CPT 00102: Anesthesia for Plastic Repair of Cleft Lip
CPT code 00102 designates anesthesia services for plastic repair of a cleft lip, a common pediatric and reconstructive procedure requiring perioperative anesthesia management. This code identifies the anesthesia component separate from the surgical procedure and is used in billing to capture professional anesthesia time and complexity for cleft lip repairs. Nationally, accurate use of this code ensures appropriate attribution of anesthesia services for resource tracking and payment.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of coverage considerations across major payers, commonly associated modifiers, and clinical context relevant to anesthesia for cleft lip repair. The publication summarizes where this code fits within anesthesia billing, highlights related CPT anesthesia codes, and provides guidance on documentation elements typically associated with services of this nature.
The content is intended to inform billing staff, anesthesiology providers, coding professionals, and policy analysts about the clinical and billing context of CPT code 00102, its role in surgical care episodes for cleft lip repair, and the expectations for payer interactions and coding accuracy at a national level.
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Billing Code Overview
CPT code 00102 describes anesthesia services provided for a patient undergoing plastic repair of a cleft lip. The service is an anesthesia procedure delivered in support of a surgical repair of congenital cleft lip deformity.
Service type: Anesthesia for reconstructive/repair surgery
Typical site of service: Operating room or ambulatory surgical center, where surgical correction of a cleft lip is performed.
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.