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    OpenPayerBilling CodesAnesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle)CPT cpt-00402-anesthesia-integumentary-extremities-trunk-perineum-breast-reconstruct
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    CPT 00402: Anesthesia for Integumentary Procedures on Extremities/Trunk/Perineum

    Commercial payers pay $105 on average nationally for this procedure.

    CPT code 00402 describes anesthesia services for procedures on the integumentary system involving the extremities, anterior trunk, and perineum, including reconstructive surgeries of the breast; service type: anesthesia for integumentary and reconstructive procedures; typical site of service: operating room or procedure suite for surgical procedures on the extremities, anterior trunk, perineum, and breast reconstruction.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    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.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old male with a history of chronic hoarseness is diagnosed with a malignant lesion of the glottis (C32.0) and scheduled for surgical excision with possible reconstruction of adjacent integumentary tissues of the anterior neck. The patient has intermittent stridor and prior partial vocal cord paralysis (J38.00), and a prior tracheostomy with scarring and a documented tracheostomy complication (J95.02). Preoperative evaluation by the anesthesiology team documents abnormal sputum production (R09.3) and congenital laryngomalacia as a childhood history (Q31.5) noted in the records.

    The clinical workflow:

    • Preoperative assessment by the anesthesiology physician or Certified Registered Nurse Anesthetist (CRNA) including airway evaluation, review of prior tracheostomy details, and risk stratification.

    • Preparation for potential difficult airway management: plan for awake fiberoptic intubation or inhalational induction, availability of tracheostomy tray and surgical airway team, and consideration of postoperative airway monitoring.

    • Intraoperative anesthesia is provided for resection of the glottic malignancy and any reconstructive procedures on the anterior neck or breast integumentary tissues; anesthesia management includes airway control, hemodynamic monitoring, and potential blood loss management.

    • Postoperative care includes monitoring in PACU or ICU for airway compromise, suctioning for abnormal sputum, and management of any tracheostomy-related issues.

    This scenario aligns with anesthesia services reported under for procedures on the integumentary system of the extremities, anterior trunk, and perineum, including reconstructive procedures on the breast, when such procedures involve the anterior neck/upper trunk region and require specialized airway and anesthetic management.

    Related Modifiers

    7 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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    367500000X
    207RA0401X
    102X00000X
    332900000X
    2080T0004X
    363A00000X
    207UN0902X

    Related ICD-10-CM Codes

    30 rows

    ICD-10-CM CodeDescription
    B35.1Tinea unguium
    C32.0Malignant neoplasm of glottis
    C43.9Malignant melanoma of skin, unspecified
    C44.219Basal cell carcinoma of skin of left ear and external auricular canal
    C44.91Basal cell carcinoma of skin, unspecified
    C50.912Malignant neoplasm of unspecified site of left female breast
    D23.9Other benign neoplasm of skin, unspecified
    I83.90Asymptomatic varicose veins of unspecified lower extremity
    J38.00Paralysis of vocal cords and larynx, unspecified
    J95.02Infection of tracheostomy stoma

    Showing 1–10 of 30

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    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
    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

    Related Codes

    CPT-00400-ANESTHESIA-INTEGUMENTARY-EXTREMITIES-ANTERIOR-TRUNK-PERINEUM

    CPT 00400: Anesthesia for Integumentary Procedures on Extremities/Trunk/Perineum

    CPT-00404-ANESTHESIA-INTEGUMENTARY-EXTREMITIES-TRUNK-PERINEUM-BREAST

    CPT 00404: Anesthesia for Integumentary Procedures on Extremities/Trunk/Perineum

    CPT-00406-ANESTHESIA-INTEGUMENTARY-EXTREMITIES-ANTERIOR-TRUNK-PERINEUM

    CPT 00406: Anesthesia for Integumentary and Breast Procedures

    CPT-00410-ANESTHESIA-INTEGUMENTARY-PROCEDURES-ELECTRICAL-CARDIOVERSION

    CPT 00410: Anesthesia for Integumentary Procedures with Cardiac Electrical Conversion

    CPT-00450-ANESTHESIA-CLAVICLE-SCAPULA-PROCEDURE

    CPT 00450: Anesthesia for Clavicle and Scapula Procedures

    CPT-00454-CLAVICLE-BIOPSY-ANESTHESIA

    CPT 00454: Anesthesia for Clavicle Biopsy

    CPT-00470-PARTIAL-RIB-REMOVAL-ANESTHESIA

    CPT 00470: Anesthesia for Partial Rib Removal

    CPT-00472-PARTIAL-RIB-RESECTION-THORACOPLASTY-ANESTHESIA

    CPT 00472: Anesthesia for Partial Rib Resection with Thoracoplasty

    CPT-00474-ANESTHESIA-PARTIAL-RIB-RESECTION-THORACIC

    CPT 00474: Anesthesia for Partial Rib Resection

    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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    00402

    Related Diagnoses

    ICD-10 CodeDescriptionClinical Relevance
    C32.0Malignant neoplasm of glottisPrimary diagnosis often necessitating surgical excision with anesthesia in the airway and anterior neck region.
    J38.00Paralysis of vocal cords and larynx, unspecifiedPreexisting vocal cord dysfunction increases airway management complexity during anesthesia.
    J95.02Tracheostomy complicationPrior tracheostomy issues can alter airway anatomy and affect perioperative anesthetic planning.
    Q31.5Congenital laryngomalaciaHistory of upper airway structural abnormality that may contribute to difficult airway or postoperative airway obstruction.
    R09.3Abnormal sputumActive sputum production increases aspiration risk and informs anesthesia induction and suctioning strategies.