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    OpenPayerBilling CodesAnesthesia for Procedures on the HeadCPT cpt-00100-anesthesia-for-salivary-gland-procedures
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    CPT 00100: Anesthesia for Salivary Gland Procedures

    Commercial payers pay $88 on average nationally for this procedure.

    CPT code 00100 describes anesthesia services provided for procedures on the salivary glands, including biopsy; the service is anesthesia care typically delivered in an ambulatory surgical center or hospital operating room for diagnostic or therapeutic salivary gland procedures.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    National Reimbursement Benchmarks

    Commercial national rates for CPT 00100 cluster around BUCA’s average commercial rate of $88.10, which serves as a mid-market reference point. Blue Cross Blue Shield shows a relatively tight interquartile spread (P75–P25 = $94.20 − $51.80 = $42.40), and UnitedHealth Group is similarly compressed (P75–P25 = $80.90 − $52.00 = $28.90), indicating less dispersion around their medians. Cigna and BUCA exhibit wider spreads (Cigna: $125.00 − $68.40 = $56.60; BUCA: $114.70 − $54.30 = $60.40), while Aetna has the largest absolute spread (Aetna: $199.60 − $50.00 = $149.60), reflecting significant variability in upper-tier contractual rates.

    Payer-specific central tendencies vary: Aetna’s mean of $148.50 and maximum of $504.60 contrast with UnitedHealth Group’s mean of $67.40 and max of $122.70, framing a broad market ceiling. Cigna (mean $96.50) and BCBS (mean $72.20) sit between those extremes, with BUCA’s mean ($88.10) near the center of the commercial distribution. These characteristics highlight where rate concentration and outliers are most pronounced across commercial payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old male presents with recurrent left submandibular swelling, pain with meals, and a palpable firm mass. Imaging (ultrasound and CT) demonstrates a 1.2 cm sialolith obstructing Wharton duct with associated gland inflammation. Otolaryngology schedules an operative procedure for removal of the stone and possible limited gland exploration with biopsy if chronic changes are seen. The patient has controlled hypertension and type 2 diabetes (ASA II–III) and receives preoperative evaluation by the anesthesia team.

    An anesthesiologist or CRNA performs general anesthesia with endotracheal intubation for an intraoral and possible transcervical approach to the submandibular gland/duct. The workflow includes pre-op evaluation, airway assessment, induction, maintenance of anesthesia, intraoperative monitoring, management of surgical bleeding and hemodynamics, emergence, and immediate post-anesthesia recovery. If the procedure is limited to biopsy or minimally invasive stone extraction, monitored anesthesia care or local with sedation may be appropriate; for excision or complex exploration, general anesthesia is typical. Documentation includes ASA physical status, airway plan, anesthesia start/stop times, anesthetic agents, airway device, intraoperative events, and any modifiers applicable to the service.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    42410Excision of parotid tumorMajor salivary gland surgery that may require more extensive anesthesia planning and longer anesthesia time compared with biopsy or limited duct procedures

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    207RA0401XAddiction Medicine (Internal Medicine) PhysicianAn internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified b…
    284300000XSpecial HospitalA designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have…
    163WW0000XWound Care Registered NurseNursing Service Providers · Registered Nurse
    1835P1300XPsychiatric PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and mo…
    207WX0109XNeuro-ophthalmology PhysicianA neuro-ophthalmologist is a subspecialist of ophthalmology. This physician evaluates, treats, and studies disorders of the eye, orbit and nervous sy…
    364SE0003XEmergency Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

    Related ICD-10-CM Codes

    21 rows

    ICD-10-CM CodeDescription
    B95.2Enterococcus as the cause of diseases classified elsewhere
    C08.0Malignant neoplasm of submandibular gland
    C08.1Malignant neoplasm of sublingual gland
    C08.9Malignant neoplasm of major salivary gland, unspecified
    F41.9Anxiety disorder, unspecified
    J35.1Hypertrophy of tonsils
    K11.0Atrophy of salivary gland
    K11.3Abscess of salivary gland
    K11.4Fistula of salivary gland
    K11.5Sialolithiasis

    Showing 1–10 of 21

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 2

    7 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-00102-ANESTHESIA-CLEFT-LIP-REPAIR

    CPT 00102: Anesthesia for Plastic Repair of Cleft Lip

    CPT-00103-ANESTHESIA-RECONSTRUCTIVE-EYELID-SURGERY

    CPT 00103: Anesthesia for Reconstructive Eyelid Procedures

    CPT-00104-ANESTHESIA-FOR-ELECTROCONVULSIVE-THERAPY

    CPT 00104: Anesthesia for Electroconvulsive Therapy

    CPT-00120-ANESTHESIA-FOR-EAR-PROCEDURES

    CPT 00120: Anesthesia for External, Middle, and Inner Ear Procedures

    CPT-00124-ANESTHESIA-EXTERNAL-MIDDLE-INNER-EAR-BIOPSY-OTOSCOPY

    CPT 00124: Anesthesia for External, Middle, and Inner Ear Procedures

    CPT-00126-ANESTHESIA-FOR-OTOLOGIC-PROCEDURES-TYMPANOTOMY-BIOPSY

    CPT 00126: Anesthesia for External, Middle, and Inner Ear Procedures

    CPT-00140-ANESTHESIA-FOR-EYE-PROCEDURE-OPHTHALMIC-SURGERY

    CPT 00140: Anesthesia for Eye Procedure

    CPT-00142-ANESTHESIA-FOR-EYE-LENS-PROCEDURE

    CPT 00142: Anesthesia for Eye Lens Procedure

    CPT-00144-ANESTHESIA-CORNEAL-TRANSPLANT

    CPT 00144: Anesthesia for Corneal Transplant

    CPT-00145-ANESTHESIA-VITREORETINAL-SURGERY

    CPT 00145: Anesthesia for Vitreoretinal Surgery

    Showing 1–10 of 30

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    42415Excision of submandibular glandDefinitive surgical removal of the submandibular gland; often performed when stones or chronic disease are not amenable to limited extraction and requires general anesthesia
    42420Excision of sublingual glandSurgical removal of sublingual gland for tumors or chronic disease; similar anesthetic implications when compared to submandibular or parotid surgeries