CPT 00542: Anesthesia for Thoracotomy with Pulmonary Decortication
CPT code 00542 denotes anesthesia services for thoracotomy with pulmonary decortication, a major intraoperative anesthetic procedure for patients undergoing removal of the lung’s fibrous lining. This code captures high-complexity anesthesia care associated with open-chest thoracic surgery and is relevant to hospitals, anesthesiology practices, and payer policy teams because of its resource intensity and implications for case classification and payment. Major national payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will gain a concise clinical and billing overview of the code, how it fits within related thoracic anesthesia codes, and the typical clinical context for use. The publication summarizes common operational considerations for coding and billing, highlights related CPT anesthesia codes for thoracotomy procedures, and outlines typical clinical scenarios that justify reporting this code. The content is intended to support revenue cycle, clinical documentation, and policy staff in understanding the clinical scope and billing context of CPT code 00542 at a national level.
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Billing Code Overview
CPT code 00542 describes anesthesia services provided for a surgical procedure that opens the chest wall to perform decortication, the surgical peeling of the lung’s lining. The service type is intraoperative anesthesia for thoracotomy with pulmonary decortication. The typical site of service is an inpatient or operating room setting where thoracic surgical procedures are performed.
National Reimbursement Benchmarks
National commercial reimbursement for CPT 00542 centers near the BUCA average commercial rate of $69.30, with notable variation among major payers. Cigna sits well above that average with a mean of $92.70 and a high-end concentration (P75 $121.60), while UnitedHealth Group and Aetna cluster closer to BUCA with means of $67.30 and $67.20 respectively. Blue Cross Blue Shield’s mean of $62.90 is slightly below BUCA. These figures frame BUCA as a mid-market reference point for commercial performance.
Dispersion measured by the interquartile range (P75 minus P25) is tightest for Aetna and Blue Cross Blue Shield at $49.30 (Aetna: $83.30–$42.00) and $45.60 (BCBS: $83.40–$43.80) respectively, indicating more consistency in contracted rates. UnitedHealth Group’s IQR is $28.80, even tighter, while Cigna shows the widest spread at $54.40, reflecting greater variability toward higher reimbursements. BUCA’s IQR is $40.40, placing it between the tighter UnitedHealth Group and the wider Cigna distribution.