CPT 00170: Anesthesia for Intraoral Procedure, Including Biopsy
Commercial payers pay $87 on average nationally for this procedure.
CPT code 00170 describes anesthesia services provided for a patient undergoing an intraoral procedure, such as a biopsy; this represents anesthesia care (general or monitored anesthesia care as clinically appropriate) delivered in an oral surgery or dental operative setting, typically an operating room, ambulatory surgery center, or procedure suite where intraoral surgical interventions are performed.
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National Reimbursement Benchmarks
National commercial reimbursement for CPT 00170 centers on BUCA’s average commercial benchmark of $86.80, with variation among large payers. Aetna’s mean of $140.30 sits well above BUCA, while Cigna’s mean of $96.50 and UnitedHealth Group’s mean of $67.60 bracket BUCA on either side; Blue Cross Blue Shield’s mean of $72.20 is just below BUCA. This frames BUCA as a mid-market reference point, with Aetna notably higher and UnitedHealth Group and Blue Cross Blue Shield toward the lower end of the commercial spectrum.
Dispersion measured by the interquartile difference (P75 minus P25) highlights where rates are most and least concentrated. Aetna’s IQR is $100.50 ($181.80 - $83.30), the widest among the set, followed by Cigna at $58.60 ($125.00 - $68.40). Blue Cross Blue Shield and UnitedHealth Group show tighter spreads of $41.20 ($93.40 - $52.00) and $29.10 ($81.10 - $52.00) respectively, indicating more consistent contracted ranges across those payers.