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Summary & Overview

CPT 00216: Anesthesia for Intracranial Percutaneous Vascular Procedures

Headline: New Focus on Anesthesia Coding for Intracranial Vascular Procedures

Lead: CPT 00216 designates anesthesia for intracranial percutaneous vascular procedures, reflecting a high-acuity anesthetic service used during endovascular cerebrovascular interventions. This code matters nationally because it captures specialized anesthetic care in complex neurovascular procedures that carry significant perioperative risk and resource intensity.

What the code represents and why it matters: CPT 00216 is used for anesthetic management during intracranial vascular interventions. Proper coding affects clinical documentation, hospital billing, and alignment of care intensity with reimbursement and quality monitoring. As endovascular techniques expand, consistent use of this code supports accurate reporting of anesthesia resources tied to neurovascular cases.

Key payers covered: The analysis covers policies from Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.

What readers will learn: The publication provides a concise overview of coding scope for intracranial vascular anesthesia, payer coverage considerations, common billing modifiers and related procedural codes, and the clinical context linking anesthesia services to intracranial endovascular procedures. It identifies documentation elements commonly required by payers and highlights associated procedural CPTs for cross-reference. Data not available in the input for some service-line specifics will be noted where applicable.

Scope: Content is intended for anesthesia departments, coding and billing teams, and policy analysts seeking a clear national summary of CPT 00216 and its role in neurointerventional case reporting.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00216AnesthesiologyIntracranial Vascular ProceduresInpatient HospitalNeuroanesthesiaCodingBillingEndovascular

CPT Code Overview

CPT 00216 describes anesthesia for intracranial percutaneous vascular procedures. The service is classified under Anesthesiology and typically occurs in an Inpatient Hospital (POS 21) setting. This code represents the anesthetic management provided for patients undergoing intracranial endovascular or percutaneous vascular interventions, where specialized anesthetic techniques and intraoperative physiological control are required.

Clinical & Coding Specifications

Clinical Context

A patient with symptomatic carotid or intracranial cerebrovascular disease is admitted to the inpatient hospital for a vascular neurointerventional procedure requiring general anesthesia. Typical presentation includes transient ischemic attacks, progressive focal neurologic deficits, or acute ischemic symptoms attributed to carotid or middle cerebral artery stenosis/occlusion (e.g., I65.21, I65.22, I65.23, I65.29, I66.01). The anesthesiology team evaluates airway status, hemodynamic goals, and neurologic monitoring needs preoperatively. In the operating room or interventional radiology suite, the anesthesiologist provides induction, maintenance, intraoperative hemodynamic management, and emergence for intracranial or carotid vascular procedures, including catheter-based interventions to restore or assess cerebral perfusion. Postprocedure, the patient is returned to the inpatient setting for neurologic monitoring and postoperative pain and hemodynamic management.

Coding Specifications

Common Modifiers
QS — Monitored anesthesia care service. Use when anesthesia is reported as monitored anesthesia care rather than general anesthesia.
QX — CRNA service with medical direction by a physician. Use when a certified registered nurse anesthetist provides the anesthesia service under medical direction by an anesthesiologist.
Provider Taxonomies and Specialties
207L00000X — Anesthesiology: Physicians specialized in perioperative anesthesia care.
207LA0401X — Pain Medicine (Anesthesiology): Anesthesiologists with subspecialty focus on pain management.
367H00000X — Anesthesiologist Assistant: Non-physician anesthesia care providers who work under anesthesiologist supervision.

