Summary & Overview
CPT 00214: Anesthesia for Intracranial Burr Holes with Ventricular Access
CPT code 00214 covers anesthesia services for intracranial procedures involving burr holes with ventricular access, a critical component in neurosurgical care. This code is nationally recognized and utilized in outpatient hospital settings, reflecting its importance in facilitating safe and effective surgical interventions for conditions requiring ventricular access. The publication examines coverage and policy benchmarks from major payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, providing a comprehensive overview of payer policies and reimbursement trends.
Readers will gain insight into the clinical context of 00214, including its role in neurosurgery, typical service environments, and associated billing practices. The summary also highlights relevant modifiers and taxonomies, offering clarity on coding nuances and professional classifications. Additionally, the publication outlines related CPT codes and common ICD-10 diagnoses linked to intracranial procedures, equipping stakeholders with a thorough understanding of the code's application and payer landscape. This resource is designed to inform healthcare professionals, administrators, and policy analysts about current standards and updates in anesthesia billing for intracranial procedures.
CPT Code Overview
CPT code 00214 is designated for anesthesia services during intracranial procedures involving burr holes with ventricular access. This code is used when anesthesia is provided for patients undergoing neurosurgical interventions that require the creation of burr holes and access to the ventricular system. The typical site of service for this procedure is an outpatient hospital setting, classified as Place of Service 22. As a specialized anesthesia code, 00214 is integral to ensuring patient safety and comfort during complex intracranial operations.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital with symptoms suggestive of increased intracranial pressure or hydrocephalus, such as headache, nausea, or altered mental status. The neurosurgical team determines that an intracranial procedure involving burr holes with ventricular access is necessary, often for the placement of a ventricular drain or shunt. An anesthesiologist provides anesthesia services throughout the procedure, ensuring patient safety and comfort. The workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative care in the recovery area. The procedure is typically performed by providers specializing in anesthesiology, pain medicine (anesthesiology), or pediatric anesthesiology, depending on patient age and complexity.
Coding Specifications
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Modifiers:
Modifier Code Description Usage QSMonitored anesthesia care service Used when anesthesia is provided as monitored anesthesia care rather than general anesthesia. P1A normal healthy patient Indicates the patient has no systemic disease and is otherwise healthy. -
Provider Taxonomies:
Taxonomy Code Specialty 207L00000XAnesthesiology 207LA0401XPain Medicine (Anesthesiology) 207LP2900XPediatric Anesthesiology
These taxonomies represent the specialties qualified to provide anesthesia services for intracranial procedures.
Related Diagnoses
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M75.100- Unspecified rotator cuff tear or rupture of unspecified shoulder- Not directly relevant to intracranial procedures; may be present as a comorbidity or unrelated diagnosis.
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S43.401A- Sprain of unspecified acromioclavicular joint, initial encounter- Not directly related to intracranial anesthesia; could be a comorbid condition.
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M19.011- Primary osteoarthritis, right shoulder- Unrelated to intracranial procedures; may be documented as a comorbidity.
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M19.012- Primary osteoarthritis, left shoulder- Not clinically relevant to the intracranial procedure; possible comorbidity.
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S42.001A- Fracture of unspecified part of right clavicle, initial encounter- Not directly associated with intracranial anesthesia; may be present in trauma cases where multiple injuries are managed.
None of the listed ICD-10 codes are directly relevant to the clinical scenario for CPT code 00214, but they may be documented as comorbidities or in cases of polytrauma.
Related CPT Codes
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00210- ANESTHESIA INTRACRANIAL PROCEDURES NOS- Used for anesthesia services during unspecified intracranial procedures; may be an alternative to
00214when the procedure is not specifically burr holes with ventricular access.
- Used for anesthesia services during unspecified intracranial procedures; may be an alternative to
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00211- ANES ICR PX CRANIOTOMY/CRANIECTOMY HMTMA- Used for anesthesia during craniotomy or craniectomy for hematoma evacuation; related when the procedure involves more extensive skull opening.
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00212- ANESTHESIA INTRACRANIAL PROCEDURE SUBDURAL TAPS- Used for anesthesia during subdural taps; may be performed in similar clinical scenarios as burr holes.
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00215- ANES ICR PX CRNOP/ELEVATION DEPRS SKULL FX XDRL- Used for anesthesia during elevation of depressed skull fractures; related in cases of traumatic injury.
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00216- ANESTHESIA INTRACRANIAL PX VASCULAR PROCEDURES- Used for anesthesia during intracranial vascular procedures; alternative when vascular access or repair is required.
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00218- ANES INTRACRANIAL PROCEDURE IN SITTING POSITION- Used for anesthesia when the procedure is performed in the sitting position; may be used in specific neurosurgical approaches.
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00220- ANES ICR PX CEREBROSPINAL FLUID SHUNTING PX- Used for anesthesia during cerebrospinal fluid shunting procedures; commonly used together with
00214if shunt placement follows burr holes.
- Used for anesthesia during cerebrospinal fluid shunting procedures; commonly used together with
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00222- ANES INTRACRANIAL PX ELECTROCOAGULATION ICR NRV- Used for anesthesia during intracranial electrocoagulation of nerves; alternative for procedures targeting neural structures.
National Reimbursement Benchmarks
National mean rates for CPT code 00214 show significant variation between payers. The average commercial rate (BUCA) is $231.19, which is substantially higher than the UnitedHealth Group mean rate of $65.47. Among the major commercial payers, Cigna and Blue Cross Blue Shield have the highest mean rates at $500.10 and $487.87, respectively, while Aetna is lower at $320.38.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies widely. UnitedHealth Group has the tightest range ($24.83), indicating less variability in rates, while Cigna exhibits the widest range ($690.50), reflecting significant rate spread. Blue Cross Blue Shield and Aetna also show considerable dispersion, with ranges of $288.42 and $535.75, respectively. The table and chart below present the full breakdown of national benchmarks for this code.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska demonstrates a substantial rate spread for CPT code 00214, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $330.60 ($800.00 minus $469.40). BUCA also shows a wide spread of $360.80, while Aetna, Cigna, and UnitedHealth Group have much narrower spreads, all under $21.00. This indicates significant variability in reimbursement depending on payer, with some offering consistently low rates and others much higher.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are considerably higher, while Aetna, Cigna, and UnitedHealth Group are closer to or slightly above their national benchmarks. The table and chart below present the full breakdown of payer-specific rates and percentiles for Alaska.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 00214 in Alaska, with a mean rate of $617.30.
- UnitedHealth Group offers the lowest mean rate at $75.12, significantly below both the state and national averages.
- Alaska's mean rates for most payers, especially BCBS and BUCA, are notably higher than their respective national averages, indicating a premium reimbursement environment.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.