Summary & Overview
CPT 01922: Anesthesia for Non-Invasive Imaging or Radiation Therapy Procedures
CPT code 01922 covers anesthesia services for non-invasive imaging or radiation therapy procedures, a vital component in modern medical care for patients undergoing diagnostic or therapeutic radiological interventions. This code is particularly relevant for cases where patient cooperation or comfort necessitates anesthesia, such as pediatric imaging or complex radiation therapy sessions. The service is most commonly performed in outpatient hospital settings, reflecting the shift toward ambulatory care for many radiological procedures.
Major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare recognize and reimburse for CPT code 01922, underscoring its widespread clinical and billing significance. The publication provides an overview of payer coverage, typical clinical scenarios, and the operational context for anesthesia in radiology. Readers will gain insights into current benchmarks, policy updates, and the clinical rationale for anesthesia use in non-invasive imaging and radiation therapy. The summary also highlights the importance of accurate coding and documentation to ensure appropriate reimbursement and compliance with payer requirements.
Key topics include the role of anesthesia in facilitating patient care during radiological procedures, payer coverage trends, and the evolving landscape of outpatient hospital services. This information is essential for healthcare administrators, billing professionals, and clinicians seeking to understand the national context for CPT code 01922.
CPT Code Overview
CPT code 01922 is used to report anesthesia services provided for non-invasive imaging or radiation therapy procedures. This code applies to cases where anesthesia is required to facilitate radiological procedures that do not involve surgical intervention. The typical site of service for these procedures is an outpatient hospital setting, designated as Place of Service 22. Providers specializing in anesthesia play a critical role in ensuring patient comfort and safety during these diagnostic and therapeutic imaging sessions.
Clinical & Coding Specifications
Clinical Context
A patient diagnosed with a malignant neoplasm, such as cancer of the lung, breast, or prostate, is scheduled for non-invasive imaging or radiation therapy as part of their treatment plan. The procedure is performed in an outpatient hospital setting. Due to the complexity or duration of the imaging or radiation therapy, anesthesia services are required to ensure patient comfort and immobility. An anesthesiologist or a certified registered nurse anesthetist (CRNA) provides monitored anesthesia care during the procedure, coordinating with the radiology and oncology teams to optimize safety and procedural outcomes.
Coding Specifications
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Modifiers:
Modifier Code Description QSMonitored anesthesia care service QXCRNA service with medical direction by a physician - Modifier
QSis used when monitored anesthesia care is provided. - Modifier
QXis used when a CRNA delivers the anesthesia service under physician medical direction.
- Modifier
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Provider Taxonomies:
Taxonomy Code Specialty 207L00000XAnesthesiology 207LA0401XPain Medicine (Anesthesiology) 367500000XCertified Registered Nurse Anesthetist - These taxonomies represent providers specializing in anesthesia and pain management, including CRNAs.
Related Diagnoses
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Z51.0- Encounter for antineoplastic radiation therapy- Indicates the patient is receiving radiation therapy for cancer treatment, directly relevant to the use of anesthesia during such procedures.
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Z51.11- Encounter for antineoplastic chemotherapy- Represents a patient undergoing chemotherapy. May be relevant if imaging or radiation therapy is part of the overall cancer management plan.
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C34.90- Malignant neoplasm of unspecified part of bronchus or lung- Used for patients with lung cancer, who may require imaging or radiation therapy procedures necessitating anesthesia.
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C50.919- Malignant neoplasm of unspecified site of unspecified female breast- Applies to breast cancer patients, often needing imaging or radiation therapy as part of their treatment, where anesthesia may be required.
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C61- Malignant neoplasm of prostate- Used for prostate cancer patients, who may undergo imaging or radiation therapy procedures with anesthesia support.
Related CPT Codes
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01920- Anesthesia for diagnostic imaging procedures- Used when anesthesia is required for diagnostic imaging, such as MRI or CT scans. May be used in conjunction with or as an alternative to
01922depending on the procedure type.
- Used when anesthesia is required for diagnostic imaging, such as MRI or CT scans. May be used in conjunction with or as an alternative to
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01921- Anesthesia for therapeutic radiological procedures- Applied when anesthesia is needed for therapeutic radiology, such as interventional procedures. Related to
01922but focused on therapeutic rather than non-invasive imaging or radiation therapy.
- Applied when anesthesia is needed for therapeutic radiology, such as interventional procedures. Related to
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01924- Anesthesia for procedures on the eye- Used for anesthesia during eye procedures. Not typically used with
01922, but may be relevant if imaging or radiation involves the eye.
- Used for anesthesia during eye procedures. Not typically used with
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01925- Anesthesia for procedures on the ear- Used for anesthesia during ear procedures. Similar to
01924, not commonly paired with01922unless imaging or radiation involves the ear.
- Used for anesthesia during ear procedures. Similar to
National Reimbursement Benchmarks
National mean rates for CPT code 01922 show that BUCA (average commercial) pays $239.50, while Medicare rates are not available in the input. Among individual commercial payers, Aetna and Cigna have the highest mean rates at $410.65 and $402.28, respectively, while UnitedHealth Group is significantly lower at $65.61.
Rate dispersion varies notably across payers. Aetna exhibits the widest spread, with a difference of $605.22 between its 75th and 25th percentiles, indicating substantial variability in contracted rates. In contrast, UnitedHealth Group has the tightest range, with only $25.08 separating its 75th and 25th percentiles, suggesting more consistent reimbursement levels. Blue Cross Blue Shield and Cigna fall in between, with ranges of $182.30 and $519.00, respectively.
The table and chart below present the full breakdown of national benchmarks for CPT code 01922 by payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska exhibits a wide spread in reimbursement rates for CPT code 01922 across commercial payers. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($225.75) and BUCA ($270.67), indicating significant variability in payment levels. In contrast, Aetna and UnitedHealth Group show minimal spread ($0), suggesting uniformity in their rates. Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are notably higher, while Cigna and UnitedHealth Group are substantially lower than their respective national benchmarks.
The table and chart below present the full breakdown of mean rates and percentile values for each payer in Alaska, highlighting the differences in reimbursement levels and the range of payments available for CPT code 01922.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 01922 in Alaska, with a mean rate of $480.52.
- UnitedHealth Group offers the lowest mean rate at $74.78, significantly below both state and national averages.
- Cigna's mean rate in Alaska ($89.33) is much lower than its national mean ($402.28), indicating a substantial deviation.
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.