Related Diagnoses

I65.21 — Occlusion and stenosis of right carotid artery.
- Clinical relevance: Right carotid artery stenosis/occlusion can cause ipsilateral cerebral ischemia and is an indication for carotid or intracranial vascular procedures requiring anesthetic management under 00216.
I65.22 — Occlusion and stenosis of left carotid artery.
- Clinical relevance: Left carotid stenosis/occlusion may lead to left hemispheric ischemic symptoms and necessitates diagnostic angiography or intervention performed with anesthesia coded by 00216.
I65.23 — Occlusion and stenosis of bilateral carotid arteries.
- Clinical relevance: Bilateral carotid disease increases procedural complexity and monitoring requirements during endovascular or surgical interventions where 00216 describes anesthesia care.
I65.29 — Occlusion and stenosis of unspecified carotid artery.
- Clinical relevance: Used when laterality is not specified; represents carotid pathology that can prompt intracranial vascular procedures managed with anesthesia under 00216.
I66.01 — Occlusion and stenosis of right middle cerebral artery.
- Clinical relevance: Intracranial middle cerebral artery occlusion often necessitates neurointerventional procedures (e.g., thrombectomy, angioplasty) performed with anesthetic services represented by 00216.

Related CPT Codes

36221 — Non-selective catheter placement, carotid artery.
- Relationship: Used during diagnostic or interventional cerebral angiography to access the carotid circulation prior to intracranial procedures; typically performed by the interventionalist while anesthesia is provided per 00216.
36222 — Selective catheter placement, common carotid artery.
- Relationship: More selective catheterization of the common carotid used during diagnostic or therapeutic endovascular procedures; may be performed in the same case as anesthesia reported by 00216.
36223 — Selective catheter placement, internal carotid artery.
- Relationship: Selective access to the internal carotid artery for intracranial angiography or intervention; commonly paired with anesthetic management described by 00216.
36224 — Selective catheter placement, external carotid artery.
- Relationship: Access to the external carotid for diagnostic or embolization procedures; may occur in the same procedural episode when anesthesia is provided under 00216.
Common usage: These endovascular catheterization codes are frequently performed in the same operative episode as the anesthetic service represented by 00216; they are procedure codes for the interventionalist and are billed separately from anesthesia services.

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Summary & Overview

CPT 00216: Anesthesia for Intracranial Percutaneous Vascular Procedures

Headline: New Focus on Anesthesia Coding for Intracranial Vascular Procedures

Key payers covered: The analysis covers policies from Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00216AnesthesiologyIntracranial Vascular ProceduresInpatient HospitalNeuroanesthesiaCodingBillingEndovascular

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Common Modifiers
QS — Monitored anesthesia care service. Use when anesthesia is reported as monitored anesthesia care rather than general anesthesia.
QX — CRNA service with medical direction by a physician. Use when a certified registered nurse anesthetist provides the anesthesia service under medical direction by an anesthesiologist.
Provider Taxonomies and Specialties
207L00000X — Anesthesiology: Physicians specialized in perioperative anesthesia care.
207LA0401X — Pain Medicine (Anesthesiology): Anesthesiologists with subspecialty focus on pain management.
367H00000X — Anesthesiologist Assistant: Non-physician anesthesia care providers who work under anesthesiologist supervision.

Related Diagnoses

I65.21 — Occlusion and stenosis of right carotid artery.
- Clinical relevance: Right carotid artery stenosis/occlusion can cause ipsilateral cerebral ischemia and is an indication for carotid or intracranial vascular procedures requiring anesthetic management under 00216.
I65.22 — Occlusion and stenosis of left carotid artery.
- Clinical relevance: Left carotid stenosis/occlusion may lead to left hemispheric ischemic symptoms and necessitates diagnostic angiography or intervention performed with anesthesia coded by 00216.
I65.23 — Occlusion and stenosis of bilateral carotid arteries.
- Clinical relevance: Bilateral carotid disease increases procedural complexity and monitoring requirements during endovascular or surgical interventions where 00216 describes anesthesia care.
I65.29 — Occlusion and stenosis of unspecified carotid artery.
- Clinical relevance: Used when laterality is not specified; represents carotid pathology that can prompt intracranial vascular procedures managed with anesthesia under 00216.
I66.01 — Occlusion and stenosis of right middle cerebral artery.
- Clinical relevance: Intracranial middle cerebral artery occlusion often necessitates neurointerventional procedures (e.g., thrombectomy, angioplasty) performed with anesthetic services represented by 00216.

