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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Spine and Spinal CordCPT cpt-00670-anesthesia-spine-instrumentation-vascular-procedure
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    CPT 00670: Anesthesia for Extensive Spine and Spinal Cord Procedures

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

    CPT code 00670 describes anesthesia services for extensive spine and spinal cord procedures, including implantation of spinal instrumentation such as plates and screws to stabilize the spine and concurrent vascular procedures on blood vessels; service type: general/neuraxial anesthesia for major spine surgery; typical site of service: inpatient or ambulatory surgical center setting for complex spinal operations.

    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 00670 center around BUCA’s average commercial benchmark of $82.60, with individual commercial payers showing meaningful variation. Blue Cross Blue Shield’s interdecile spread (P75–P25) is $34.50, Cigna’s spread is $52.20, Aetna’s spread is $53.00, and UnitedHealth Group’s spread is $27.00, indicating Cigna and Aetna exhibit the widest mid‑distribution dispersion while UnitedHealth Group and Blue Cross Blue Shield are comparatively tighter.

    Beyond dispersion, payers also differ in central tendency: Blue Cross Blue Shield and UnitedHealth Group sit below BUCA’s average commercial benchmark on mean rates, while Cigna and Aetna have higher mean benchmarks. These differences reflect a mix of tighter contracted ranges for some payers and broader variability for others, with the largest P75–P25 gaps implying more heterogeneity in allowed amounts across locations or contracts.

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    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old male with chronic progressive low back pain, neurogenic claudication and bilateral lower-extremity radiculopathy is scheduled for complex lumbar spinal fusion with posterior segmental instrumentation and possible decompression. Preoperative evaluation documents diagnoses of M48.06 (spinal stenosis, lumbar region) and M51.26 (other intervertebral disc displacement, lumbar region), with intermittent severe axial low back pain M54.5 and prior lumbar compression fracture S32.9XXA noted. The operative plan includes open posterior lumbar decompression (laminectomy/foraminotomy), pedicle screw and rod fixation (instrumentation), and possible anterior interbody fusion if instability requires additional anterior approach.

    Perioperative workflow: preoperative assessment by anesthesia team (Anesthesiology or Certified Registered Nurse Anesthetist), intraoperative general endotracheal anesthesia with invasive monitoring for potential significant blood loss, intraoperative neuromonitoring as indicated, postoperative handoff to PACU and admission to an inpatient surgical unit with multimodal analgesia and pain-medicine consultation as needed.

    Typical site of service: inpatient hospital operating room given the extensive spine instrumentation and potential for vascular repair and significant blood loss.

    Service type: complex general anesthesia for extensive spine and spinal cord procedures with instrumentation and potential vascular procedures.

    Related CPT Codes

    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…
    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…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    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…

    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…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    261QM1000XMigrant Health Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    225200000XPhysical Therapy Assistant(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accred…
    125J00000XDental TherapistA Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the releva…
    231HA2400XAssistive Technology Practitioner AudiologistSpeech, Language and Hearing Service Providers · Audiologist
    101YP1600XPastoral CounselorBehavioral Health & Social Service Providers · Counselor

    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-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

    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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    CPT Code
    Description
    Relationship to This Procedure
    22840Posterior non-segmental instrumentation (e.g., Harrington rod technique)Alternative posterior instrumentation technique that may be performed in the same operative setting or as a historical/technical variant to 00670 cases.
    22842Posterior segmental instrumentationCommonly performed with spinal fusion and correlates directly to the instrumentation portion of the anesthetized procedure billed under 00670.
    63047Laminectomy, facetectomy and foraminotomy (unilateral or bilateral)Decompression procedure frequently performed before or with instrumentation during the same operative episode requiring the anesthesia services captured by 00670.
    22558Arthrodesis, anterior interbody technique, including minimal discectomyAnterior interbody fusion may be performed in the same admission or as a staged procedure and complements posterior instrumentation; anesthesia coverage for combined anterior-posterior procedures falls under complex anesthesia coding such as 00670.