{"id":163339,"date":"2026-07-27T11:53:35","date_gmt":"2026-07-27T11:53:35","guid":{"rendered":"https:\/\/pabau.com\/?p=163339"},"modified":"2026-08-17T11:45:50","modified_gmt":"2026-08-17T11:45:50","slug":"cpt-code-00450","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/","title":{"rendered":"CPT Code 00450: Anesthesia for clavicle and scapula procedures"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 00450: Anesthesia for Clavicle and Scapula Procedures\",\"description\":\"Complete reference for CPT Code 00450 (anesthesia for procedures on the clavicle and scapula, not otherwise specified). Covers base units, Medicare fee schedule 2026, modifiers, ICD-10 crosswalk, and documentation requirements.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00450\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-07-25\",\"dateModified\":\"2026-07-25\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key Takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key Takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT Code 00450 covers anesthesia for surgical procedures on the clavicle and scapula, not otherwise specified, as defined by the American Medical Association (AMA).<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Base units for 00450 are 5, used in the standard anesthesia reimbursement formula: (base units + time units) x conversion factor.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Modifier selection (AA, QK, QX, QZ) determines how the claim is paid under Medicare; incorrect modifier use is a leading audit trigger for this code.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Pabau&rsquo;s claims management software helps practices track claim status, flag missing required details before submission, and reconcile insurer payments from one dashboard.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT Code 00450 is the anesthesia code for surgical procedures on the clavicle and scapula that don&rsquo;t have a more specific code assigned. It carries 5 base units and covers a broad range of shoulder-girdle surgeries, from clavicle fracture repair to scapulectomy, delivered as general anesthesia, regional anesthesia, or monitored anesthesia care (MAC).<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div>\n<\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">This reference covers the full clinical scope of CPT Code 00450, including its 2026 Medicare fee schedule, base unit value, applicable anesthesia modifiers, ICD-10 crosswalk, documentation requirements, and CRNA (Certified Registered Nurse Anesthetist) billing rules, along with the compliance pitfalls that most often trigger a payer audit or claim denial.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">CPT Code 00450: definition and clinical scope<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 00450 describes anesthesia services for surgical procedures performed on the clavicle and scapula, not otherwise specified. It sits within the Anesthesia section of the <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">AMA&rsquo;s CPT code set<\/a>, under the subsection covering procedures on the shoulder girdle.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The \u00ab\u00a0not otherwise specified\u00a0\u00bb (NOS) descriptor is important. It signals that no more specific anesthesia code exists for the procedure being performed. Coders should always verify whether a more specific code applies before defaulting to 00450.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CPT 00450<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Full descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for procedures on clavicle and scapula; not otherwise specified<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code section<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia (00100-01999)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Subsection<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Procedures on the shoulder girdle (clavicle and scapula)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Base units<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Anesthesia type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">General, regional, or monitored anesthesia care (MAC)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Maintained by<\/td>\n<td style=\"padding:12px 16px;color:#374151\">American Medical Association (AMA)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\">Clinical procedures covered by CPT Code 00450<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 00450 applies when a patient undergoes surgery on the clavicle or scapula and requires anesthesia services. The range of qualifying procedures is broad, reflecting the NOS designation. Orthopedic and sports medicine practices bill it most often for post-injury clavicle repairs.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Clavicle fracture open reduction and internal fixation (ORIF)<\/strong> &#8211; the most frequently billed procedure paired with 00450<\/li><li><strong>Clavicle excision or resection<\/strong> &#8211; including distal clavicle excision for acromioclavicular joint pathology<\/li><li><strong>Scapula fracture repair<\/strong> &#8211; surgical stabilization of displaced scapular fractures<\/li><li><strong>Scapulectomy (partial or total)<\/strong> &#8211; resection procedures for tumor or chronic infection<\/li><li><strong>Clavicle biopsy<\/strong> &#8211; open biopsy for suspected neoplasm or infection<\/li><li><strong>Shoulder girdle decompression<\/strong> &#8211; procedures on the clavicle or scapula not covered by a more specific anesthesia code<\/li><li><strong>Pseudarthrosis repair<\/strong> &#8211; surgical correction of failed clavicle fracture union<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">If the procedure involves the glenohumeral joint, humeral head, or acromioclavicular joint as the primary surgical site, a different anesthesia code may apply. Head and neck procedures. Always cross-reference the operative report against the CPT anesthesia code hierarchy before billing 00450.