CPT 00470: Anesthesia for Partial Rib Removal
CPT code 00470 designates anesthesia services for partial rib removal procedures that are not otherwise specified by a different anesthesia code. As an anesthesia-specific CPT entry, it identifies the anesthesia care component associated with thoracic surgical procedures involving partial rib excision. Nationally, accurate use of this code matters for procedural classification, claims processing, and aggregated reporting of anesthesia utilization for chest wall procedures.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise explanation of the clinical context for the code, common billing considerations, and how 00470 relates to nearby anesthesia codes for chest wall and rib surgery. The publication also outlines relevant ICD-10 diagnoses typically billed with this service and points to related anesthesia CPT codes for comparable chest wall procedures. This summary equips coding, billing, and clinical teams with the contextual information needed to identify when 00470 applies and where it fits within the broader anesthesia coding framework.
Sign up for cpt 00470 policy alerts
Get alerted when payer policies referencing 00470 are released or updated.
Billing Code Overview
CPT code 00470 describes anesthesia services provided for a patient undergoing partial rib removal in a procedure not otherwise specified by another code. This code captures anesthesia management associated with surgical excision of part of one or more ribs.
-
Service type: General anesthesia services for thoracic surgical procedure involving partial rib removal
-
Typical site of service: Hospital operating room or an ambulatory surgery center where thoracic surgery is performed
Clinical & Coding Specifications
Clinical Context
A 48-year-old male presents after a motor vehicle collision with severe right-sided chest wall pain and imaging demonstrating a displaced fracture of one rib (S22.3) and a nondisplaced fracture of the right clavicle (S42.001A). The surgical team schedules a partial rib resection to remove sharp bone fragments and stabilize the chest wall due to persistent pain, risk of pulmonary injury, and impaired ventilation. The patient undergoes preoperative evaluation by the anesthesiology team, including airway assessment, review of pulmonary status given a concurrent diagnosis of other disorders of lung (J98.4), and determination of ASA physical status (commonly P2–P3). In the operating room the anesthesiologist provides general endotracheal anesthesia, monitors for ventilatory compromise, and may employ regional techniques (e.g., paravertebral or erector spinae block) for postoperative analgesia. Intraoperative management addresses potential blood loss and intraoperative conversion of procedure complexity. Typical recovery occurs in a post-anesthesia care unit (PACU) with monitoring of respiratory status and pain control; the setting of care is an inpatient or ambulatory surgical facility depending on clinical stability and comorbidities.
Coding Specifications
- Below are the most clinically relevant modifiers for anesthesia services during a partial rib removal, with concise use cases.
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when intraoperative management is substantially greater than typical for 00470 (document increased work). |
23 | Unusual anesthesia | Use when emergency or unusual circumstances require general anesthesia for a procedure normally done with local/monitored anesthesia care. |
50 | Bilateral procedure | Use when comparable procedures are performed on both sides of the chest during the same anesthetic. |
52 | Reduced services | Use when the procedure is partially reduced or not completed but anesthesia services were provided. |
53 | Discontinued procedure | Use when the procedure is terminated for patient safety after anesthesia has begun. |
54 | Surgical care only | Use when the anesthesiologist provides only intraoperative care and another clinician provides pre/postoperative anesthesia services. |
55 | Postoperative management only | Use when the anesthesiologist provides only postoperative pain/anesthesia management. |
62 | Two surgeons | Use when two surgeons of different specialties are required concurrently for operative care of the rib area. |
78 | Unplanned return to OR | Use when the patient returns to the OR for a related procedure requiring additional anesthesia during the global period. |
AA | Anesthesia by anesthesiologist | Use to identify services personally performed by a physician anesthesiologist. |
AD | Medical supervision by physician; more than four concurrent anesthesia procedures | Use when supervising a team with >4 concurrent anesthesia procedures. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for anesthesia | Use when these professionals perform anesthesia services under appropriate supervision. |
QK | Medical direction by CRNA with two–four concurrent anesthesia procedures | Use when an anesthesiologist medically directs CRNAs for this case. |
QS | Monitored anesthesia care (MAC) service | Use when the anesthetic is provided as MAC rather than general endotracheal anesthesia. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Primary specialty providing anesthesia for thoracic and chest wall procedures. |
207LA0401X | Pain Medicine (Anesthesiology) | Relevant when regional blocks or complex multimodal pain control are planned/performed. |
207LC0200X | Critical Care Medicine (Anesthesiology) | Relevant if perioperative critical care management is required for respiratory compromise. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
J98.4 | Other disorders of lung | Indicates concurrent pulmonary pathology that increases anesthetic and perioperative respiratory risk and influences intraoperative ventilatory management. |
S22.3 | Fracture of one rib | Direct indication for partial rib removal when fractures are displaced, symptomatic, or pose risk to intrathoracic structures. |
S42.001A | Fracture of unspecified part of right clavicle, initial encounter for closed fracture | Associated ipsilateral shoulder girdle injury that may affect positioning, operative approach, and postoperative pain management. |
M25.511 | Pain in right shoulder | Symptom commonly accompanying clavicle/rib injuries; impacts perioperative analgesic planning and rehabilitation. |
M54.6 | Pain in thoracic spine | Thoracic spine pain can coexist with chest wall trauma and may influence regional block selection and postoperative pain control. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
00472 | Anesthesia for chest wall repair | Used for anesthesia when the operative procedure involves complex chest wall repair, closely related to rib procedures and may be selected if repair extent aligns more with chest wall reconstruction. |
00474 | Anesthesia for surgery of rib(s) | Used for anesthesia specifically for rib surgery; may be used alternatively to 00470 depending on exact procedure nomenclature and intraoperative complexity. |