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    v1.0.30
    OpenPayerBilling CodesAnesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle)CPT cpt-00406-anesthesia-integumentary-extremities-anterior-trunk-perineum
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    CPT 00406: Anesthesia for Integumentary and Breast Procedures

    Commercial payers pay $68 on average nationally for this procedure.

    CPT code 00406 describes anesthesia services provided for procedures on the integumentary system of the extremities, anterior trunk, and perineum, including radical or modified radical breast procedures with internal mammary node dissection; service type: surgical anesthesia for integumentary and breast procedures; typical site of service: hospital operating room or ambulatory surgical center for surgical procedures involving the skin, soft tissue of extremities, anterior trunk, perineum, and breast with node dissection.

    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

    Across national commercial payers, BUCA’s mean commercial rate of $68.20 sits near the middle of the distribution and serves as a practical reference for average commercial reimbursement for CPT 00406. Cigna and Blue Cross Blue Shield show higher central tendencies—Cigna’s median is $85.70 and BCBS’s median is $58.50—while Aetna and UnitedHealth Group have lower medians at $48.00 and $64.00 respectively. Cigna posts the highest mean at $92.60, and BUCA’s mean of $68.20 aligns more closely with UnitedHealth Group ($67.30) and BCBS ($64.30).

    Examining dispersion using the interquartile range (P75 minus P25) highlights variability across payers: Cigna’s IQR is $52.20 ($119.90−$67.70), indicating the widest mid‑range spread, while UnitedHealth Group’s IQR is $27.60 ($80.80−$52.00), the tightest among listed payers. Blue Cross Blue Shield’s IQR is $30.80, Aetna’s is $28.00, and BUCA’s IQR is $37.40, placing BUCA in the middle of the spread spectrum relative to other commercial payers.

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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 female with a diagnosis of malignant neoplasm of the glottis (C32.0) and progressive voice change is scheduled for surgery involving the integumentary system of the anterior trunk and perineum — in this billing context the anesthetic services cover procedures such as radical or modified radical breast surgery with internal mammary node dissection. The patient has a history of prior tracheostomy with a documented complication (J95.02) and intermittent abnormal sputum production (R09.3). Preoperative evaluation is performed by the anesthesiology team (physician or Certified Registered Nurse Anesthetist) to assess airway risk given vocal cord paralysis (J38.00) and congenital laryngomalacia (Q31.5) history. Airway planning may include awake fiberoptic intubation or planned tracheostomy support depending on exam and prior surgical history.

    On the day of surgery the anesthesia team documents airway management, monitoring, and regional or general anesthetic techniques appropriate for breast and adjacent integumentary procedures. Intraoperative management includes standard ASA monitors, possible invasive monitoring for complex resections, and coordination with surgical oncology for lymph node dissection. Postoperative handoff includes disposition to PACU or ICU with notes on airway status, analgesic plan, and any tracheostomy-related issues.

    Related CPT Codes

    CPT CodeDescription

    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
    207LA0401X
    163WM1400X
    207YS0012X
    341800000X
    207U00000X
    208C00000X

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    C32.0Malignant neoplasm of glottis
    C50.111Malignant neoplasm of central portion of right female breast
    C50.112Malignant neoplasm of central portion of left female breast
    C50.129Malignant neoplasm of central portion of unspecified male breast
    C50.911Malignant neoplasm of unspecified site of right female breast
    C50.912Malignant neoplasm of unspecified site of left female breast
    C50.919Malignant neoplasm of unspecified site of unspecified female breast
    E10.621Type 1 diabetes mellitus with foot ulcer
    E11.621Type 2 diabetes mellitus with foot ulcer
    I83.819Varicose veins of unspecified lower extremity with pain

    Showing 1–10 of 28

    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-00402-ANESTHESIA-INTEGUMENTARY-EXTREMITIES-TRUNK-PERINEUM-BREAST-RECONSTRUCT

    CPT 00402: 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-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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    Relationship to This Procedure
    31500Intubation, endotracheal, emergency procedureMay be performed emergently for airway compromise in patients with vocal cord paralysis or tracheostomy complications prior to or during anesthesia.
    31575Laryngoscopy, flexible; diagnosticUsed for airway assessment (flexible laryngoscopy) in preoperative evaluation of patients with glottic pathology or vocal cord dysfunction.
    31600Tracheostomy, planned (separate procedure)Performed when long-term airway management is required or when airway anatomy precludes safe prolonged intubation; relevant given tracheostomy complication history.
    60240Thyroidectomy, total or completeMay be performed in the same oncologic care pathway for head and neck malignancies; anesthesia planning considerations overlap for airway and neck surgery.