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    v1.0.30
    OpenPayerBilling CodesImaging, Evaluation, Programming and Recording ProceduresCPT cpt-0472t-artificial-retina-programming-and-evaluation
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    CPT 0472T: Initial Evaluation and Programming of Artificial Retina

    CPT code 0472T describes the initial evaluation, interrogation (testing), programming, iterative adjustment, and visual training of an implanted artificial retina or intraocular retinal electrode array performed personally by a qualified healthcare professional; typical service type is initial device evaluation and programming with functionality testing and patient visual training, usually delivered in an outpatient specialty clinic or ambulatory surgical center where retinal prosthesis follow-up and programming are performed.

    For related coverage guidance, see recent payer policy updates: Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mapping, Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mapping, Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mapping.

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with end-stage retinitis pigmentosa receives a surgically implanted artificial retinal prosthesis (retinal electrode array). After a successful implantation, the patient returns for the initial device activation visit in an outpatient ophthalmology clinic or ambulatory surgery center. A qualified healthcare professional (retina specialist, ophthalmic electrophysiologist, or implanted device technician under physician direction) performs a comprehensive session that includes direct evaluation of the implanted system, interrogation of the device, stepwise programming and adjustment of stimulation parameters, functional testing of visual responses, repeated parameter refinement to optimize percepts, brief structured visual training with the patient, and documentation of findings and programmed permanent values. The service is typically billed when the clinician personally conducts the evaluation, testing, and programming and includes the visual training and report as part of the single bundled service. Typical workflow elements include pre-session device check, baseline visual function assessment, iterative parameter mapping, patient feedback collection, safety checks, and final documentation. The typical site of service is an ophthalmology outpatient clinic or ambulatory surgery center with appropriate electrophysiologic testing equipment and device programming hardware.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    0472TInitial evaluation, testing (interrogation), and programming of an artificial retina or intraocular retinal electrode array; includes visual training and reportPrimary code describing the initial activation, iterative programming, and training session for a retinal prosthesis.
    67028Intravitreal injection of a pharmacologic agent (separate procedure)May be performed before or after device implantation to manage inflammation or comorbid retinal disease in the perioperative period.
    65435Removal of intraocular foreign body (retained device components)Related when unplanned device component removal is required prior to re-implantation or revision.
    66378Surgical procedure for retinal prosthesis implantation (hypothetical analogous code for implantation)Represents the surgical implantation procedure that precedes the programming service (0472T is used after implantation).
    92083Visual electrophysiology testing (e.g., electroretinography) with interpretation and reportMay be used for adjunctive functional testing to document retinal responses during programming and optimization.
    97112Therapeutic procedure, neuromuscular reeducation (e.g., visual rehabilitation training)Used by rehabilitation providers for structured visual training sessions complementing device programming.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    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…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    367500000X
    207YP0228X
    208M00000X
    163WX0002X
    261QG0250X
    103TP2700X
    163WG0600X

    Related ICD-10-CM Codes

    20 rows

    ICD-10-CM CodeDescription
    E11.39Type 2 diabetes mellitus with other diabetic ophthalmic complication
    G12.21Amyotrophic lateral sclerosis
    G31.84Mild cognitive impairment of uncertain or unknown etiology
    G45.9Transient cerebral ischemic attack, unspecified
    H25.13Age-related nuclear cataract, bilateral
    H26.9Unspecified cataract
    H33.8Other retinal detachments
    H35.351Cystoid macular degeneration, right eye
    H35.352Cystoid macular degeneration, left eye
    H35.353Cystoid macular degeneration, bilateral

    Showing 1–10 of 20

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mappingpremerabluecrossofwashington2027-02-05
    Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mappingpremerabluecrossofwashington2027-02-05
    Navigated Transcranial Magnetic Stimulation for Preoperative Brain Mappingpremerabluecrossofwashington2027-02-05
    Calcitonin Gene-Related Peptide (CGRP) Inhibitors: Vyepti (eptinezumab-jjmr)Mass General Brigham Health Plan2027-01-04
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Open Neuroplasty Lumbar PlexusCigna2026-12-15
    Laser Interstitial Thermal TherapyCigna2026-11-15
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Microdiscectomyuniverahealthcare2026-10-15

    Related Codes

    CPT-0464T-VISUAL-EVOKED-POTENTIAL-TESTING

    CPT 0464T: Visual Evoked Potential (VEP) Testing

    CPT-0469T-RETINAL-POLARIZATION-SCANNING-VISUAL-SCREENING

    CPT 0469T: Retinal Polarization Scanning Visual Screening

    CPT-0473T-ARTIFICIAL-RETINA-REPROGRAMMING

    CPT 0473T: Artificial Retina/Retinal Electrode Array Reprogramming

    CPT-0474T-ANTERIOR-SEGMENT-AQUEOUS-DRAINAGE-DEVICE-SUPRACILIARY-RESERVOIR

    CPT 0474T: Supraciliary Aqueous Drainage Device Placement, Anterior Segment

    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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