CPT 00145: Anesthesia for Vitreoretinal Surgery
CPT code 00145 denotes anesthesia services furnished for vitreoretinal surgery, covering anesthetic management during procedures on the vitreous and retina. This code is nationally relevant because vitreoretinal surgery is a common subspecialty ophthalmic procedure that often requires specialized anesthesia techniques to manage patient immobility, ocular physiology, and potential intraoperative complications. Accurate coding affects clinical workflow, reimbursement, and quality reporting across surgical and anesthesiology practices.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of clinical context for anesthesia in vitreoretinal procedures, expected sites of service, and how this code fits within related ophthalmic and anesthesia service lines. The publication also highlights typical billing considerations and comparator procedure codes used in ophthalmic surgery bundles.
The analysis provides national benchmarks and policy-relevant guidance on coding alignment (where available), reimbursement patterns across major payers, and common clinical scenarios that drive use of this anesthesia code. The goal is to help hospital administrators, anesthesiologists, and coding professionals understand the role of CPT code 00145 in perioperative documentation and claims submission for vitreoretinal surgical cases.
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Billing Code Overview
CPT code 00145 describes anesthesia services provided for vitreoretinal surgery. The service involves administration and management of anesthesia by an anesthesiology provider for a patient undergoing procedures on the vitreous and/or retina.
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Service type: Anesthesia for ophthalmic surgery (vitreoretinal procedures)
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Typical site of service: Operating room or ambulatory surgical center where vitreoretinal surgery is performed
National Reimbursement Benchmarks
Across national commercial payers the average commercial benchmark (BUCA) centers at $81.1, offering a useful mid-market reference for CPT 00145. Blue Cross Blue Shield ($69.7 mean) and UnitedHealth Group ($67.3 mean) sit below the BUCA average, while Aetna ($122 mean) and Cigna ($87.7 mean) are above it; Aetna’s distribution also reaches the highest observed maximum of $321.7 and a substantial spread between upper and lower percentiles.
Examining interquartile dispersion (P75 minus P25) highlights differences in rate consistency: Blue Cross Blue Shield has a relatively tight IQR of $38.8, and UnitedHealth Group’s IQR is $26.8, indicating narrower variability. Aetna shows the widest IQR at $75.1, with Cigna next at $37.5 and BUCA’s IQR at $42.5, signaling more variability among higher-paying contracts for Aetna and more concentration for UnitedHealth Group and Blue Cross Blue Shield.