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-00120-anesthesia-for-ear-procedures
    Ask Trek AI about this page

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

    Commercial payers pay $94 on average nationally for this procedure.

    CPT code 00120 describes anesthesia services provided for procedures involving the external, middle, and inner ear — including biopsies — indicating perioperative anesthesia management for otologic surgery; service type: anesthesia for otologic procedures; typical site of service: operating room or ambulatory surgical center for ear 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.

    Customize your policy alerts

    Sign up for cpt 00120 policy alerts

    Get alerted when payer policies referencing 00120 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 pricing for CPT 00120 centers around BUCA’s average commercial benchmark of $93.50, with observable variation among major payers. Blue Cross Blue Shield shows a relatively tight middle spread (P75–P25 = $37.20), while UnitedHealth Group also presents a narrow interquartile range of $30.90, indicating more consistent contracted rates. Cigna’s IQR is wider at $58.00, and Aetna demonstrates the largest dispersion with an IQR of $164.00, highlighting substantial variability in upper-quartile commercial pricing for this code.

    Mean rates vary meaningfully: Aetna’s mean is $182.50, Cigna’s is $96.50, BUCA’s average is $93.50, UnitedHealth Group’s mean is $67.60, and Blue Cross Blue Shield’s mean is $71.60. The combination of a high mean and the widest IQR for Aetna suggests both higher central tendency and greater spread, while Blue Cross Blue Shield and UnitedHealth Group reflect more clustered commercial reimbursement levels around their medians.

    Table of contents

    Progress1 / 8

    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 45-year-old patient with chronic mucoid otitis media (H65.3) and progressive bilateral sensorineural hearing loss (H90.3) is scheduled for surgical exploration of the middle ear and possible tympanoplasty under general anesthesia. The perioperative workflow includes preoperative evaluation by the anesthesiology team, intraoperative anesthesia management (airway, hemodynamic monitoring, positioning for otologic access, and ototoxic medication avoidance), and postoperative recovery in the post-anesthesia care unit with monitoring for vertigo, bleeding, or vestibular dysfunction. Procedures addressed under 00120 include operative interventions on the external, middle, or inner ear such as formal biopsy, debridement of chronic infection, or limited middle ear surgery. Typical perioperative diagnoses encountered include acute otitis externa (H60.3), other peripheral vertigo (H81.3), and noise-related inner ear injury (H83.3). The typical site of service is an ambulatory surgical center or hospital operating room. Typical clinical staff includes an anesthesiologist or anesthesiology assistant (taxonomies listed below), otolaryngology surgeon, surgical nursing team, and postoperative PACU staff. Common payors for claims processing include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    CPT CodeDescription

    Related Modifiers

    6 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…
    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…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    207LC0200XCritical Care Medicine (Anesthesiology) PhysicianAn anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
    282NW0100XWomen's HospitalHospitals · General Acute Care Hospital
    111NN1001XNutrition ChiropractorChiropractic Nutrition is that specialty within the chiropractic profession that deals with the overall factors that affect the patient's ability to m…
    1835P2201XAmbulatory Care PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmaci…
    332000000XMilitary/U.S. Coast Guard PharmacyA Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated…
    363LF0000XFamily Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

    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-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-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
    00124Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomyPerformed for tympanotomy procedures on the middle ear that may be alternative or concurrent procedures covered under the ear anesthesia series.
    00126Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanoplastyUsed when tympanoplasty is performed; closely related otologic reconstructive procedure requiring similar anesthesia services.
    00140Anesthesia for procedures on eye; not otherwise specifiedMay be used in cases where combined ocular and otologic procedures occur or for coding adjacent regional anesthesia specialties.
    00160Anesthesia for procedures on nose and accessory sinuses; not otherwise specifiedRelevant when concurrent nasal or sinus procedures are performed in the same anesthetic episode with ear surgery.