPT-00104-ANESTHESIA-FOR-ELECTROCONVULSIVE-THERAPY

    CPT 00104: Anesthesia for Electroconvulsive Therapy

    CPT-00120-ANESTHESIA-FOR-EAR-PROCEDURES

    CPT 00120: Anesthesia for External, Middle, and Inner Ear Procedures

    CPT-00124-ANESTHESIA-EXTERNAL-MIDDLE-INNER-EAR-BIOPSY-OTOSCOPY

    CPT 00124: Anesthesia for External, Middle, and Inner Ear Procedures

    CPT-00126-ANESTHESIA-FOR-OTOLOGIC-PROCEDURES-TYMPANOTOMY-BIOPSY

    CPT 00126: Anesthesia for External, Middle, and Inner Ear Procedures

    CPT-00140-ANESTHESIA-FOR-EYE-PROCEDURE-OPHTHALMIC-SURGERY

    CPT 00140: Anesthesia for Eye Procedure

    CPT-00142-ANESTHESIA-FOR-EYE-LENS-PROCEDURE

    CPT 00142: Anesthesia for Eye Lens Procedure

    CPT-00144-ANESTHESIA-CORNEAL-TRANSPLANT

    CPT 00144: Anesthesia for Corneal Transplant

    CPT-00145-ANESTHESIA-VITREORETINAL-SURGERY

    CPT 00145: Anesthesia for Vitreoretinal Surgery

    Showing 1–10 of 30

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Blepharoplasty, lower eyelid
    Lower eyelid blepharoplasty may be performed concurrently or in staged fashion with upper eyelid reconstruction; anesthesia billed separately with 00103 for eyelid procedures.
    15823Blepharoplasty, upper eyelidPrimary surgical procedure for upper eyelid dermatochalasis; anesthesia services for this procedure are reported with 00103.
    67904Repair of blepharoptosis; (tarso) levator resection or advancement, external approachCommon surgical technique for ptosis repair; anesthesia code 00103 applies when anesthetic services are provided for this reconstructive eyelid operation.
    67908Repair of blepharoptosis; conjunctivo-tarso-Müller's muscle-levator resection (e.g., Fasanella-Servat type)Alternate ptosis repair technique; anesthetic management and billing use 00103 when providing perioperative anesthesia for this surgical approach.