CPT 00322 Reimbursement Benchmarks & Policy | OpenPayer

Summary & Overview

CPT 00322: Anesthesia for Neck Procedures Including Thyroid Biopsy

CPT code 00322 is a critical billing code for anesthesia services provided during procedures on the esophagus, thyroid, larynx, trachea, and lymphatic system of the neck, including needle biopsies of the thyroid. This code is widely used in outpatient hospital settings and is recognized by major national payers such as Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. The code is relevant for anesthesiology and pain medicine specialists, as it covers a range of procedures that require specialized anesthesia care.

This publication provides a comprehensive overview of CPT 00322, including payer coverage, clinical context, and related billing codes. Readers will gain insights into national benchmarks, policy updates, and the typical clinical scenarios where this code is applied. The summary also highlights common modifiers and associated taxonomies, offering clarity on how the code is used in practice. By understanding the scope and application of CPT 00322, healthcare professionals and billing specialists can stay informed about current trends and requirements in anesthesia billing for neck procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00322anesthesia servicesoutpatient hospitalneck proceduresthyroid biopsyclinical codingbilling policyanesthesiologypain medicineprocedure benchmarks

CPT Code Overview

CPT 00322 is used to report anesthesia services for procedures involving the esophagus, thyroid, larynx, trachea, and lymphatic system of the neck. This includes cases such as a needle biopsy of the thyroid. The typical site of service for these procedures is an outpatient hospital setting, designated as Place of Service 22. These anesthesia services are essential for ensuring patient comfort and safety during complex interventions in the neck region.

Clinical & Coding Specifications

Clinical Context

A patient presents to an outpatient hospital setting with symptoms such as neck pain, cervicalgia, or chronic pain. The patient is scheduled for a procedure involving the esophagus, thyroid, larynx, trachea, or lymphatic system of the neck, such as a needle biopsy of the thyroid. An anesthesiologist provides anesthesia services to ensure patient comfort and safety during the procedure. The clinical workflow includes preoperative assessment, administration of anesthesia, monitoring throughout the procedure, and post-anesthesia care. The service is typically performed on patients who are otherwise healthy, as indicated by modifier P1.

Coding Specifications

Modifier Code	Description	When Used
`QS`	Monitored anesthesia care service	Used when anesthesia is provided as monitored anesthesia care rather than general anesthesia.
`P1`	A normal healthy patient	Used to indicate the patient has no systemic disease and is otherwise healthy.

Associated Provider Taxonomies:

National Reimbursement Benchmarks

National mean rates for CPT code 00322 show that Blue Cross Blue Shield and Cigna have the highest average reimbursement, with mean rates of $202.39 and $197.66, respectively. UnitedHealth Group is the lowest among the major commercial payers at $65.56. The BUCA average commercial mean rate is $109.03, which is substantially higher than typical Medicare rates, though Medicare data is not available in the input for this code.

Rate dispersion varies significantly across payers. UnitedHealth Group has the tightest range between the 25th and 75th percentiles ($25.51), indicating less variability in contracted rates. In contrast, Aetna shows the widest spread ($176.00), reflecting greater variability in reimbursement. Blue Cross Blue Shield and Cigna also exhibit wide ranges, with $130.25 and $172.79, respectively.

The table and chart below present the full breakdown of national benchmarks for CPT code 00322 across major payers.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska demonstrates a wide range of reimbursement rates for CPT code 00322 across commercial payers. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield, with a spread of $87.43 ($269.10 minus $181.67), indicating considerable variability in payments. In contrast, Aetna and UnitedHealth Group show minimal spread, with all percentiles clustered closely together, suggesting more consistent rates.

When compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are significantly higher, while Cigna and UnitedHealth Group are closer to or below national benchmarks. The table and chart below present the full breakdown of payer-specific rates in Alaska, highlighting these differences and the overall distribution of reimbursement values.

