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CPT 00402: Anesthesia for Integumentary Procedures on Extremities, Trunk, Perineum
CPT code 00402 denotes anesthesia services rendered for surgical procedures on the integumentary system of the extremities, anterior trunk, and perineum, and includes reconstructive procedures on the breast. This is a nationally relevant anesthesia code because it applies to a wide range of common and reconstructive skin and soft-tissue surgeries that require perioperative anesthetic management. Accurate coding affects clinical documentation, facility scheduling, and payment adjudication across payers.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Coverage policies and payment methodologies for anesthesia services using CPT code 00402 vary by payer and clinical setting; the code is relevant to hospital and ambulatory surgical facility workflows as well as professional anesthesia billing.
Readers will find a concise overview of the clinical context for CPT code 00402, the typical sites of service, and how the code maps to anesthesia practice for integumentary and reconstructive procedures. The publication summarizes common billing considerations, associated clinical scenarios, and related procedural codes to help finance, coding, and clinical teams align documentation with national payer expectations and reimbursement frameworks. Data not available in the input for payer-specific rates or utilization benchmarks.
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Billing Code Overview
CPT code 00402 represents anesthesia services provided for procedures on the integumentary system of the extremities, anterior trunk, and perineum, and includes reconstructive procedures on the breast. The service covers anesthesia care for surgical interventions involving skin, subcutaneous tissue, and related soft-tissue structures in these anatomic regions.
Service type: Anesthesia for integumentary system procedures (extremities, anterior trunk, perineum, and breast reconstruction)
Typical site of service: Operating room or procedure suite for surgical and reconstructive procedures involving the integumentary system of the extremities, anterior trunk, perineum, and breast.
National Reimbursement Benchmarks
Commercial reimbursement for CPT 00402 centers around a BUCA average of $105.40, with individual payer means both above and below that midpoint. Aetna shows the highest dispersion and highest maximums, while Blue Cross Blue Shield and UnitedHealth Group sit toward lower mean levels; Cigna’s mean is nearer BUCA. Highlighting payers by spread, Aetna’s interquartile range (P75–P25) is $226.10, the widest, driven by a high P75 and relatively high P25. Blue Cross Blue Shield has a moderate spread of $38.50, Cigna’s spread is $58.60, and UnitedHealth Group is tighter at $30.90, indicating more consistency in allowed amounts from UnitedHealth Group compared with Aetna.
Comparative observations: Blue Cross Blue Shield and UnitedHealth Group present the tightest distributions, suggesting less variability in contracted rates, while Aetna exhibits substantial variability between the 25th and 75th percentiles. Cigna’s dispersion sits between these groups, and BUCA at $105.40 functions as the average commercial benchmark against which these payer patterns can be viewed.