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CPT 00406: Anesthesia for Integumentary and Breast Procedures
CPT code 00406 denotes anesthesia for surgical procedures involving the integumentary system of the extremities, anterior trunk, and perineum, and specifically covers radical or modified radical breast procedures with internal mammary node dissection. As an anesthesia procedure code, it is central to perioperative billing for a range of dermatologic, soft-tissue, and oncologic breast operations. Nationally, accurate use of this CPT code matters for appropriate anesthesia payment, perioperative documentation, and alignment with surgical procedure coding.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of clinical context for 00406, guidance on common billing considerations tied to the described service type and site of service, and pointers to related procedural codes that commonly intersect with anesthesia billing. The publication highlights where 00406 is typically applied, common clinical scenarios that generate use of the code, and operational implications for hospitals and anesthesia practices. This summary provides a national perspective intended to clarify the code’s scope and situational use without state-level or payer-specific rate discussion.
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Billing Code Overview
CPT code 00406 describes anesthesia services provided for procedures on the integumentary system of the extremities, anterior trunk, and perineum, and explicitly includes radical or modified radical procedures on the breast with internal mammary node dissection. The service type is general anesthesia for surgical procedures involving skin, subcutaneous tissue, and related structures in the specified anatomical regions. The typical site of service is an operating room or surgical suite where operative management of integumentary and breast procedures is performed.
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.