CPT 00404: Anesthesia for Integumentary Procedures on Extremities/Trunk/Perineum
Commercial payers pay $82 on average nationally for this procedure.
CPT code 00404 describes anesthesia services provided for procedures on the integumentary system of the extremities, anterior trunk, and perineum, and includes anesthesia for radical or modified radical breast procedures; the service type is anesthesia for surgical procedures and the typical site of service is an operating room or procedural suite where dermatologic, plastic, or breast surgery is performed.
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National Reimbursement Benchmarks
National commercial rates for CPT 00404 center around BUCA’s average commercial rate of $81.70, with notable variation among major carriers. Blue Cross Blue Shield has a moderate median at $63.80 while Aetna’s distribution is the most dispersed, stretching to a high $555.60 and a median of $57.00; UnitedHealth Group and Cigna sit closer to BUCA, with medians of $64.00 and $87.00 respectively. These medians suggest BUCA’s average lies near the middle of the payer mix rather than at an extreme.
Examining interquartile dispersion (P75 minus P25) highlights which payers are tightest or widest: Blue Cross Blue Shield’s IQR is $37.30, UnitedHealth Group’s IQR is $30.90, Cigna’s IQR is $55.70, and Aetna’s IQR is $72.40, making Aetna the widest and UnitedHealth Group the tightest among those with listed quartiles. BUCA’s quartiles imply an IQR of $46.70, placing it between the narrowest and widest payers.