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    OpenPayerBilling CodesAnesthesia for Intrathoracic ProceduresCPT cpt-00563-cardiac-anesthesia-with-bypass-and-circulatory-arrest
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    CPT 00563: Anesthesia for Cardiac Surgery with Pump and Hypothermic Circulatory Arrest

    Commercial payers pay $72 on average nationally for this procedure.

    CPT code 00563 represents anesthesia services for cardiac procedures involving the heart, pericardium, and great vessels (for example the aorta and major pulmonary vessels) performed with cardiopulmonary bypass using a pump oxygenator and employing hypothermic circulatory arrest; service type: intraoperative anesthesia for complex cardiac surgery; typical site of service: hospital operating room, often in a cardiac surgery suite or tertiary care 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 national averages for CPT 00563 center around BUCA’s mean of $72.40, with individual payer means ranging from Blue Cross Blue Shield’s $61.50 to Cigna’s $91.80 and Aetna’s $90.30; UnitedHealth Group’s mean is $67.30. Payer medians trend near their means for some carriers (Blue Cross Blue Shield median $57, UnitedHealth Group median $64), while Cigna and Aetna show higher medians at $85.70 and $61.70 respectively, reflecting different skew in their distributions.

    Dispersion measured as P75 minus P25 is tightest for Blue Cross Blue Shield at $41.10 and for UnitedHealth Group at $27.60, indicating more concentrated commercial rates. Dispersion is widest for Aetna at $67.50 and Cigna at $52.0, with BUCA’s interquartile spread of $45.30 placing it between these extremes. These ranges highlight where commercial pricing is most variable across the major payers.

    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 severe calcific aortic stenosis (I35.0) and concomitant coronary atherosclerotic disease (I25.10) presents for an elective combined aortic valve replacement and coronary artery bypass grafting (CABG). Preoperative evaluation documents heart failure symptoms (I50.9) and an atrial septal defect (Q21.1) identified on intraoperative transesophageal echocardiography. The surgical plan requires median sternotomy, cardiopulmonary bypass with a pump-oxygenator, and periods of hypothermic circulatory arrest for safe reconstruction of the ascending aorta and repair of the atrial septal defect.

    The anesthesia workflow includes: preoperative assessment and optimization, arterial and central venous access placement in the operating room, induction with endotracheal intubation, invasive monitoring (arterial line, pulmonary artery catheter as indicated), transesophageal echocardiography for intraoperative hemodynamic guidance, management of cardiopulmonary bypass initiation and separation, active temperature management including cooling for hypothermic circulatory arrest, coagulation and blood product management, and postoperative handoff to the cardiothoracic intensive care unit for continued ventilatory and hemodynamic support.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    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.
    207LC0200XCritical Care Medicine (Anesthesiology) PhysicianAn anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
    101YP1600XPastoral CounselorBehavioral Health & Social Service Providers · Counselor
    364SP1700XPerinatal Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    126900000XDental Laboratory TechnicianAn individual who has the skill and knowledge in the fabrication of dental appliances, prostheses and devices in accordance with a dentist's laborator…
    202D00000XIntegrative Medicine PhysicianA physician who specializes in the treatment of the whole person through prevention and treatment based on medical evidence. Integrative medicine cons…
    2472R0900XRenal Dialysis TechnicianTechnologists, Technicians & Other Technical Service Providers · Technician, Other

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 2

    9 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

    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.
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    00562
    Anesthesia for procedures on the heart and pericardium, not requiring pump oxygenator
    Alternative code used when cardiopulmonary bypass is not required; contrasts with 00563.
    00560Anesthesia for procedures on the heart and pericardium, patient on heart-lung machine not specified for hypothermic arrestRelated cardiac anesthesia code used for some heart procedures; 00563 specifically denotes pump oxygenator with hypothermic circulatory arrest.