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CPT 00190: Anesthesia for Procedures on Facial Bones or Skull
CPT code 00190 designates anesthesia services for surgical procedures on the facial bones or skull. This code captures intraoperative anesthetic management when care is focused on procedures involving the facial skeleton or cranial structures. It is important nationally because anesthesia coding for head and facial procedures affects provider billing, surgical care coordination, and payment classification for a range of otolaryngologic, craniofacial, and neurosurgical services. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will learn the clinical context for use of CPT code 00190, how it relates to common surgical settings and anesthesia service lines, and where it sits in relation to closely related anesthesia codes for head and intraoral procedures. The publication outlines typical sites of service, relevant clinical scenarios, and the scope of procedures that commonly generate this anesthesia code. It also identifies related anesthesia procedure codes for head and facial operations to help clarify coding selection. Data not available in the input for payer-specific reimbursement rates and utilization benchmarks.
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Billing Code Overview
CPT code 00190 describes anesthesia services provided for procedures on the facial bones or skull. The service consists of administering and managing anesthesia for patients undergoing surgical interventions involving the facial skeleton or cranial vault.
Service Type: Anesthesia for facial bones or skull procedures
Typical Site of Service: Operating room or surgical suite for head and facial surgery
National Reimbursement Benchmarks
Commercial reimbursement for CPT 00190 centers around BUCA’s average commercial rate of $90.4, with individual payers showing distinct positions. Blue Cross Blue Shield has a relatively low spread between its 25th and 75th percentiles ($91.0 - $51.5 = $39.5), indicating moderate concentration; UnitedHealth Group is slightly tighter with a spread of $81.1 - $52.0 = $29.1. Cigna presents a wider middle spread of $125.0 - $68.4 = $56.6, while Aetna shows the largest dispersion at $221.2 - $69.8 = $151.4, reflecting substantial variability at the upper middle distribution.
Median and mean differences highlight payer positioning versus the BUCA average: Blue Cross Blue Shield and UnitedHealth Group medians (both near $64) sit below BUCA’s $90.4 mean, while Cigna’s median of $86 and Aetna’s median of $135.2 lie at and above it, respectively. Payer-specific maximums further separate Aetna and Cigna at the high end, whereas Blue Cross Blue Shield and UnitedHealth Group remain concentrated at lower maximums.