Summary & Overview
CPT 0474T: Anterior Segment Aqueous Drainage Device with Supraciliary Reservoir
CPT code 0474T identifies an ophthalmic surgical procedure that implants an aqueous drainage device into the anterior segment and creates a supraciliary reservoir to drain aqueous humor and lower intraocular pressure in patients with glaucoma. This code matters nationally because it captures a specialized glaucoma intervention with implications for surgical utilization, payer coverage policies, and clinical pathways for refractory or complex glaucoma care. Payers commonly reviewed in analyses of this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what the code represents, the typical clinical context for use, and where the procedure is performed (ambulatory surgical center or hospital operating room). The publication presents benchmark considerations, payer coverage patterns, and relevant policy or coding updates where available. Clinical context includes the intended physiologic goal of the procedure—establishing an alternate aqueous outflow route to reduce intraocular pressure—and typical patient populations considered for surgical glaucoma interventions. Data not provided in the input (such as associated taxonomies, ICD-10 diagnoses, related codes, or payer-specific payment rates) are noted as unavailable in their respective sections. The summary equips clinical, billing, and policy stakeholders with the essential facts needed to locate deeper benchmarks and payer policy details.
Billing Code Overview
CPT code 0474T describes a surgical procedure in which a provider places an aqueous drainage device in the anterior segment of the eye (the space between the cornea and the lens) and creates a supraciliary reservoir beneath the eyebrow to drain aqueous fluid and reduce intraocular pressure in patients with glaucoma. This procedure is an intraocular surgical intervention focused on lowering intraocular pressure by establishing an alternate outflow pathway from the anterior chamber to the supraciliary space.
-
Service type: Surgical ophthalmic procedure (implantation of aqueous drainage device and creation of supraciliary reservoir)
-
Typical site of service: Ambulatory surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive open-angle glaucoma despite maximally tolerated medical therapy is scheduled for surgical implantation of an aqueous drainage device to lower intraocular pressure. The ophthalmic surgeon performs an internal (intraocular) approach to place the device in the anterior segment (between the cornea and the lens) and creates a supraciliary reservoir to facilitate aqueous outflow. Typical workflow: preoperative assessment including visual acuity, intraocular pressure (IOP) measurements, gonioscopy, medication reconciliation, informed consent, and anesthesia evaluation. In the operating room, sterile prep and local or monitored anesthesia care are provided; the surgeon creates a corneal or limbal incision, inserts the drainage device into the anterior chamber, positions the distal portion to access the supraciliary space to form a reservoir, verifies patency and IOP reduction intraoperatively, and closes incisions. Postoperative care includes topical antibiotics and steroids, IOP checks, wound assessment, and scheduled follow-up visits for IOP monitoring and glaucoma medication adjustments. Typical site of service is an ambulatory surgery center or hospital outpatient department. Service type: ophthalmic surgical procedure for glaucoma management under monitored anesthesia care or local/regional anesthesia with or without sedation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special modifier applies. |