CPT 00400 Reimbursement Benchmarks & Policy | OpenPayer

Summary & Overview

CPT 00400: Anesthesia for Skin and Soft Tissue Procedures on Extremities and Trunk

CPT code 00400 covers anesthesia for procedures on the integumentary system of the extremities, anterior trunk, and perineum that are not otherwise specified. This code is significant for hospitals and surgical centers nationwide, as it applies to a broad spectrum of skin and soft tissue surgeries requiring anesthesia. The publication examines coverage and billing practices for this code across major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.

Readers will gain insight into the clinical context of CPT code 00400, including its typical use in operating room settings and its relevance to anesthesiology professionals. The summary highlights key policy updates, common modifiers, and associated provider taxonomies. Additionally, the publication provides benchmarks and comparisons with related CPT codes, offering a comprehensive overview of how this anesthesia service is coded and reimbursed. This information is essential for understanding payer requirements, clinical documentation, and billing nuances for anesthesia services in skin and soft tissue procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00400anesthesiologyanesthesia billingintegumentary systemoperating roomprocedure codingclinical documentationpolicy updatesbenchmarkingmodifier codes

CPT Code Overview

CPT code 00400 is used to report anesthesia services for procedures performed on the integumentary system of the extremities, anterior trunk, and perineum when not otherwise specified. This code falls under the anesthesiology service type and is typically utilized in the operating room setting (Place of Service 21). It is relevant for a wide range of surgical interventions involving the skin and underlying tissues in these anatomical regions.

Clinical & Coding Specifications

Clinical Context

A patient presents with a severe cutaneous abscess on the right ankle requiring surgical intervention. The procedure is performed in the operating room (Place of Service 21) under general anesthesia. An anesthesiology physician or a certified registered nurse anesthetist (CRNA) provides anesthesia care for the surgical excision and drainage of the abscess. The clinical workflow involves preoperative assessment, induction of anesthesia, intraoperative monitoring, and postoperative recovery. The anesthesia service is coded with 00400 for procedures on the integumentary system of the extremities, anterior trunk, or perineum that are not otherwise specified.

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when anesthesia is provided as monitored anesthesia care rather than general anesthesia.
- QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia under the medical direction of an anesthesiology physician.
Provider Taxonomies:

Taxonomy Code Specialty Name

National Reimbursement Benchmarks

National mean rates for CPT code 00400 show that Aetna has the highest average reimbursement at $260.89, followed by Blue Cross Blue Shield at $200.65 and Cigna at $198.40. UnitedHealth Group's mean rate is significantly lower at $65.62, while the BUCA average commercial rate stands at $150.42. Medicare rates are not available in the input.

Comparing BUCA (average commercial) to the available commercial payers, BUCA's mean rate is lower than Aetna, BCBS, and Cigna, but higher than UnitedHealth Group. Rate dispersion, measured by the difference between the 75th and 25th percentiles, is widest for Aetna ($320.00) and tightest for UnitedHealth Group ($25.42), indicating greater variability in Aetna's rates and more consistency in UnitedHealth Group's rates.

The table and chart below present the full breakdown of national benchmarks for each payer.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska's reimbursement rates for CPT code 00400 show a wide spread across payers, with Blue Cross Blue Shield offering the highest mean rate at $220.55 and UnitedHealth Group the lowest at $75.12. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($87.92) and BUCA ($87.33), indicating significant variability in payment levels. In contrast, Aetna and UnitedHealth Group display much narrower spreads ($30.00 and $4.00, respectively), suggesting more consistent rates among providers.

Compared to national averages, Alaska's mean rates for most payers are higher, except for Cigna and UnitedHealth Group, which fall below their respective national benchmarks. The table and chart below present the full breakdown of payer-specific rates in Alaska, highlighting the differences in reimbursement levels across the major commercial payers.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 00400, with a mean rate of $220.55.
UnitedHealth Group offers the lowest mean rate at $75.12, significantly below both the state and national averages.
Cigna's mean rate in Alaska ($89.33) is notably lower than its national average ($198.40), indicating a substantial deviation.

Related Codes

00406-ANESTH-SURGERY-OF

CPT 00406: Anesthesia for Breast Surgery

00472-ANESTHESIA-FOR-PARTIAL-RIB

CPT 00472: Anesthesia for Partial Rib Resection

00402-ANESTHESIA-FOR-PROCEDURES-ON-THE-ESOPHAGUS-THYROID-LARYNX

CPT 00402: Anesthesia for Neck, Esophagus, and Airway Procedures

00454-ANESTHESIA-FOR-PROCEDURES-ON-CLAVICLE-AND

CPT 00454: Anesthesia for Clavicle and Scapula Procedures

00450-ANESTHESIA-FOR-PROCEDURES-ON-CLAVICLE-AND

CPT 00450: Anesthesia for Clavicle and Scapula Procedures

00404-ANESTHESIA-FOR-PROCEDURES-ON-THE-INTEGUMENTARY-SYSTEM-ON

CPT 00404: Anesthesia for Radical Breast and Integumentary Procedures

00474-ANESTHESIA-FOR-PROCEDURES-ON-THE-THORAX-CHEST-WALL-AND

CPT 00474: Anesthesia for Thoracic Procedures, Chest Wall and Shoulder Girdle

00410-ANESTHESIA-FOR-PROCEDURE-TO-CORRECT-ABNORMAL-HEART

CPT 00410: Anesthesia for Procedure to Correct Abnormal Heart Rhythm

00470-ANESTHESIA-FOR-PARTIAL-RIB

CPT 00470: Anesthesia for Partial Rib Resection

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.