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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Spine and Spinal CordCPT cpt-00630-anesthesia-lumbar-region-procedure
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    CPT 00630: Anesthesia for Procedures in Lumbar Region

    Commercial payers pay $83 on average nationally for this procedure.

    CPT code 00630 describes anesthesia services provided for procedures in the lumbar region, typically delivered as general or regional anesthesia for surgical or diagnostic interventions on the lower spine; service type is anesthesia for lumbar procedures and the typical site of service is an operating room or procedure suite for spinal surgery or interventions.

    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

    Across national commercial payers, BUCA’s mean of $83.50 serves as an average-commercial reference point amid meaningful variation. Blue Cross Blue Shield centers lower with a mean of $66.80, while Aetna and Cigna show higher mean positions at $139.40 and $93.70 respectively; UnitedHealth Group sits near BCBS at $67.30. Maxima and minima for Aetna, Blue Cross Blue Shield, Cigna, and UnitedHealth Group indicate outliers at the high and low ends, but BUCA is presented only as an average commercial benchmark.

    Dispersion measured by the interquartile range (P75–P25) highlights who is tightest and widest: UnitedHealth Group is the tightest with a spread of $27.80, Blue Cross Blue Shield is also relatively tight at $37.30, BUCA shows a spread of $52.35, Cigna is wider at $53.10, and Aetna is the widest by far at $101.60. These differences signal varying consistency in commercial payments across payers.

    Table of contents

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with chronic lumbar radicular pain and progressive neurogenic claudication secondary to lumbar spinal stenosis (M48.06) is scheduled for an elective posterior lumbar decompression and fusion at L4–L5. Preoperative evaluation by the anesthesia team documents controlled hypertension and well-managed type 2 diabetes, ASA physical status P3. On the day of surgery the anesthesiology team performs a focused airway and cardiopulmonary assessment, establishes standard ASA monitors, places intravenous access, and induces general endotracheal anesthesia. Intraoperatively, an anesthesiologist provides continuous anesthetic management for the lumbar-region procedure, including hemodynamic optimization, intraoperative analgesia, neuromonitoring-friendly anesthetic technique, and emergence planning. Postoperatively the patient is transferred to the PACU for recovery and pain control with multimodal analgesia.

    This workflow reflects anesthesia services billed with 00630 (anesthesia for procedures in the lumbar region; not otherwise specified) and commonly accompanies lumbar spine surgical procedures such as decompression, fusion, or instrumentation for diagnoses including M54.5, M51.26, M47.816, and M53.3.

    Related CPT Codes

    CPT CodeDescription

    Related Modifiers

    12 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…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    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…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

    Showing 1–10 of 12

    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…
    367H00000XAnesthesiologist AssistantAn individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants …
    213EG0000XDeactivated - Podiatrist
    247100000XRadiologic TechnologistA medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and…
    2086S0102XSurgical Critical Care PhysicianA surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critica…
    207QB0505XDiabetology (Internal Medicine) PhysicianAn internist who specializes in diagnosis and management of type 1, type 2, gestational, and atypical diabetes; diabetes complications; hospital manag…
    171100000XAcupuncturistAn acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long,…

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    G54.1Lumbosacral plexus disorders
    M43.16Spondylolisthesis, lumbar region
    M47.26Other spondylosis with radiculopathy, lumbar region
    M47.27Other spondylosis with radiculopathy, lumbosacral region
    M47.816Spondylosis without myelopathy or radiculopathy, lumbar region
    M47.817Spondylosis without myelopathy or radiculopathy, lumbosacral region
    M48.06
    M48.07Spinal stenosis, lumbosacral region
    M51.26Other intervertebral disc displacement, lumbar region
    M51.27Other intervertebral disc displacement, lumbosacral region

    Showing 1–10 of 25

    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-00604-ANESTHESIA-CERVICAL-SPINE-SITTING-POSITION

    CPT 00604: Anesthesia for Cervical Spine and Spinal Cord Procedure, Sitting

    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-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
    00632Anesthesia for procedures in lumbar region; lumbar sympathectomyRelated when the lumbar procedure specifically is a lumbar sympathectomy; 00632 specifies anesthesia tailored to that procedure rather than the generic 00630.
    00635Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar punctureUsed when the lumbar-region service is a lumbar puncture; 00635 is the more specific anesthesia code for lumbar puncture procedures versus the general 00630.