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CPT 00580: Anesthesia for Heart or Heart–Lung Transplantation
CPT code 00580 designates anesthesia services for heart transplantation or combined heart–lung transplantation, covering complex intraoperative anesthetic management for high-risk cardiothoracic procedures. Nationally, this code represents a specialized anesthesia service integral to transplant programs and hospital surgical systems, reflecting high resource intensity and multidisciplinary coordination. Key commercial and public payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise clinical context for the procedure, payer coverage scope, and operational considerations relevant to coding and billing for cardiothoracic transplant anesthesia. The publication summarizes typical sites of service and the clinical scenarios in which 00580 applies, highlights related anesthesia procedures for comparison, and outlines common documentation elements that support correct code use. It also provides benchmarks and policy-relevant items where available, including payer scope and common coding relationships, to inform revenue cycle and clinical teams about national coding practices for transplant anesthesia services.
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Billing Code Overview
CPT code 00580 describes anesthesia services for transplantation of the heart or of both the heart and lungs. This service involves administration and management of anesthesia throughout the perioperative period for patients undergoing cardiac or combined heart–lung transplant procedures.
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Service type: Intraoperative anesthesia management for major cardiothoracic transplant surgery
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Typical site of service: Hospital operating room or other inpatient surgical suite
National Reimbursement Benchmarks
National commercial rates for CPT 00580 cluster around BUCA’s mean commercial benchmark of $67.50, with notable variation across major carriers. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $35.40, Cigna’s spread is $54.50, Aetna’s spread is $33.00, and UnitedHealth Group’s spread is $28.80. These spreads show Cigna with the widest middle 50% dispersion and UnitedHealth Group the tightest, indicating more consistent reimbursement from UnitedHealth Group and greater variability from Cigna relative to BUCA’s average.
Comparing medians and means, Cigna posts a higher median ($85.70) and mean ($92.10) than BUCA’s mean, while Aetna, Blue Cross Blue Shield, and UnitedHealth Group have medians and means closer to BUCA’s level. Payer-specific extremes such as Aetna’s max of $149.10 and Blue Cross Blue Shield’s max of $177.80 indicate occasional high reimbursements, but the interquartile spreads are more informative for typical commercial variability.