Summary & Overview
CPT 00524: Anesthesia for Closed Drainage of Lung Fluid
CPT code 00524 represents anesthesia for closed drainage of lung fluid, a critical service in the management of intrathoracic conditions requiring fluid removal without open surgery. This code is widely used in inpatient hospital settings, reflecting its importance in acute care and respiratory management. Nationally, the code is recognized by major commercial payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for patients undergoing these procedures.
The publication provides a comprehensive overview of 00524, including payer coverage, clinical context, and related billing practices. Readers will gain insight into typical use cases, associated service types, and relevant policy updates impacting anesthesia billing for intrathoracic procedures. The summary also highlights common modifiers and taxonomies linked to this code, as well as related CPT and ICD-10 codes that may be encountered in clinical documentation. This information is valuable for understanding reimbursement benchmarks, compliance requirements, and the evolving landscape of anesthesia services in hospital settings.
CPT Code Overview
CPT code 00524 is used to report anesthesia services for closed drainage of lung fluid. This procedure falls under the category of Anesthesia – Intrathoracic Procedures, which involves providing anesthesia care during interventions within the chest cavity that do not require open surgical access. The typical site of service for this code is the inpatient hospital setting, specifically at Place of Service 21. This code is essential for accurately documenting and billing anesthesia care provided during closed thoracic procedures, ensuring proper reimbursement and compliance with clinical standards.
Clinical & Coding Specifications
Clinical Context
A patient is admitted to an inpatient hospital with symptoms such as shortness of breath and chest pain. Imaging reveals a collection of fluid within the pleural cavity, requiring closed drainage to relieve symptoms and prevent complications. An anesthesiology provider administers anesthesia for the closed drainage of lung fluid, ensuring patient comfort and safety during the intrathoracic procedure. The service is typically performed in an inpatient hospital setting, with anesthesia provided by an anesthesiologist, CRNA, or anesthesiologist assistant.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider is present and monitoring the patient, but not providing general anesthesia.QX: CRNA service with medical direction by a physician. Used when a Certified Registered Nurse Anesthetist (CRNA) provides the anesthesia service under the medical direction of a physician.
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Provider Taxonomies:
Code Specialty Name 207L00000XAnesthesiology 207LA0401XPain Medicine (Anesthesiology) 367H00000XAnesthesiologist Assistant
These taxonomies represent providers specializing in anesthesia and pain management, including anesthesiologists, pain medicine specialists, and anesthesiologist assistants.
Related Diagnoses
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S42.001A: Fracture of unspecified part of right clavicle, initial encounter for closed fracture- Relevant when lung fluid drainage is required due to trauma or injury to the clavicle.
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S42.002A: Fracture of unspecified part of left clavicle, initial encounter for closed fracture- Indicates trauma to the left clavicle, which may necessitate intrathoracic procedures such as lung fluid drainage.
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S42.101A: Fracture of unspecified part of right scapula, initial encounter for closed fracture- Associated with trauma to the right scapula, potentially leading to complications requiring lung fluid drainage.
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S42.102A: Fracture of unspecified part of left scapula, initial encounter for closed fracture- Indicates left scapula injury, which may result in pleural fluid accumulation needing drainage.
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M75.100: Unspecified rotator cuff tear or rupture of unspecified shoulder, not specified as traumatic- Relevant when shoulder injuries lead to conditions requiring intrathoracic procedures, such as closed drainage of lung fluid.
Related CPT Codes
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23410: Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; acute- Used for surgical repair of an acute rotator cuff rupture. May require anesthesia services similar to
00524if performed in the same intrathoracic region.
- Used for surgical repair of an acute rotator cuff rupture. May require anesthesia services similar to
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23412: Repair of ruptured musculotendinous cuff (e.g., rotator cuff) open; chronic- Used for surgical repair of a chronic rotator cuff rupture. Anesthesia for these procedures may be related to
00524in workflow.
- Used for surgical repair of a chronic rotator cuff rupture. Anesthesia for these procedures may be related to
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23420: Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)- Used for complex reconstruction of the shoulder cuff. Anesthesia services may overlap with those for closed drainage of lung fluid.
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20610: Arthrocentesis, aspiration and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa)- Used for aspiration or injection procedures. While not intrathoracic, anesthesia may be required for patient comfort.
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29827: Arthroscopy, shoulder, surgical; with rotator cuff repair- Used for minimally invasive surgical repair of the rotator cuff. Anesthesia services may be similar to those for closed drainage of lung fluid.
These codes may be used together in cases where multiple procedures are performed, or as alternatives depending on the clinical scenario.
National Reimbursement Benchmarks
For CPT code 00524, national mean rates among commercial payers (BUCA) average $123.38, while individual payer rates vary significantly. Blue Cross Blue Shield and Cigna report the highest mean rates at $213.48 and $248.09, respectively, whereas UnitedHealth Group is notably lower at $65.51. The BUCA mean rate is substantially higher than typical Medicare rates, though Medicare data is not available in the input for this code.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, is widest for Cigna ($259.00) and Aetna ($235.00), indicating greater variability in contracted rates. UnitedHealth Group shows the tightest range ($24.67), suggesting more consistent reimbursement levels across providers. The table and chart below present the full breakdown of national benchmarks for each payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska's reimbursement rates for CPT code 00524 show a wide spread between payers, with Blue Cross Blue Shield offering the highest mean rate and UnitedHealth Group the lowest. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($72.95) and BUCA ($137.28), indicating significant variability in payment levels. In contrast, Aetna and UnitedHealth Group have minimal rate spreads, both with only a $4 difference between the 25th and 75th percentiles, suggesting more uniform payment structures.
Compared to national averages, Alaska generally exhibits higher mean rates for most payers except Cigna, which is notably lower in Alaska than nationally. The table and chart below present the full breakdown of payer-specific rates, highlighting the distinct reimbursement landscape in Alaska for CPT code 00524.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 00524 in Alaska, with a mean rate of $268.78.
- UnitedHealth Group offers the lowest mean rate at $75.12.
- Cigna's mean rate in Alaska ($89.33) is significantly lower than its national average ($248.09), while Blue Cross Blue Shield's Alaska mean rate is notably higher than its national mean ($213.48).
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.