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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the HeadCPT cpt-00145-anesthesia-vitreoretinal-surgery
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    CPT 00145: Anesthesia for Vitreoretinal Surgery

    Commercial payers pay $81 on average nationally for this procedure.

    CPT code 00145 describes anesthesia services provided for a patient undergoing vitreoretinal surgery, typically representing intraoperative anesthesia care delivered in an operating room or ambulatory surgical center during complex posterior segment ophthalmic procedures such as vitrectomy and retinal repair.

    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

    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.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old patient with progressive visual decline from an age-related cataract (H25.9) presents for vitreoretinal surgery to address a complicated lens and posterior segment pathology. The ophthalmic surgeon schedules a pars plana vitrectomy with possible membrane peel and intraocular lens manipulation under anesthesia. Preoperative evaluation by the anesthesia team documents medical history including hypertension and controlled diabetes, assigns an ASA physical status of P3, and discusses anesthesia options with the patient.

    On the day of surgery the typical workflow includes preoperative regional anesthesia (peribulbar or retrobulbar block) or monitored anesthesia care with sedation, induction of general endotracheal anesthesia when required (for complex cases or patient factors), intraoperative anesthetic management during vitreoretinal maneuvers, and immediate postoperative recovery in the PACU with monitoring for ocular and systemic complications. Communication between the ophthalmic surgeon and anesthesiologist guides intraoperative adjustments for patient positioning, airway management, and hemodynamic control. Typical settings are an ambulatory surgery center or hospital operating room experienced in ophthalmic microsurgery.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    66984

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…

    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…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    363LP0200XPediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    2086X0206XSurgical Oncology PhysicianA surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevent…
    261QR0400XRehabilitation Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    207RA0001XAdvanced Heart Failure and Transplant Cardiology PhysicianSpecialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced…
    208M00000XHospitalist PhysicianHospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient ca…
    251K00000XPublic Health or Welfare AgencyAgencies · Public Health or Welfare

    Related ICD-10-CM Codes

    21 rows

    ICD-10-CM CodeDescription
    H16.9Unspecified keratitis
    H18.813Anesthesia and hypoesthesia of cornea, bilateral
    H25.12Age-related nuclear cataract, left eye
    H25.9Unspecified age-related cataract
    H26.9Unspecified cataract
    H27.00Aphakia, unspecified eye
    H28Cataract in diseases classified elsewhere
    H33.003Unspecified retinal detachment with retinal break, bilateral
    H33.011Retinal detachment with single break, right eye
    H35.30Unspecified macular degeneration

    Showing 1–10 of 21

    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-00103-ANESTHESIA-RECONSTRUCTIVE-EYELID-SURGERY

    CPT 00103: Anesthesia for Reconstructive Eyelid Procedures

    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

    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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    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Extracapsular cataract removal with insertion of intraocular lens prosthesis
    Cataract extraction and IOL placement may occur concurrently with or prior to vitreoretinal surgery when lens pathology contributes to posterior segment disease.
    66982Complex cataract surgery with insertion of intraocular lens prosthesisUsed for cataract procedures with unusual complexity that may be performed in conjunction with vitreoretinal surgery.
    66821Discission of secondary membranous cataractPerformed when posterior capsular opacification or secondary membranes require treatment during the same operative episode.
    67028Intravitreal injection of a pharmacologic agentMay be performed preoperatively, intraoperatively, or postoperatively for adjunctive pharmacologic therapy related to vitreoretinal conditions.