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    OpenPayerBilling CodesAnesthesia for Intrathoracic ProceduresCPT cpt-00529-anesthesia-mediastinoscopy-one-lung-ventilation
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    CPT 00529: Anesthesia for Mediastinoscopy/Thoracoscopy with One-Lung Ventilation

    Commercial payers pay $69 on average nationally for this procedure.

    CPT code 00529 describes anesthesia services for mediastinoscopy with possible thoracoscopy that involve insertion of a video camera via a neck opening and may include thoracoscopic entry through the lateral chest, with management requiring one-lung ventilation; service type: anesthesia for invasive thoracic endoscopic procedures; typical site of service: operating room or procedure suite in a hospital or ambulatory surgical center.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    National Reimbursement Benchmarks

    Commercial reimbursement for CPT 00529 centers around a BUCA average of $69.40, with payer-specific means ranging from $62.00 (Aetna) to $92.90 (Cigna). Blue Cross Blue Shield and UnitedHealth Group both show mid-to-high central tendencies (medians $58.30 and $64.00 respectively), while Cigna posts the highest median at $85.70, indicating a generally higher payment level for that carrier compared with others.

    Dispersion varies notably: Blue Cross Blue Shield has a P75–P25 range of $40.20 ($85.50 − $45.30), Aetna’s range is $44.40 ($81.30 − $37.00), UnitedHealth Group’s range is $29.00 ($81.00 − $52.00), and Cigna’s range is $53.30 ($120.00 − $67.70). Cigna therefore exhibits the widest interquartile spread at $53.30, while UnitedHealth Group is the tightest at $29.00, with BUCA’s quartiles ($49.00 to $89.80) implying a range of $40.80 around the average commercial level.

    National Payer Mean Reimbursement Rates

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    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 68-year-old male with known atherosclerotic coronary artery disease (I25.10), nonrheumatic aortic stenosis (I35.0), and heart failure with preserved ejection fraction (I50.9) is scheduled for mediastinoscopy with one-lung ventilation to evaluate and biopsy suspicious mediastinal lymphadenopathy identified on chest imaging. The patient presents to the preoperative holding area in an outpatient surgical center attached to a tertiary hospital. The anesthesiology team performs a focused preoperative assessment, documents cardiovascular and pulmonary risk, confirms airway evaluation, reviews anticoagulation status, and obtains informed anesthesia consent.

    On arrival to the OR, standard monitors are placed and invasive arterial monitoring is considered due to cardiac comorbidities. A double-lumen endotracheal tube or bronchial blocker is placed by the anesthesia provider to facilitate selective one-lung ventilation per the procedural requirements. General endotracheal anesthesia with volatile agent or total intravenous anesthesia is induced. The surgical team performs mediastinoscopy via a small suprasternal incision; thoracoscopic exploration may be performed via a separate lateral thoracostomy for pleural inspection if indicated. Hemodynamic and respiratory management focuses on maintaining oxygenation with one-lung ventilation, ventilator adjustments, and hemodynamic stability given underlying cardiac disease.

    Postprocedure, the patient is extubated in the OR or taken intubated to PACU/ICU depending on intraoperative course and comorbidities. Documentation includes anesthesia start and stop times, airway device used, one-lung ventilation details, intraoperative events, blood loss, fluids, vasoactive medication use, and postoperative disposition with pain and respiratory management plan.

    Related CPT Codes

    Related Modifiers

    9 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…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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 CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    207LC0200XCritical Care Medicine (Anesthesiology) PhysicianAn anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
    213ES0131XFoot Surgery PodiatristPodiatric Medicine & Surgery Service Providers · Podiatrist
    156FX1800XOpticianOpticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide whi…
    364SF0001XFamily Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    2278S1500XSNF/Subacute Care Certified Respiratory TherapistCare of residents in a long-term care environment. Respiratory modalities delivered include those similar in the general care and critical care areas…
    246RM2200XMedical Laboratory TechnicianTechnologists, Technicians & Other Technical Service Providers · Technician, Pathology

    Related ICD-10-CM Codes

    30 rows

    ICD-10-CM CodeDescription
    C34.11Malignant neoplasm of upper lobe, right bronchus or lung
    C34.12Malignant neoplasm of upper lobe, left bronchus or lung
    C34.2Malignant neoplasm of middle lobe, bronchus or lung
    C34.30Malignant neoplasm of lower lobe, unspecified bronchus or lung
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C34.92Malignant neoplasm of unspecified part of left bronchus or lung
    C77.9Secondary and unspecified malignant neoplasm of lymph node, unspecified
    C78.00Secondary malignant neoplasm of unspecified lung
    C78.01Secondary malignant neoplasm of right lung
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris

    Showing 1–10 of 30

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 2

    7 rows

    PolicyPayerEffective Date
    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-00500-ANESTHESIA-ESOPHAGUS-PROCEDURE

    CPT 00500: Anesthesia for Esophageal Procedure

    CPT-00520-ANESTHESIA-CLOSED-CHEST-BRONCHOSCOPY

    CPT 00520: Anesthesia for Closed Chest Procedures, Bronchoscopy

    CPT-00522-NEEDLE-PLEURAL-BIOPSY-ANESTHESIA-CLOSED-CHEST

    CPT 00522: Anesthesia for Pleural Needle Biopsy

    CPT-00524-ANESTHESIA-CLOSED-CHEST-PNEUMOCENTESIS

    CPT 00524: Anesthesia for Closed-Chest Pneumocentesis

    CPT-00528-ANESTHESIA-MEDIASTINOSCOPY-DIAGNOSTIC-THORACOSCOPY

    CPT 00528: Anesthesia for Mediastinoscopy and Diagnostic Thoracoscopy

    CPT-00530-ANESTHESIA-PERMANENT-TRANSVENOUS-PACEMAKER-INSERTION

    CPT 00530: Anesthesia for Permanent Transvenous Pacemaker Insertion

    CPT-00532-ANESTHESIA-FOR-CENTRAL-VENOUS-ACCESS

    CPT 00532: Anesthesia for Central Venous Access

    CPT-00534-ANESTHESIA-FOR-TRANSVENOUS-CARDIOVERTER-DEFIBRILLATOR-INSERTION

    CPT 00534: Anesthesia for Transvenous Cardioverter–Defibrillator Insertion

    CPT-00537-CARDIAC-ELECTROPHYSIOLOGY-ANESTHESIA

    CPT 00537: Anesthesia for Cardiac Electrophysiology Procedures

    CPT-00539-TRACHEOBRONCHIAL-RECONSTRUCTION-ANESTHESIA

    CPT 00539: Anesthesia for Tracheobronchial Reconstruction

    Showing 1–10 of 23

    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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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    CPT Code
    Description
    Relationship to This Procedure
    33405Replacement, aortic valve, with cardiopulmonary bypassMajor cardiac surgery listed as a related cardiac procedure in patients with valvular disease who may require perioperative anesthesia planning; not concurrent with mediastinoscopy but relevant to overall anesthesia risk profiling.
    33533Coronary artery bypass, using arterial graft(s); single arterial graftRepresents major cardiac revascularization procedures that inform anesthesia risk and perioperative management of patients with I25.10.
    33208Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricularCardiac device implantation that may be part of the patient’s cardiac history and influence intraoperative monitoring and precautions.
    92928Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branchPercutaneous coronary intervention relevant to patients with coronary artery disease who undergo mediastinal procedures and require antiplatelet management considerations.