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    OpenPayerBilling CodesAnesthesia for Procedures on the HeadCPT cpt-00220-anesthesia-intracranial-csf-shunting
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    CPT 00220: Anesthesia for Intracranial CSF Shunting

    Commercial payers pay $77 on average nationally for this procedure.

    CPT code 00220 describes anesthesia services provided for intracranial procedures to create, revise, or manage cerebrospinal fluid (CSF) shunting; the service is an anesthesia care encounter typically performed in an operating room or neurosurgical procedural suite for patients undergoing intracranial CSF shunt placement or related neurosurgical interventions.

    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 00220 cluster around the BUCA average of $77.30, with payer-specific medians that are both above and below that benchmark. Blue Cross Blue Shield’s interquartile spread ($83.50 - $46.30 = $37.20) and Cigna’s spread ($120.00 - $67.80 = $52.20) indicate moderate to wide dispersion, while UnitedHealth Group’s interquartile spread ($80.80 - $52.00 = $28.80) and Aetna’s spread ($155.70 - $48.00 = $107.70) show contrasting variability — Aetna exhibiting the widest IQR and UnitedHealth Group the tightest among those with full quartile data.

    Looking across payer means and medians, Aetna posts the highest maximum at $335.70 while Cigna and Aetna have higher central tendencies ($93.10 and $111.50 mean, respectively) than BUCA’s average. Blue Cross Blue Shield and UnitedHealth Group cluster closer to BUCA on median values ($58.20 and $64.00), reflecting more compact commercial pricing around the BUCA benchmark.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 56-year-old male presents with progressive headaches, intermittent nausea, and gait instability. Neuroimaging demonstrates ventricular enlargement secondary to obstructive hydrocephalus from a presumed posterior fossa lesion. The neurosurgery team schedules intracranial cerebrospinal fluid (CSF) shunt placement to divert CSF and relieve intracranial pressure. The patient has a history of hypertension and prior transient ischemic attacks, increasing anesthetic risk (ASA PS P3). Preoperative workflow includes neurosurgical and anesthesia evaluation, airway assessment, review of intracranial pathology, and authorization for general endotracheal anesthesia with invasive arterial monitoring. In the operating room, the anesthesia team induces general anesthesia, secures the airway, places an arterial line for real-time blood pressure monitoring, manages intracranial pressure with anesthetic technique and osmotherapy as needed, coordinates with neurosurgery during ventricular catheter insertion and shunt tunneling, and provides postoperative emergence and handoff to the neurosurgical intensive care unit for neurological monitoring and pain control. Postoperative documentation includes total anesthesia time, intraoperative events (hemodynamic instability, blood loss), airway management, monitoring modalities, and any applicable modifiers for unusual circumstances (e.g., unexpected complexity or multiple anesthesia providers).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    00100Anesthesia for procedures on salivary glands, including biopsy

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    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…
    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…
    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…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

    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…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    2084N0400XNeurology PhysicianA Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, auton…
    2471V0105XVascular Sonography Radiologic TechnologistA radiologic technologist who specializes in vascular sonography and is trained in the use of ultrasound equipment to image veins and arteries, which …
    246ZE0500XEEG Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Other
    364SP0808XPsychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    364SP0813XGeropsychiatric Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 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
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    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-00120-ANESTHESIA-FOR-EAR-PROCEDURES

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

    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

    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.
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    Distantly related cranial/airway anesthesia codes; not typically used for intracranial shunting but listed as related in coding references.
    00210Anesthesia for intracranial procedures; craniotomy or craniectomyRelated intracranial anesthesia code for open cranial procedures; represents broader intracranial anesthetic services compared to CSF shunting.
    00215Anesthesia for craniotomy for evacuation of hematomaRelated when intracranial hemorrhage with hematoma evacuation is the surgical indication instead of shunt placement.
    00218Anesthesia for craniotomy for excision of brain tumorRelated when tumor resection is performed rather than CSF shunting; similar intracranial anesthetic considerations.
    00222Anesthesia for craniotomy for treatment of cranial nerve disordersRelated for intracranial procedures addressing cranial nerve pathology; shares intraoperative monitoring and anesthetic complexity.