CPT code 00103: Eyelid anesthesia, reconstructive procedures2026 Medicare rate & RVUs in Maryland
Anesthesia for reconstructive eyelid operations, including correction of eyelid position or structure and reconstruction of eyelid defects.
CMS doesn’t publish an office rate for 00103 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 00103 covers
This code is for anesthesia during reconstructive surgery of the eyelid, such as operations to correct ptosis, entropion, or ectropion, and reconstruction of an eyelid defect. Ophthalmologists and plastic surgeons commonly perform these procedures in a hospital or ambulatory surgery center; an anesthesia practitioner reports the anesthesia service. The operative plan should identify the eyelid reconstruction rather than surgery directed at the eye itself.
Choose this code for eyelid reconstruction rather than anesthesia for procedures on the eye, lens, or cornea, which use neighboring codes when applicable. The operative report should identify the eyelid and reconstructive work, while the anesthesia record supports the service and documents start and end times. This code has 5 base units; Medicare calculates payment as (base units + time units) multiplied by the locality’s anesthesia conversion factor, which varies by locality. Anesthesia time is reported in minutes and converted to 15-minute units to one decimal place; it begins when the practitioner starts preparing the patient for anesthesia and ends when the practitioner is no longer in personal attendance and the patient can safely be placed under postoperative care.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 00103 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | Unavailable |
| Rest of Maryland | Unavailable | Unavailable |
| Washington, DC area | Unavailable | Unavailable |
How the 00103 rate is calculated
Each of 00103’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 00103
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 00103
00103 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 00103
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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00103 isn’t priced in this setting.
00103 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 00140Eye procedure anesthesiaEye procedures not otherwise specified
- Use 00103 for reconstructive eyelid surgery. Use 00140 for other procedures on the eye that do not fit a more specific anesthesia code.
- 00142Lens surgery anesthesiaLens procedures
- 00142 is for anesthesia during lens surgery, such as cataract surgery; 00103 is for eyelid reconstruction.
- 00144Corneal transplant anesthesiaCorneal graft surgery
- 00144 applies to anesthesia for corneal transplantation. Choose 00103 when the operation reconstructs the eyelid instead.
00103 billing questions
When should this code be chosen instead of 00140?
Use 00103 when the anesthetized operation reconstructs the eyelid. Code 00140 is for other procedures on the eye, rather than eyelid reconstruction.
Does this code cover anesthesia for lens or corneal surgery?
No. Lens surgery and corneal transplantation have separate anesthesia codes; 00103 is for reconstructive eyelid procedures.
What should the records establish?
The operative report should identify the eyelid and the reconstructive procedure, such as correction of eyelid position or repair of a defect. The anesthesia record should support the anesthesia service and its start and end times.
How are time units calculated?
Report anesthesia time in minutes; CMS converts it to 15-minute units, rounded to one decimal place. For example, 38 minutes equals 2.5 time units.
How does Medicare handle medically directed anesthesia?
When an anesthesiologist medically directs a CRNA, Medicare pays each professional 50% of the allowance for the personally performed service.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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