Summary & Overview
CPT 00550: Anesthesia for Direct Coronary Artery Bypass Grafting, Without Pump Oxygenator
CPT 00550 represents the anesthesia service for direct coronary artery bypass grafting performed without a pump oxygenator (off‑pump CABG). This code is used to document the anesthetic management of patients undergoing major cardiac surgery where a cardiopulmonary bypass machine is not employed. The distinction between on‑pump and off‑pump CABG has implications for procedure coding, intraoperative monitoring, and perioperative resource use, making accurate code selection important for clinical documentation and billing.
Major national payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Coverage and payment policies from these carriers affect how facilities and anesthesiology teams report the service and may influence modifier application and bundling considerations handled elsewhere in the publication.
Readers will find a concise overview of the clinical context for 00550, its relationship to related surgical and anesthesia codes, and the common diagnostic indications that typically accompany its use. The publication provides operational benchmarks, coding guidance, and comparisons to related anesthesia codes for cardiac procedures. Where input fields lacked details, the publication notes "Data not available in the input." The focus is national in scope and intended for clinicians, coding professionals, and administrative staff seeking clear, non‑prescriptive information about this anesthesia code.
CPT Code Overview
CPT 00550 describes anesthesia for direct coronary artery bypass grafting; without pump oxygenator. This procedure-specific anesthesia service is categorized under Anesthesiology and is typically provided in an Inpatient Hospital (POS 21) setting. The code denotes anesthetic management during coronary artery bypass grafting (CABG) performed without the use of a cardiopulmonary bypass pump (off‑pump CABG).
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with symptomatic coronary artery disease is admitted to the inpatient hospital for direct coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG). Preoperative evaluation documents atherosclerotic disease of the native coronary arteries, with episodes of angina. The anesthesiology team provides general endotracheal anesthesia in the operating room, monitors invasive arterial pressure and central venous pressure, manages hemodynamics during grafting on the beating heart, and facilitates postoperative transfer to the cardiac intensive care unit for continued monitoring and ventilatory support.
Coding Specifications
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Modifiers:
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QS: Monitored anesthesia care service. Use when monitored anesthesia care is provided for procedures where MAC is appropriate. -
QX: CRNA service with medical direction by a physician. Use when a certified registered nurse anesthetist (CRNA) furnishes the anesthesia service under the medical direction of a physician and reporting requires this modifier. -
Associated provider taxonomies:
| Taxonomy Code | Specialty |
|---|---|
207L00000X | Anesthesiology |
207RC0000X | Cardiovascular Disease Physician |
207RG0300X | Geriatric Medicine Physician |
Related Diagnoses
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I25.10: Atherosclerotic heart disease of native coronary artery without angina pectorisClinical relevance: Indicates obstructive coronary atherosclerosis that may necessitate coronary artery bypass grafting without cardiopulmonary bypass when ischemia is present or lesion severity warrants revascularization.
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I25.110: Atherosclerotic heart disease of native coronary artery with unstable angina pectorisClinical relevance: Represents active ischemia and unstable symptoms that commonly prompt urgent or emergent CABG; anesthesia management must account for hemodynamic instability.
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I25.119: Atherosclerotic heart disease of native coronary artery with unspecified angina pectorisClinical relevance: Denotes symptomatic coronary artery disease with angina, supporting the medical necessity for surgical revascularization and associated anesthesia services.
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I25.700: Atherosclerosis of coronary artery bypass graft(s), unspecified, with unstable angina pectorisClinical relevance: Reflects pathology in previous bypass grafts with unstable angina, which may require repeat bypass or graft revision; anesthetic care for reoperation is reported with
00550when performed off-pump. -
I25.709: Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectorisClinical relevance: Indicates graft atherosclerosis with angina symptoms; supports need for surgical intervention and corresponding anesthesia services.
Related CPT Codes
| CPT Code | Description | Relationship to 00550 |
|---|---|---|
33510 | Coronary artery bypass, vein only; single coronary venous graft | Often the primary surgical procedure for which anesthesia 00550 is provided when a single venous graft is used. Commonly used together when vein grafting is performed off-pump. |
33533 | Coronary artery bypass, using arterial graft(s); single arterial graft | Alternative surgical technique using arterial grafts; anesthesia 00550 applies when the bypass is performed without pump oxygenator on the beating heart. |
00560 | Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator | Related anesthesia code for cases that require cardiopulmonary bypass with pump oxygenator; contrasts with 00550 which is without pump. |
36620 | Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous | Adjunct monitoring procedure frequently performed perioperatively for invasive arterial pressure monitoring during CABG anesthesia; billed separately when performed as a distinct procedure. |
National Reimbursement Benchmarks
National mean rates show that Medicare is substantially lower than the BUCA (average commercial) benchmark when comparing mean values: Medicare mean is not present in the input while BUCA mean is $240.07, indicating higher commercial averages relative to the unavailable Medicare mean. The full payer breakdown is presented in the table and chart below.
Rate dispersion (P75 minus P25) varies by payer. Cigna and BCBS show the widest spread (Cigna: $777.00; BCBS: $325.00), indicating larger variability in allowed rates, while UnitedHealth Group and Aetna are among the tightest (UHC: $25.00; Aetna: $565.00 shows wider than UHC but tighter than Cigna by percentile spread). See the table and chart below for the complete percentile and mean details.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a wide rate spread for CPT code 00550, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $222.00 ($740.00 minus $518.00). In contrast, Aetna, Cigna, and UnitedHealth Group show minimal rate variation, with spreads of $0.00 to $8.00, indicating highly standardized reimbursement rates for these payers. Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and Aetna are notably higher, while UnitedHealth Group and Cigna are only slightly above or below their respective national means.
The table and chart below present the full breakdown of mean rates and percentile values for each payer in Alaska, highlighting the significant differences in reimbursement levels across payers.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 00550 in Alaska, with a mean rate of $635.09.
- UnitedHealth Group offers the lowest mean rate at $75.12.
- Alaska's mean rates for most payers, especially Blue Cross Blue Shield, are significantly higher than national averages, except for UnitedHealth Group, which is only slightly above the national mean.
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