CPT Code 00148: Anesthesia for Eye Procedures in Patients Under 1 Year — Complete Billing & Coding Guide
What Does CPT Code 00148 Mean?
CPT code 00148 describes anesthesia services provided for procedures on the eye in patients under 1 year of age. This age-specific code covers all ophthalmic procedures in infants — including congenital cataract extraction, congenital glaucoma surgery, retinopathy of prematurity (ROP) treatment, nasolacrimal duct probing, and strabismus correction. With base units of 5, this code reflects the higher complexity, increased risk, and specialized expertise required for providing anesthesia to neonatal and infant patients.
Key Code Attributes:
- Billable Status: Fully billable as a standalone anesthesia service
- Base Units (CMS 2026): 5 — higher than standard eye codes (4) due to age
- Patient Population: Infants under 1 year of age (neonates and infants)
- Primary Setting: Hospital outpatient department or pediatric ambulatory surgery center
- Provider Type: Pediatric anesthesiologist or general anesthesiologist with pediatric expertise
- Service Category: General anesthesia (standard for infant eye surgery)
- Effective Status: Active CPT code with no planned retirement (verified through 2026)
What Services and Procedures Does CPT 00148 Cover?
CPT 00148 covers anesthesia for any eye procedure — including anterior segment, posterior segment, and adnexal procedures — when the patient is under 1 year of age.
Covered Procedures:
- Congenital cataract extraction with or without IOL implantation
- Congenital glaucoma surgery (goniotomy, trabeculotomy, trabeculectomy)
- Retinopathy of prematurity (ROP) laser photocoagulation or anti-VEGF injection
- Nasolacrimal duct probing, irrigation, or intubation
- Strabismus surgery in infants under 1 year
- Corneal transplant or repair in infants
- Iris or ciliary body procedures in infants
- Eyelid or orbital procedures in infants
- Enucleation or evisceration for congenital conditions
Code Selection
| Code | Procedure | Base Units (2026) |
|---|---|---|
| 00148 | Eye — patient under 1 year | 5 |
| 00140 | Eye — general | 4 |
| 00142 | Lens surgery | 4 |
| 00144 | Corneal surgery | 4 |
| 00145 | Vitreoretinal surgery | 5 |
| 00147 | Iris and ciliary body | 4 |
Documentation
Preoperative: Weight (kg), age in months, gestational age at birth, history of prematurity, fasting status, airway assessment, ASA classification. Intraoperative: Start/stop times, vitals q5min (including temperature), anesthetic agents and doses (weight-based), fluid management, glucose monitoring, temperature management. Postoperative: PACU times, pain scores (FLACC or equivalent), PONV, Aldrete score.
Base Units
| Component | Value |
|---|---|
| Base Units (CMS 2026) | 5 |
| Time Increment | 15 min |
| P3 | +1 unit |
| P4 | +2 units |
Reimbursement
| Component | Facility |
|---|---|
| Total RVU | 1.67 |
| Est. Medicare | ~$55-60 |
Modifiers
| Modifier | Use |
|---|---|
| AA | Personally performed |
| QX/QZ | CRNA |
| P1-P4 | ASA status |
Real-World Scenario
A 3-month-old with congenital cataract undergoes lens extraction with anterior vitrectomy under general anesthesia. Time: 45 min. ASA II.
Coding: CPT 00148 + AA + P2. Base 5, time 3, total 8 units.
Key Takeaways
- CPT 00148 is age-specific for patients under 1 year
- Base units 5 — higher complexity and risk than other eye codes
- General anesthesia is standard for infant eye surgery
- Document weight, age in months, and gestational history
- Single code per anesthetic session regardless of bilateral procedures
References
- CMS PFS: cms.gov
- ASA Relative Value Guide
- American Academy of Pediatrics
- AAPOS clinical guidelines
