CPT 00454: Anesthesia for Clavicle Biopsy
Commercial payers pay $80 on average nationally for this procedure.
CPT code 00454 describes anesthesia services provided for a patient undergoing a biopsy of the clavicle (collarbone); this represents an anesthesia service for a diagnostic musculoskeletal biopsy typically performed in an operating room or procedure suite where monitored anesthesia care or general/regional anesthesia is delivered depending on clinical needs.
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National Reimbursement Benchmarks
National commercial rates for CPT 00454 center around BUCA’s average commercial benchmark of $80.10, with notable variation by payer. Blue Cross Blue Shield displays a relatively wide interquartile spread (P75–P25 = $45.30), while Cigna shows the next-widest dispersion at $61.00. UnitedHealth Group and Aetna are tighter by comparison, with interquartile ranges of $30.90 and $44.00 respectively, indicating more clustered pricing among those payers.
Maximum-to-minimum spreads also underscore variability: Blue Cross Blue Shield reaches a maximum of $238.70 versus a minimum of $3.20, and Cigna’s maximum of $176.80 contrasts with a $52.00 minimum. UnitedHealth Group and Aetna remain more concentrated near their medians of $65 and $48, reinforcing that payer choice materially affects reimbursement levels for this code.