CPT 00174: Anesthesia for Intraoral Retropharyngeal Tumor Excision
Commercial payers pay $84 on average nationally for this procedure.
CPT code 00174 describes anesthesia services for an intraoral surgical procedure involving biopsy and excision of a retropharyngeal tumor, classified as anesthesia care for head and neck surgery; the service type is anesthesia for intraoral/retropharyngeal tumor excision and the typical site of service is an operating room or ambulatory surgical center for a head and neck surgical procedure.
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 00174 center on BUCA’s average commercial benchmark of $83.90, with payer medians and means showing notable variation. Blue Cross Blue Shield’s median of $65.90 and mean of $76.40 sit below BUCA, while Cigna’s median and mean are both high at $154.70 and $148.20 respectively. Aetna and UnitedHealth Group present lower medians ($48.00 and $64.00) and means ($58.40 and $67.30), indicating a spread of pricing that ranges from more conservative to substantially higher commercial rates.
Examining dispersion (P75 minus P25) highlights differences in rate consistency: Blue Cross Blue Shield’s interquartile spread is $44.90 (P75 $97.09 minus P25 $54.20), BUCA’s spread is $33.00 (P75 $100.10 minus P25 $68.10), Aetna’s spread is $31.50 (P75 $73.50 minus P25 $42.00), UnitedHealth Group’s spread is $28.80 (P75 $80.80 minus P25 $52.00), and Cigna shows the tightest spread at $2.50 (P75 $154.70 minus P25 $152.20). Thus Blue Cross Blue Shield exhibits the widest dispersion and Cigna the tightest.