Summary & Overview

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

CPT code 00402 covers anesthesia services for procedures on the esophagus, thyroid, larynx, trachea, and lymphatic system of the neck that are not otherwise specified. This code is significant for its role in supporting safe surgical interventions in these critical anatomical areas, often requiring specialized anesthesiology expertise. Nationally, the code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for patients undergoing these procedures.

Readers will gain insight into the clinical context of CPT 00402, including its application in inpatient hospital settings and its relevance to both anesthesiology physicians and certified registered nurse anesthetists. The publication provides benchmarks, policy updates, and an overview of related billing practices, helping stakeholders understand how this code fits into broader anesthesia service lines. Additionally, the summary highlights associated modifiers and taxonomies, as well as common ICD-10 diagnoses linked to procedures requiring this anesthesia code. This comprehensive overview supports informed decision-making for healthcare administrators, billing professionals, and clinical teams.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00402anesthesiologyinpatient hospitalneck proceduresesophagusthyroidlarynxtrachealymphatic systemmedical billing

CPT Code Overview

CPT 00402 is designated for anesthesia services provided during procedures involving the esophagus, thyroid, larynx, trachea, and lymphatic system of the neck when not otherwise specified. This code is primarily utilized by professionals in the field of anesthesiology. The typical site of service for procedures billed under CPT 00402 is the inpatient hospital setting, specifically at Place of Service 21. This code ensures appropriate documentation and billing for complex anesthesia care required during surgeries or interventions in these anatomical regions.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves an adult patient admitted to an inpatient hospital for a surgical procedure on the neck region, such as the esophagus, thyroid, larynx, trachea, or lymphatic system. The patient may present with conditions like malignant neoplasm of the glottis, vocal cord paralysis, tracheostomy complications, congenital laryngomalacia, or abnormal sputum. An anesthesiology provider administers anesthesia to facilitate the surgical intervention, ensuring patient safety and comfort throughout the procedure. The workflow includes preoperative assessment, induction and maintenance of anesthesia, intraoperative monitoring, and postoperative care in the hospital setting.

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when the anesthesia provider is present and monitoring the patient, but not providing general anesthesia.
- QX: CRNA service with medical direction by a physician. Used when a Certified Registered Nurse Anesthetist (CRNA) is providing anesthesia under the supervision of a physician.
Provider Taxonomies:

Taxonomy Code	Specialty Name

National Reimbursement Benchmarks

Nationally, the mean rate for CPT code 00402 among commercial payers (BUCA) is $217.19, which is substantially higher than the UnitedHealth Group (UHC) mean rate of $65.71. Blue Cross Blue Shield and Cigna both report mean rates near $300, while Aetna stands out with the highest mean rate at $416.16.

Rate dispersion varies significantly across payers. Aetna exhibits the widest spread, with a difference of $485.00 between its 75th and 25th percentiles, indicating substantial variability in contracted rates. In contrast, UnitedHealth Group shows the tightest range, with only $25.67 separating its 75th and 25th percentiles, suggesting more consistent reimbursement levels. The table and chart below present the full breakdown of national benchmarks for each payer.

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Alaska shows significant variation in reimbursement rates for CPT code 00402 across commercial payers. Blue Cross Blue Shield exhibits the widest rate spread, with a 75th percentile of $371.50 and a 25th percentile of $274.60, resulting in a spread of $96.90. In contrast, Aetna, Cigna, and UnitedHealth Group have much narrower spreads, each with a difference of only $4.00 between their 75th and 25th percentiles. This indicates that Blue Cross Blue Shield's rates are not only higher but also more variable compared to other payers in the state.

Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are above the national mean, while Aetna, Cigna, and UnitedHealth Group are below their respective national means. The table and chart below present the full breakdown of payer-specific reimbursement rates in Alaska for CPT code 00402.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 00402, with a mean rate of $330.16, while UnitedHealth Group is the lowest at $75.12.
Cigna and UnitedHealth Group both reimburse well below the national mean rates for CPT 00402.
The rate spread for Blue Cross Blue Shield in Alaska is notably higher than other payers, indicating greater variability in reimbursement.

Related Codes

00528

CPT 00528: Anesthesia for Closed Chest Procedures, Mediastinoscopy/Thoracoscopy

00532

CPT 00532: Anesthesia for Central Venous Circulation Access

00625

CPT 00625: Anesthesia for Thoracic Spine Procedures, Anterior Approach

00604

CPT 00604: Anesthesia for Cervical Spine Procedures in Sitting Position

00537

CPT 00537: Anesthesia for Cardiac Electrophysiologic Procedures

00472

CPT 00472: Anesthesia for Partial Rib Resection

00563

CPT 00563: Anesthesia for Heart Procedures with Pump

00632

CPT 00632: Anesthesia for Lumbar Region Procedures Including Sympathectomy

00634

CPT 00634: Anesthesia for Thoracic Spine and Cord Procedures

00470

CPT 00470: Anesthesia for Partial Rib Resection

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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.

National Reimbursement Benchmarks

National Mean Rates for CPT Code 00402 by Payer

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Mean Reimbursement Rates by Payer in Alaska for CPT 00402

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 00402, with a mean rate of $330.16, while UnitedHealth Group is the lowest at $75.12.
Cigna and UnitedHealth Group both reimburse well below the national mean rates for CPT 00402.
The rate spread for Blue Cross Blue Shield in Alaska is notably higher than other payers, indicating greater variability in reimbursement.