Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the HeadCPT cpt-00102-anesthesia-cleft-lip-repair
    Ask Trek AI about this page

    CPT 00102: Anesthesia for Plastic Repair of Cleft Lip

    Commercial payers pay $74 on average nationally for this procedure.

    CPT code 00102 describes anesthesia services provided for a patient undergoing a plastic repair of a cleft lip, representing perioperative general anesthesia care for a surgical reconstructive procedure; service type: anesthesia for plastic/reconstructive surgery; typical site of service: inpatient or outpatient surgical suite in a hospital or ambulatory surgery center.

    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.

    Customize your policy alerts

    Sign up for cpt 00102 policy alerts

    Get alerted when payer policies referencing 00102 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    National Reimbursement Benchmarks

    National commercial rates for CPT 00102 cluster around BUCA’s average commercial rate of $74.00, which serves as an anchor for comparison. Cigna and Aetna show higher central tendencies with Cigna’s mean at $95.30 and Aetna’s mean at $68.00; Blue Cross Blue Shield (BCBS) and UnitedHealth Group sit near BUCA with means of $71.10 and $67.30 respectively. Cigna posts the highest single observed maximum at $154.70 while UnitedHealth Group and BCBS report lower maxima of $122.70 and $201.30 respectively.

    Dispersion measured by the interquartile range (P75–P25) highlights variability across payers: Cigna’s IQR is $56.40 (P75 $123.20 minus P25 $68.00), BCBS’s IQR is $40.50, BUCA’s IQR is $37.30, Aetna’s IQR is $44.30, and UnitedHealth Group’s IQR is $27.80. UnitedHealth Group exhibits the tightest middle 50% spread, while Cigna displays the widest IQR, indicating the greatest mid-range variability among these commercial payers.

    Table of contents

    Progress1 / 9

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools
    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 6-month-old infant with a unilateral congenital cleft lip is scheduled for primary cleft lip repair in the ambulatory pediatric surgical suite. The child presents preoperatively to the anesthesia clinic for evaluation, including history of feeding difficulties and intermittent upper respiratory symptoms. The anesthesia team (pediatric anesthesiologist or Certified Registered Nurse Anesthetist under supervision) performs a pre-anesthetic assessment, documents American Society of Anesthesiologists (ASA) physical status P2, and obtains informed consent for general anesthesia with endotracheal intubation.

    On the day of surgery, standard monitors are applied. An induction with inhaled sevoflurane or intravenous agents is performed, followed by tracheal intubation with a cuffed or uncuffed endotracheal tube appropriate for age, with attention to airway anomalies. The provider administers anesthetic maintenance, analgesia (intravenous opioids and local infiltration by the surgeon), and intraoperative antiemetic prophylaxis as indicated. The anesthesia record documents induction time, airway management, vital signs, estimated blood loss, and emergence. Postoperative care includes transfer to post-anesthesia care unit (PACU) with monitoring for airway patency, bleeding, and pain control. Discharge occurs when PACU recovery criteria are met or transfer to an inpatient pediatric unit if complications arise.

    Billing for the anesthetic service is reported with 00102 to reflect anesthesia for plastic repair of cleft lip; appropriate modifiers are appended based on circumstances such as provider type, unusual procedural difficulty, or concurrent care.

    Related CPT Codes

    CPT CodeDescription

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    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…
    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…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

    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…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    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…
    163WR1000XReproductive Endocrinology/Infertility Registered NurseNursing Service Providers · Registered Nurse
    207QG0300XGeriatric Medicine (Family Medicine) PhysicianA family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitati…
    251300000XLocal Education Agency (LEA)The term local education agency means a public board of education or other public authority legally constituted within a State to either provide admin…
    224ZF0002XFeeding, Eating & Swallowing Occupational Therapy AssistantOccupational therapy assistants provide environmental modifications under the supervision of an occupational therapist. OTAs develop and implement an…

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    F81.9Developmental disorder of scholastic skills, unspecified
    K11.5Sialolithiasis
    K11.8Other diseases of salivary glands
    K11.9Disease of salivary gland, unspecified
    P04.3Newborn affected by maternal use of alcohol
    P92.5Neonatal difficulty in feeding at breast
    Q36.0Cleft lip, bilateral
    Q36.1Cleft lip, median
    Q36.9Cleft lip, unilateral
    Q37.0Cleft hard palate with bilateral cleft lip

    Showing 1–10 of 25

    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-00100-ANESTHESIA-FOR-SALIVARY-GLAND-PROCEDURES

    CPT 00100: Anesthesia for Salivary Gland Procedures

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    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.

    Relationship to This Procedure
    00100ANESTHESIA PX ON SALIVARY GLANDS WITH BIOPSYRelated anatomically and by anesthesia service group; used when procedures on the salivary glands with biopsy are performed requiring anesthesia services similar in complexity.
    00103ANESTHESIA RECONSTRUCTIVE PROCEDURES OF EYELIDRelated as another facial reconstructive anesthesia code; useful for cross-referencing anesthesia valuation for adjacent facial procedures.
    00104ANESTHESIA ELECTROCONVULSIVE THERAPYListed as a related anesthesia code in the series; distinct clinical procedures but within the anesthesia coding family.