Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesAnesthesia for Intrathoracic ProceduresCPT cpt-00541-anesthesia-one-lung-ventilation-thoracotomy
    Ask Trek AI about this page

    CPT 00541: Anesthesia for Thoracotomy with One-Lung Ventilation

    Commercial payers pay $79 on average nationally for this procedure.

    CPT code 00541 describes anesthesia services provided for procedures that involve opening the chest wall (thoracotomy) with one-lung ventilation, typically performed in an operating room setting for thoracic surgery; the service covers perioperative anesthesia management for patients undergoing procedures requiring isolation of one lung to facilitate surgical exposure and protect the contralateral lung.

    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.

    Customize your policy alerts

    Sign up for cpt 00541 policy alerts

    Get alerted when payer policies referencing 00541 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    National Reimbursement Benchmarks

    Commercial rates for CPT 00541 cluster around BUCA’s average commercial rate of $79. Across national payers, Aetna presents a high mean and wide ceiling with a max of $337.30 and mean $124.10, while Cigna and UnitedHealth Group show mid-to-high means at $92.70 and $67.30 respectively. Blue Cross Blue Shield (BCBS) has a lower mean of $63.40. These differences indicate a tiered market where Aetna and Cigna occupy higher-paying segments compared with BCBS and UnitedHealth Group.

    Dispersion measured by the interquartile range (P75–P25) is widest for Aetna at $118.50 (P75 $174.40 minus P25 $55.90) and for Cigna at $54.80 (P75 $121.60 minus P25 $68.00). Blue Cross Blue Shield is relatively tight at $40.20 (P75 $83.50 minus P25 $44.30), and UnitedHealth Group is modestly compact at $27.80 (P75 $80.80 minus P25 $52.00). BUCA’s quartiles (P25 $51.50, P75 $104.50) produce an interquartile range of $53.00, near the market midline.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools
    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 4-year-old child with congenital cardiac anomalies is scheduled for a right thoracotomy to repair a ventricular septal defect and address concomitant pulmonary venous malposition. The patient has preoperative diagnoses of Q21.0 (ventricular septal defect) and Q26.2 (total anomalous pulmonary venous connection) with associated pulmonary hypertension. The anesthesia team (pediatric anesthesiology and pediatric critical care available) conducts a preoperative evaluation focused on airway assessment, baseline oxygenation, pulmonary vascular status, and hemodynamic optimization. General endotracheal anesthesia with a double-lumen tube or bronchial blocker is planned to permit one-lung ventilation for optimal surgical exposure during thoracotomy. Intraoperative management includes invasive arterial monitoring, central venous access as indicated, careful ventilation strategies during one-lung ventilation, and vasoactive support for hemodynamic instability. Postoperatively the patient is transferred to the pediatric intensive care unit for ventilatory weaning, pain control, and monitoring for bleeding, respiratory complications, and cardiac dysfunction. Billing is reported with anesthesia code 00541 for anesthesia services during thoracotomy procedures requiring one-lung ventilation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    00540

    Related Modifiers

    7 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…
    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.
    2080P0203XPediatric Critical Care Medicine PhysicianA pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the criti…
    1835C0205XCritical Care PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the delivery of patient care services by pharmacists, as integral member…
    225XM0800XMental Health Occupational TherapistOccupational therapists provide treatment for people recovering from a mental or physical illness to regain their independence and stability and to en…
    1835E0208XEmergency Medicine PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the care for patients at the bedside in emergency medicine settings.
    2083T0002XMedical Toxicology (Preventive Medicine) PhysicianMedical toxicologists are physicians who specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to dr…
    283Q00000XPsychiatric HospitalAn organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients r…

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 2

    10 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
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    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-00529-ANESTHESIA-MEDIASTINOSCOPY-ONE-LUNG-VENTILATION

    CPT 00529: Anesthesia for Mediastinoscopy/Thoracoscopy with One-Lung Ventilation

    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

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    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.

    Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum; not otherwise specified
    Alternative anesthesia code used for thoracotomy cases not specifically requiring one-lung ventilation; used when one-lung ventilation is not performed.
    00542Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum; decorticationRelated when the thoracotomy includes pleural decortication procedures; selection depends on the specific surgical procedure performed alongside or instead of the indexed repair.