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    OpenPayerBilling CodesAnesthesia for Procedures on the Spine and Spinal CordCPT cpt-00604-anesthesia-cervical-spine-sitting-position
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    CPT 00604: Anesthesia for Cervical Spine and Spinal Cord Procedure, Sitting

    Commercial payers pay $69 on average nationally for this procedure.

    CPT code 00604 describes anesthesia services provided for a patient undergoing a procedure on the cervical spine and spinal cord while positioned sitting, representing a procedure-specific anesthesia service; typical service type is anesthesia for spine and spinal cord procedures and the usual site of service is an operating room or procedural suite where spine surgery is performed.

    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

    National commercial rates for CPT 00604 cluster around BUCA’s average commercial rate of $68.70, with variation across individual carriers. Blue Cross Blue Shield shows the highest upper-end observation at $184.90 and a median of $58.80, while Cigna centers higher with a median of $85.90 and a mean of $92.90. UnitedHealth Group and Aetna have lower medians ($64.00 and $48.00 respectively) with means of $67.40 and $56.60, indicating more concentration nearer the mid-range for those payers.

    Dispersion measured as the interquartile range (P75 minus P25) highlights differences in rate spread: Blue Cross Blue Shield has a range of $40.60, Cigna $54.80, UnitedHealth Group $29.00, Aetna $24.70, and BUCA $37.60. Cigna therefore has the widest IQR at $54.80, signaling the greatest middle-50% variability, while Aetna is the tightest at $24.70, indicating the most consistent middle-range commercial payments.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old male with a history of chronic obstructive lung disease presents after a fall with acute right clavicle fracture and rib fracture, severe right shoulder pain, and intermittent chest pain. Imaging confirms a fracture of the right clavicle (S42.001A) and a single rib fracture (S22.3); pulmonary evaluation documents J98.4 changes consistent with a reactive or non-specific lung disorder. The patient is scheduled for a cervical spine and cord decompression performed in the sitting position due to surgical exposure and cerebrospinal fluid management considerations. Preoperative assessment includes cardiopulmonary optimization given J98.4 and chest pain R07.9, airway evaluation for potential difficult airway related to positioning, and informed consent for anesthesia risks.

    On the day of surgery, the anesthesia team (Anesthesiologist and/or Certified Registered Nurse Anesthetist) provides general endotracheal anesthesia with invasive monitoring (arterial line) given the sitting position and potential for hemodynamic shifts. Positioning-related concerns (neurologic monitoring, risk of venous air embolism) and coexisting injuries (clavicle and rib fractures) influence anesthetic plan and postoperative pain control. Recovery occurs in a post-anesthesia care unit with enhanced respiratory monitoring due to underlying lung disorder and recent chest trauma.

    Related CPT Codes

    CPT CodeDescription

    Related Modifiers

    9 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…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    207LC0200XCritical Care Medicine (Anesthesiology) PhysicianAn anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
    261QR0200XRadiology Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    364SA2200XAdult Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    284300000XSpecial HospitalA designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have…
    261QR0800XRecovery Care Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    208200000XPlastic Surgery PhysicianA plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal sys…

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    D33.4Benign neoplasm of spinal cord
    G95.0Syringomyelia and syringobulbia
    J98.4Other disorders of lung
    M25.511Pain in right shoulder
    M47.22Other spondylosis with radiculopathy, cervical region
    M47.812Spondylosis without myelopathy or radiculopathy, cervical region
    M47.817Spondylosis without myelopathy or radiculopathy, lumbosacral region
    M48.02Spinal stenosis, cervical region
    M50.10Cervical disc disorder with radiculopathy, unspecified cervical region
    M50.11Cervical disc disorder with radiculopathy, high cervical region

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 4

    7 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

    Related Codes

    CPT-00600-ANESTHESIA-CERVICAL-SPINE-CORD-PROCEDURES

    CPT 00600: Anesthesia for Cervical Spine and Cord Procedure

    CPT-00620-ANESTHESIA-THORACIC-SPINE-SPINAL-CORD-PROCEDURE

    CPT 00620: Anesthesia for Thoracic Spine and Spinal Cord Procedures

    CPT-00625-ANESTHESIA-THORACIC-SPINE-ANTERIOR-TRANSTHORACIC-NO-ONE-LUNG-VENTILATION

    CPT 00625: Anesthesia for Thoracic Spine Procedure, Anterior Transthoracic

    CPT-00626-ANESTHESIA-THORACIC-SPINE-ANTERIOR-TRANSTHORACIC-ONE-LUNG

    CPT 00626: Anesthesia for Thoracic Spine Procedure, One-Lung Ventilation

    CPT-00630-ANESTHESIA-LUMBAR-REGION-PROCEDURE

    CPT 00630: Anesthesia for Procedures in Lumbar Region

    CPT-00632-LUMBAR-REGION-ANESTHESIA-LUMBAR-SYMPATHECTOMY

    CPT 00632: Anesthesia for Lumbar Region Procedures, Including Lumbar Sympathectomy

    CPT-00635-LUMBAR-REGION-ANESTHESIA-LUMBAR-PUNCTURE

    CPT 00635: Anesthesia for Lumbar Procedures Including Lumbar Puncture

    CPT-00640-ANESTHESIA-FOR-SPINE-MANIPULATION-CLOSED-SPINAL-PROCEDURE

    CPT 00640: Anesthesia for Manipulation or Closed Procedure on the Spine

    CPT-00670-ANESTHESIA-SPINE-INSTRUMENTATION-VASCULAR-PROCEDURE

    CPT 00670: Anesthesia for Extensive Spine and Spinal Cord Procedures

    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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    Relationship to This Procedure
    00600Anesthesia for procedures on the spine and spinal cordGeneral category for anesthesia services for spine/spinal cord procedures; 00604 is a site- and position-specific variant for cervical spine in the sitting position.
    00620Anesthesia for procedures on the spine and spinal cord (other)Alternative spine/spinal cord anesthesia codes for procedures not specifically described by 00600 or 00604; may apply to different levels or positions.