Related CPT Codes

36221 — Non-selective catheter placement, carotid artery.
- Relationship: Used during diagnostic or interventional cerebral angiography to access the carotid circulation prior to intracranial procedures; typically performed by the interventionalist while anesthesia is provided per 00216.
36222 — Selective catheter placement, common carotid artery.
- Relationship: More selective catheterization of the common carotid used during diagnostic or therapeutic endovascular procedures; may be performed in the same case as anesthesia reported by 00216.
36223 — Selective catheter placement, internal carotid artery.
- Relationship: Selective access to the internal carotid artery for intracranial angiography or intervention; commonly paired with anesthetic management described by 00216.
36224 — Selective catheter placement, external carotid artery.
- Relationship: Access to the external carotid for diagnostic or embolization procedures; may occur in the same procedural episode when anesthesia is provided under 00216.
Common usage: These endovascular catheterization codes are frequently performed in the same operative episode as the anesthetic service represented by 00216; they are procedure codes for the interventionalist and are billed separately from anesthesia services.

National Reimbursement Benchmarks

National commercial mean rates are materially higher than the BUCA (average commercial) benchmark when Medicare is treated as substantially lower; BUCA’s mean of $352.24 sits between the low UnitedHealth Group mean of $65.63 and higher commercial payers such as Cigna ($810.34) and Blue Cross Blue Shield ($735.22). Medicare is not provided in the input and is represented as absent relative to the commercial benchmarks.

Rate dispersion (P75 minus P25) varies notably across payers. Aetna shows very wide dispersion (P75 $954.00 vs P25 $40.00), and Cigna also shows a large spread (P75 $1,298.00 vs P25 $88.33). UnitedHealth Group is the tightest (P75 $75.80 vs P25 $50.33). Blue Cross Blue Shield and BUCA show moderate dispersion. The table and chart below present the full breakdown.

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Alaska shows a wide spread in reimbursement rates for CPT code 00216, with Blue Cross Blue Shield offering the highest mean rate at $941.46 and UnitedHealth Group the lowest at $75.12. The rate spread, measured by the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($344.40) and BUCA ($519.27), indicating substantial variability in payments across payers. In contrast, Aetna, Cigna, and UnitedHealth Group have minimal rate spreads, with all percentiles clustered closely together.

Compared to national averages, most payers in Alaska—especially Blue Cross Blue Shield and BUCA—provide significantly higher mean rates. However, Cigna and UnitedHealth Group's mean rates are similar to or below their national benchmarks. The table and chart below present the full breakdown of payer-specific reimbursement rates in Alaska.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 00216 in Alaska, with a mean rate of $941.46.
UnitedHealth Group offers the lowest mean rate at $75.12.
Mean rates for most payers in Alaska are significantly higher than their respective national averages, except for Cigna and UnitedHealth Group, which are close to or below national levels.

Related Codes

00174

CPT 00174: Anesthesia for Eye Lens Surgery

00220

CPT 00220: Anesthesia for Intracranial Procedures, Not Otherwise Specified

00147

CPT 00147: Anesthesia for Head Procedures (e.g., Iridectomy)

00172

CPT 00172: Anesthesia for Procedures on the Head

00170

CPT 00170: Anesthesia for Intraoral Procedures, Including Biopsy

00140

CPT 00140: Anesthesia for Unspecified Eye Procedures

00190

CPT 00190: Anesthesia for Facial Bones or Skull Procedures

00352

CPT 00352: Anesthesia for Simple Ligation of Major Neck Vessels

00214

CPT 00214: Anesthesia for Intracranial Burr Holes with Ventricular Access

00144

CPT 00144: Anesthesia for Eye Lens Surgery

Showing 1–10 of 36

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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National Reimbursement Benchmarks

National Mean Rates by Payer for CPT `00216`

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Mean Reimbursement Rates by Payer for CPT 00216 in Alaska

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 00216 in Alaska, with a mean rate of $941.46.
UnitedHealth Group offers the lowest mean rate at $75.12.
Mean rates for most payers in Alaska are significantly higher than their respective national averages, except for Cigna and UnitedHealth Group, which are close to or below national levels.