Key Insights for Alaska

Blue Cross Blue Shield offers the highest mean reimbursement rate for CPT 00322 in Alaska at $221.11, while UnitedHealth Group is the lowest at $75.12.
The rate spread for Blue Cross Blue Shield is substantial, with a 75th percentile of $269.10 and a 25th percentile of $181.67, indicating significant variability.
Compared to national averages, Alaska's mean rates for most payers (except Cigna and UnitedHealth Group) are notably higher, especially for Blue Cross Blue Shield and BUCA.

CPT 00300: Anesthesia for Head, Neck and Posterior Trunk Procedures

00350-ANESTHESIA-FOR-PROCEDURES-ON-MAJOR-VESSELS-OF-NECK-NOT

CPT 00350: Anesthesia for Major Vessels of the Neck

00326-ANESTHESIA-FOR-ALL-PROCEDURES-ON-THE-LARYNX-AND-TRACHEA-IN

CPT 00326: Anesthesia for Infant Larynx and Trachea Procedures

00320-ANESTHESIA-FOR-ALL-PROCEDURES-ON-ESOPHAGUS-THYROID-LARYNX

CPT 00320: Anesthesia for Procedures on Esophagus, Thyroid, Larynx, Trachea, Neck

00352-ANESTHESIA-FOR-PROCEDURES-ON-MAJOR-VESSELS-OF-NECK-SIMPLE

CPT 00352: Anesthesia for Simple Ligation of Major Neck Vessels

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.

Related CPT Codes

CPT Code	Description	Clinical Relationship
`00320`	Under anesthesia for procedures on the neck when the patient is one year or older	Used for neck procedures requiring anesthesia in patients aged one year or older; may be an alternative to `00322` depending on procedure specifics.
`00326`	Under anesthesia for procedures on the larynx and trachea in children younger than one year of age	Used for larynx and trachea procedures requiring anesthesia in infants under one year; serves as an age-specific alternative to `00322`.

These codes are selected based on patient age and specific anatomical site. They are not typically billed together but may be considered alternatives depending on the clinical scenario.

National Reimbursement Benchmarks

The table and chart below present the full breakdown of national benchmarks for CPT code 00322 across major payers.

National Mean Rates by Payer for CPT Code `00322`

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Mean Reimbursement Rates by Payer in Alaska for CPT 00322

Key Insights for Alaska

Blue Cross Blue Shield offers the highest mean reimbursement rate for CPT 00322 in Alaska at $221.11, while UnitedHealth Group is the lowest at $75.12.
The rate spread for Blue Cross Blue Shield is substantial, with a 75th percentile of $269.10 and a 25th percentile of $181.67, indicating significant variability.
Compared to national averages, Alaska's mean rates for most payers (except Cigna and UnitedHealth Group) are notably higher, especially for Blue Cross Blue Shield and BUCA.

CPT 00300: Anesthesia for Head, Neck and Posterior Trunk Procedures

00350-ANESTHESIA-FOR-PROCEDURES-ON-MAJOR-VESSELS-OF-NECK-NOT

CPT 00350: Anesthesia for Major Vessels of the Neck

00326-ANESTHESIA-FOR-ALL-PROCEDURES-ON-THE-LARYNX-AND-TRACHEA-IN

CPT 00326: Anesthesia for Infant Larynx and Trachea Procedures

00320-ANESTHESIA-FOR-ALL-PROCEDURES-ON-ESOPHAGUS-THYROID-LARYNX

CPT 00320: Anesthesia for Procedures on Esophagus, Thyroid, Larynx, Trachea, Neck

00352-ANESTHESIA-FOR-PROCEDURES-ON-MAJOR-VESSELS-OF-NECK-SIMPLE

CPT 00352: Anesthesia for Simple Ligation of Major Neck Vessels

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Summary & Overview

CPT 00322: Anesthesia for Neck Procedures Including Thyroid Biopsy

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes