CPT 00635: Anesthesia for Lumbar Procedures Including Lumbar Puncture
Commercial payers pay $83 on average nationally for this procedure.
CPT code 00635 describes anesthesia services provided for procedures in the lumbar region, including diagnostic or therapeutic lumbar puncture, typically delivered as regional or general anesthesia in an operating room or procedure suite setting for spine 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
Commercial reimbursement for CPT 00635 clusters around BUCA’s average commercial rate of $83.3, with individual payers showing meaningful differences in central tendency and spread. Aetna and Cigna sit above BUCA on mean and median values (Aetna mean $113.6, median $93.8; Cigna mean $91.4, median $84.4), while Blue Cross Blue Shield’s mean ($75.7) and UnitedHealth Group’s mean ($67.9) fall below BUCA’s average. Minimums and maximums amplify Aetna’s higher ceiling ($314.1 max) and Blue Cross Blue Shield’s lower floor ($3.3 min), highlighting asymmetry across the market.
Dispersion measured by the interquartile spread (P75–P25) is widest for Aetna at $101.0 (P75 $156.2 minus P25 $51.2), followed by Cigna at $41.5 (P75 $108.1 minus P25 $67.6). Blue Cross Blue Shield shows a moderate IQR of $39.4 (P75 $94.9 minus P25 $54.9), BUCA’s IQR is $44.9 (P75 $105.0 minus P25 $56.1), and UnitedHealth Group is the tightest at $30.9 (P75 $81.1 minus P25 $52.0), indicating the most consistent commercial rates among the listed payers.