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CPT 00540: Anesthesia for Thoracotomy Procedures
CPT code 00540 denotes anesthesia services provided for surgical procedures involving a thoracotomy when no more specific anesthesia code applies. Thoracotomy is a major intra-thoracic operation that typically requires complex anesthetic management, advanced airway techniques, and intraoperative monitoring. Nationally, this code is relevant for hospitals and anesthesiology groups that provide care for complex chest surgeries, including resections and interventions requiring chest exploration.
Key payers addressed in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The content outlines clinical context for use of the code, typical sites of service, and common companion information that organizations track for billing and compliance.
Readers will find a concise explanation of the clinical scenario captured by 00540, comparisons to related anesthesia codes for thoracic procedures, and the typical administrative considerations associated with billing this service. The publication also highlights customary clinical indications and relevant ICD-10 diagnostic conditions commonly billed with thoracotomy anesthesia, as well as a brief review of related anesthesia codes for chest procedures. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 00540 describes anesthesia services for procedures in which the surgical provider performs a thoracotomy. Thoracotomy involves opening the chest for surgical treatment or investigation of intrathoracic structures. This code is used when the anesthesia services are not specifically described by another anesthesia code but the operative procedure requires a thoracotomy.
Service type: Anesthesia for thoracic surgical procedures
Typical site of service: Inpatient operating room or other hospital surgical suite where thoracotomy and related intrathoracic procedures are performed
National Reimbursement Benchmarks
For CPT 00540, BUCA’s mean commercial rate of $75.40 serves as a practical market reference point; it sits between higher averages such as Aetna ($103.50) and Cigna ($92.80) and lower means like Blue Cross Blue Shield ($62.90) and UnitedHealth Group ($67.30). Aetna also shows the highest single observed maximum at $369.40, indicating occasional outliers above the commercial cohort, while Blue Cross Blue Shield and UnitedHealth Group have lower ceilings at $183.80 and $122.70 respectively.
Examining dispersion using the interquartile range (P75–P25) highlights variation: Aetna’s IQR is $87.90 (P75 $131.40 minus P25 $45.00), Cigna’s is $52.20 (P75 $120.00 minus P25 $67.80), BUCA’s is $47.80 (P75 $97.20 minus P25 $49.40), Blue Cross Blue Shield’s is $43.30 (P75 $83.70 minus P25 $44.40), and UnitedHealth Group’s is $28.80 (P75 $80.80 minus P25 $52.00). UnitedHealth Group shows the tightest middle distribution, while Aetna displays the widest spread across the interquartile band.