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    OpenPayerBilling CodesAnesthesia for Procedures on the HeadCPT cpt-00147-anesthesia-for-iridectomy-ophthalmic-surgery
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    CPT 00147: Anesthesia for Iridectomy (Iris Surgery)

    Commercial payers pay $97 on average nationally for this procedure.

    CPT code 00147 describes anesthesia services provided for a patient undergoing an iridectomy (surgical removal of part of the iris), typically classified as anesthesia for ophthalmic surgery and commonly performed in an ambulatory surgery center or hospital operating room for eye procedures.

    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 00147 center around BUCA’s average commercial rate of $97.20, with notable variation among major payers. Cigna’s mean of $140.60 sits well above BUCA, while Aetna ($74.90), Blue Cross Blue Shield ($99.90), and UnitedHealth Group ($67.90) cluster closer to or below BUCA. Absolute medians and extremes vary by carrier, and the overall landscape shows payers spanning low- to high-end reimbursements.

    Dispersion measured as the interquartile difference (P75 minus P25) highlights where variability is tightest or widest: UnitedHealth Group is the tightest with a spread of $29.00 ($81.10 − $52.00), while Blue Cross Blue Shield has the widest IQR at $62.10 ($132.10 − $69.90). Cigna and BUCA also show substantial spreads of $64.30 ($167.40 − $103.10) and $57.20 ($125.90 − $67.80) respectively, with Aetna’s IQR at $66.90 ($110.30 − $42.00).

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old patient with progressive vision blurring and glare due to an irregular pupil from peripheral iris tissue causing monocular diplopia is scheduled for a surgical iridectomy. The ophthalmologist documents failed medical management and mechanical pupillary block symptoms. Preoperative evaluation includes focused ophthalmic exam, lens status assessment, topical and systemic medications review, and anesthesia pre-op evaluation by an anesthesiology physician or certified registered nurse anesthetist. On the day of surgery the patient receives monitored anesthesia care or general anesthesia per airway and cooperation status; regional ocular blocks (peribulbar or retrobulbar) may be used when appropriate. The operating room or ambulatory surgery center is the typical site of service. The anesthesiologist documents intraoperative management, airway, medications, hemodynamics, and postoperative recovery. Postoperative discharge occurs to home with routine ophthalmic follow-up.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    66984Extracapsular cataract removal with insertion of intraocular lens prosthesisPerformed when cataract extraction with IOL placement is done in the same operative session or as a related cataract procedure.
    66982

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…

    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…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    207W00000XOphthalmology PhysicianAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically train…
    261QA1903XAmbulatory Surgical Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    208VP0000XPain Medicine PhysicianPain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on sc…
    2279S1500XSNF/Subacute Care Registered Respiratory TherapistCare of residents in a long-term care environment. Respiratory modalities delivered include those similar in the general care and critical care areas…
    2085R0205XRadiological Physics PhysicianA radiological physicist deals with the diagnostic and therapeutic applications of roentgen rays, gamma rays from sealed sources, ultrasonic radiation…
    174M00000XVeterinarianA doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery.

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 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
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    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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    Complex cataract surgery with insertion of intraocular lens prosthesis
    Related when cataract surgery is complicated by zonular instability or other factors concurrent with iridectomy.
    66821Discission of secondary membranous cataractRelated postoperative procedure for managing posterior capsular opacification; may occur in the same care pathway.
    67028Intravitreal injection of a pharmacologic agentMay occur in the perioperative or follow-up period for adjunctive therapy (e.g., anti‑VEGF) though not a direct component of iridectomy.