CPT Code 00147: Anesthesia for Procedures on the Iris and Ciliary Body — Complete Billing & Coding Guide
What Does CPT Code 00147 Mean?
CPT code 00147 describes anesthesia services provided for procedures on the iris and ciliary body of the eye. This code covers iridectomy, iridotomy, ciliary body destruction (cyclophotocoagulation), and related procedures involving the iris and ciliary body structures. It is a specific code within the ophthalmic anesthesia family (00140-00148) and is used when the surgical procedure is confined to the iris or ciliary body without involvement of the lens, cornea, or posterior segment.
Key Code Attributes:
- Billable Status: Fully billable as a standalone anesthesia service
- Base Units (CMS 2026): 4
- Primary Setting: Ambulatory surgery center or hospital outpatient department
- Provider Type: Anesthesiologist (MD/DO), CRNA with physician supervision
- Service Category: Monitored anesthesia care (MAC) or general anesthesia
- Effective Status: Active CPT code with no planned retirement (verified through 2026)
- Common Procedures: Iridectomy, laser iridotomy, cyclophotocoagulation, iris tumor excision
What Services and Procedures Does CPT Code 00147 Cover?
Covered Procedures:
- Surgical iridectomy (peripheral or sector)
- Laser iridotomy under anesthesia (when anesthesia provider required)
- Cyclophotocoagulation (ciliary body destruction for glaucoma)
- Iris tumor or cyst excision
- Iris repair or reconstruction
- Ciliary body biopsy
- Goniotomy or trabeculotomy (limited to iris/ciliary approach — congenital glaucoma)
- Surgical management of iris prolapse
- Iridodialysis repair
- Synechialysis under anesthesia
Exclusions
| Excluded | Correct Code | Rationale |
|---|---|---|
| Combined cataract with iridectomy | 00140 | Multiple eye structures |
| Glaucoma surgery (trabeculectomy, tube shunt) | 00140 | Broader eye code |
| Corneal transplant | 00144 | Corneal procedure |
| Vitreoretinal surgery | 00145 | Posterior segment |
| Pediatric eye surgery (under 1 year) | 00148 | Age-specific code |
| Laser iridotomy without anesthesia provider | Not billable | No anesthesia code |
Code Selection
| Code | Anatomic Focus | Base Units (2026) |
|---|---|---|
| 00147 | Iris and ciliary body | 4 |
| 00140 | Eye — general | 4 |
| 00142 | Lens surgery | 4 |
| 00144 | Corneal surgery | 4 |
| 00145 | Vitreoretinal surgery | 5 |
| 00148 | Eye — under 1 year | 5 |
Documentation
Preoperative: History, ASA class, airway assessment, anticoagulant review, anesthesia plan (MAC vs. GA), NPO status. Intraoperative: Start/stop times, vitals q5min, anesthetic agents and doses, level of sedation, oxygen administration. Postoperative: PACU times, pain scores, PONV assessment, Aldrete score.
Base Units
| Component | Value |
|---|---|
| Base Units (CMS 2026) | 4 |
| Time Increment | 15 min |
| P3 | +1 unit |
| P4 | +2 units |
Reimbursement
2026 RVU
| Component | Facility |
|---|---|
| Total RVU | 1.33 |
| Est. Medicare | ~$44-48 |
Modifiers
| Modifier | Use |
|---|---|
| AA | Personally performed |
| QS | MAC service |
| QX/QZ | CRNA |
| P1-P4 | ASA status |
Coding Errors
- Using 00140 when 00147 is more specific
- Combined procedures with other eye structures = use 00140
- Laser iridotomy without anesthesia provider — no code
- Billing block separately (bundled)
Real-World Scenario
A 58-year-old with plateau iris syndrome undergoing surgical iridectomy under MAC. Time: 25 min. ASA II.
Coding: CPT 00147 + AA + P2 + QS. Base 4, time 1, total 5 units.
Key Takeaways
- CPT 00147 is specific to iris and ciliary body procedures
- Base units 4 — same as 00140/00142/00144
- Rarely billed compared to cataract and corneal codes
- Combined with other eye procedures = use 00140
- Single code per anesthetic session
References
- CMS PFS: cms.gov
- ASA Relative Value Guide
- American Academy of Ophthalmology
