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CPT 00626: Anesthesia for Thoracic Spine Surgery, Anterior Transthoracic
CPT code 00626 represents anesthesia services for thoracic spine and spinal cord procedures performed through an anterior transthoracic approach that require one-lung ventilation. This code captures a specialized anesthesia encounter for complex thoracic spinal surgery where lung isolation and advanced airway and ventilation management are necessary. Nationally, accurate use of 00626 matters for clinical documentation, perioperative risk stratification, and appropriate billing for high-acuity anesthetic care.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the code, common associated procedure types, and the typical site of service. The publication also summarizes payer coverage considerations and common modifiers and taxonomies associated with this service for operational clarity.
The content provides actionable reference material for coding teams, anesthesia departments, and billing professionals: it clarifies when 00626 applies, outlines related spinal surgical procedures that commonly coincide with its use, and indicates diagnostic contexts where thoracic spine anesthesia may be required. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 00626 describes anesthesia services provided for a patient undergoing a procedure on the thoracic spine and cord performed via an anterior transthoracic approach with one-lung ventilation.
Service type: Anesthesia for thoracic spine surgery, anterior transthoracic approach, one-lung ventilation
Typical site of service: Operating room / inpatient surgical suite (thoracic spinal surgery via transthoracic approach)
National Reimbursement Benchmarks
National commercial reimbursement for CPT 00626 centers on a BUCA average commercial rate of $68.5, with individual payer means diverging around that level. Cigna posts the highest mean at $92.4, Blue Cross Blue Shield averages $64.8, UnitedHealth Group is at $67.4, and Aetna is lower at $56.9. These means indicate a modest clustering near the BUCA average but with notable upward deviation from Cigna.
Dispersion (P75 minus P25) highlights variability: Aetna’s interquartile range is $27.0 ($69.3 - $42.0), Blue Cross Blue Shield’s is $40.7 ($84.6 - $43.9), BUCA’s is $38.4 ($87.3 - $48.9), Cigna’s is $53.4 ($120.0 - $67.6), and UnitedHealth Group’s is $29.0 ($81.0 - $52.0). Cigna shows the widest spread at $53.4, while Aetna is the tightest at $27.0.