CPT 00640: Anesthesia for Manipulation or Closed Procedure on the Spine
Commercial payers pay $79 on average nationally for this procedure.
CPT code 00640 describes anesthesia services provided for a patient undergoing manipulation of the spine or a closed procedure on the cervical, thoracic, or lumbar spine; service type: anesthesia for spine manipulation/closed spinal procedures; typical site of service: hospital operating room or ambulatory surgery center where closed spinal procedures or spinal manipulations are 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 00640 cluster around the BUCA average commercial rate of $78.80, with payers showing meaningful variation. Cigna posts a higher mean ($105) and wider upper tail (P90 $176.80), while Blue Cross Blue Shield averages $78.10. Aetna and UnitedHealth Group sit below BUCA on median/mean metrics with means of $65 and $68.40 respectively. This places BUCA near the market center but not at the lowest or highest extremes.
Rate dispersion (P75 minus P25) highlights where commercial contracts are tighter or more spread. Aetna’s dispersion is $45.0, Blue Cross Blue Shield’s is $44.6, BUCA’s is $45.5, and UnitedHealth Group’s is $26.3, making UnitedHealth Group the tightest spread. Cigna shows the widest dispersion at $61.9, indicating greater variability among high-end commercial payments for this code.