Summary & Overview
CPT 00350: Anesthesia for Major Vessels of the Neck
Headline: CPT 00350: Anesthesia for Major Neck Vessel Procedures — National Overview
Lead: CPT 00350 designates anesthesiology services for procedures on major vessels of the neck when no more specific anesthesia code applies. This code captures perioperative anesthesia care for high-risk vascular procedures affecting carotid and other major cervical arteries.
What the code represents and why it matters: CPT 00350 identifies anesthesia services for complex neck vascular procedures that carry elevated neurologic and cardiopulmonary risk. Nationally, accurate use of this code affects clinical documentation, billing clarity, and alignment of anesthesiology resources with procedural intensity.
Key payers covered: This overview addresses policy and billing considerations relevant to Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
Overview of reader takeaways: Readers will find a concise reference to the clinical context and service setting for CPT 00350, common coding adjacency, and payer relevance. The publication provides benchmarks and policy-oriented context for anesthesiology services tied to neck vessel procedures, highlights documentation elements that typically support use of the code, and summarizes payer coverage considerations and coding relationships to related anesthesia codes.
Scope and limitations: This summary is national in scope. Detailed fee schedules, state-specific rules, and payer-specific authorization requirements are outside the summary; where information is unavailable, the publication notes "Data not available in the input."
CPT Code Overview
CPT 00350 describes anesthesia for procedures on major vessels of the neck; not otherwise specified. This code applies to anesthesiology services provided during surgical or endovascular procedures involving major cervical vasculature. The service type is Anesthesiology. The typical site of service is Inpatient Hospital (POS 21).
Clinical & Coding Specifications
A patient with symptomatic carotid artery disease is admitted to the inpatient hospital for surgical intervention on major neck vessels, such as carotid endarterectomy for severe carotid stenosis or repair of carotid artery occlusion. Preoperative evaluation includes neurologic assessment, vascular imaging (duplex ultrasound, CT angiography), and anesthetic risk assessment. On the day of surgery, the anesthesiology team (anesthesiologist or Certified Registered Nurse Anesthetist) provides general or regional anesthesia tailored to vascular surgery, secures hemodynamic stability, and facilitates intraoperative neurophysiologic monitoring when indicated. Postoperative care occurs in the inpatient setting with focused monitoring for neurologic deficits, hemodynamic changes, and vascular complications.
Modifiers:
-
QS- Monitored anesthesia care service- Use when the service furnished is monitored anesthesia care rather than general anesthesia; documents monitoring intensity and anesthesia personnel involved.
-
QX- CRNA service with medical direction by a physician- Use when a Certified Registered Nurse Anesthetist (CRNA) provides the anesthesia service while a physician anesthesiologist provides medical direction as defined by applicable payer rules.
Provider Taxonomies:
| Taxonomy Code | Specialty |
|---|---|
207L00000X | Anesthesiology |
367500000X | Certified Registered Nurse Anesthetist |
207LC0200X | Critical Care Medicine (Anesthesiology) |
Related Diagnoses:
-
I65.21- Occlusion and stenosis of right carotid artery- Relevant as a common indication for surgical intervention on major neck vessels, which may require anesthesia covered by
00350.
- Relevant as a common indication for surgical intervention on major neck vessels, which may require anesthesia covered by
-
I65.22- Occlusion and stenosis of left carotid artery- Relevant as an indication for left-sided carotid procedures requiring anesthetic management for major vessel surgery.
-
I65.23- Occlusion and stenosis of bilateral carotid arteries- Relevant when bilateral carotid disease necessitates operative intervention on major neck vessels; anesthesia planning may reflect bilateral disease complexity.
-
I65.29- Occlusion and stenosis of unspecified carotid artery- Relevant when documentation does not specify laterality but the procedure involves major carotid vessels.
-
I66.9- Occlusion and stenosis of unspecified cerebral artery- Relevant when cerebrovascular arterial occlusion or stenosis is part of the clinical picture leading to neck vessel procedures that require anesthesia services.
Related CPT Codes:
| CPT Code | Description |
|---|---|
00352 | Anesthesia for procedures on major vessels of neck; simple ligation |
Clinical relationship:
-
00352is a related anesthesia code for procedures on major neck vessels that are classified as a simpler ligation procedure; it may be used as an alternative when the surgical procedure is limited to simple ligation rather than more complex vascular reconstruction. -
00352can be used in the same clinical workflow as00350when the documented surgical procedure matches the simpler service definition; these codes are alternatives based on procedural complexity and the specific operative service performed.
National Reimbursement Benchmarks
National average commercial rates exceed Medicare for CPT 00350 when comparing BUCA (average commercial proxy) to Medicare; BUCA's mean rate of $256.28 is substantially higher than Medicare's rate as represented here ($0.00), indicating a notable gap between commercial contracting levels and the Medicare baseline.
Rate dispersion varies considerably across payers. Cigna shows the widest spread (P75 − P25 = $775.67), followed by BCBS (P75 − P25 = $235.25) and BUCA (P75 − P25 = $355.50). Aetna and UnitedHealth Group are tighter in distribution by these percentiles, with Aetna's interquartile range at $630.00 and UnitedHealth Group the tightest at $25.67. The table and chart below present the full breakdown.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a wide spread in reimbursement rates for CPT code 00350, with Blue Cross Blue Shield offering the highest mean rate at $635.68 and UnitedHealth Group the lowest at $75.12. The rate spread is most pronounced for Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $219.50, indicating substantial variability in payments. In contrast, Aetna, Cigna, and UnitedHealth Group show minimal spread, with their 25th and 75th percentiles nearly identical, suggesting consistent rates across providers.
Compared to national averages, Alaska's mean rates for Aetna and Blue Cross Blue Shield are notably higher, while Cigna and UnitedHealth Group are close to or below their national benchmarks. The table and chart below present the full breakdown of payer-specific rates in Alaska, highlighting these differences and the overall distribution.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 00350 in Alaska, with a mean rate of $635.68.
- UnitedHealth Group offers the lowest mean rate at $75.12.
- Mean rates for Aetna and Blue Cross Blue Shield in Alaska are significantly higher than their respective national averages, while Cigna and UnitedHealth Group are close to or below national benchmarks.
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.