CPT 00172: Anesthesia for Intraoral Procedure, Cleft Palate Repair/Biopsy
Commercial payers pay $77 on average nationally for this procedure.
CPT code 00172 describes anesthesia services provided for intraoral surgical procedures such as biopsies and repair of a cleft palate, indicating provision of perioperative anesthesia care for procedures in the oral cavity; service type: anesthesia for intraoral surgery; typical site of service: operating room or ambulatory surgical center where intraoral surgical procedures are performed.
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
National commercial rates for CPT 00172 cluster around BUCA’s average commercial rate of $76.80, with important variation by insurer. Blue Cross Blue Shield (BCBS) shows a moderate center with a median of $62.50, while Cigna and Aetna sit higher in central tendency with medians of $81.00 and $57.00 respectively; UnitedHealth Group’s median is $64.00. Cigna’s mean of $87.70 and Aetna’s mean of $94.90 pull their averages upward, whereas BCBS and UnitedHealth Group have lower means, reflecting insurer-level pricing differences around the BUCA average.
Dispersion measured as P75 minus P25 highlights where rates are tightest and widest: BCBS has the tightest interquartile spread at $40.60 ($91.80 - $51.20), while Aetna is the widest at $69.00 ($113.30 - $44.30). UnitedHealth Group’s spread is $29.00 ($81.00 - $52.00), Cigna’s is $37.80 ($103.30 - $65.50), and BUCA’s interquartile spread is $41.10 ($95.50 - $52.40). These ranges indicate Aetna and BUCA encompass broader mid‑to‑upper commercial rate variability compared with BCBS and UnitedHealth Group.