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Anesthesia base units for CPT Code 00450<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The American Society of Anesthesiologists (ASA) assigns base units to each anesthesia CPT code based on the complexity and risk of the associated surgical procedure. CPT Code 00450 carries a base unit value of <strong>5<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Base units are the starting point for every anesthesia reimbursement calculation. They reflect the inherent difficulty of providing anesthesia for that category of procedure, independent of how long the case takes. You can verify current base unit values through the <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU 2026 RVU lookup tool<\/a>, which pulls CMS data directly.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Value for 00450<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Base units (B)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Assigned by ASA Relative Value Guide; reflects procedure complexity<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Time units (T)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Variable<\/td>\n<td style=\"padding:12px 16px;color:#374151\">1 unit per 15 minutes of anesthesia time (payer-specific; some use 10-minute increments)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Qualifying circumstances<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Variable<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Add-on units from codes 99100, 99116, 99135, 99140 when applicable<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Conversion factor (CF)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CMS-published annually<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicare 2026 anesthesia CF varies by locality; check CMS fee schedule<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Comparing <a href=\"https:\/\/pabau.com\/blog\/best-medical-practice-management-software\/\">practice management systems for medical teams<\/a> is worth the effort before anesthesia time-unit billing becomes a spreadsheet job.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How anesthesia reimbursement is calculated using CPT Code 00450<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare and most commercial payers use a standardized formula to calculate anesthesia reimbursement. The formula is: <strong>(Base Units + Time Units + Qualifying Circumstance Units) x Conversion Factor = Allowed Amount<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Here is a worked example for CPT Code 00450 under Medicare:<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li><strong>Base units:<\/strong> 5 (fixed for 00450)<\/li><li><strong>Time units:<\/strong> 4 (a 60-minute procedure at 1 unit per 15 minutes)<\/li><li><strong>Qualifying circumstances:<\/strong> 1 (if the patient is under age 1 or over age 70, add 1 unit via code 99100)<\/li><li><strong>Total units:<\/strong> 5 + 4 + 1 = 10<\/li><li><strong>Conversion factor (example):<\/strong> $20.32 per unit (2025 national rate; the 2026 rate is set annually by CMS via the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">Physician Fee Schedule<\/a>)<\/li><li><strong>Allowed amount:<\/strong> 10 x $20.32 = $203.20<\/li><\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">Actual reimbursement varies by locality, payer contract, and whether qualifying circumstance add-on codes apply. The conversion factor changes each January 1 under the Medicare Physician Fee Schedule Final Rule.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Track anesthesia start and stop times precisely. One missed 15-minute interval across a full day of cases can represent hundreds of dollars in underbilled time units per anesthesiologist. Build a consistent timestamping protocol into your anesthesia record template and audit it quarterly.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">2026 Medicare fee schedule for CPT Code 00450<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare publishes locality-adjusted anesthesia conversion factors annually. The national rate below is illustrative; your actual reimbursement depends on the CMS locality for your practice&rsquo;s billing address. Check the procedure code fee schedule reference for multi-payer context.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Scenario<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Base Units<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Time Units (example)<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Approx. Medicare rate*<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">30-minute procedure, no QC<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$142 (national estimate)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">60-minute procedure, no QC<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$183 (national estimate)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">90-minute procedure, with 99100<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">6 + 1 QC<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$244 (national estimate)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">*Approximate figures based on a national conversion factor near $20.32 per unit. Always verify the current CMS-published rate for your locality before submitting claims. The 2026 final conversion factor is set in the CMS Physician Fee Schedule Final Rule. QC in the table above stands for qualifying circumstances, the add-on units covered in detail below.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Simplify anesthesia billing and claim tracking                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&rsquo;s claims management tools help surgical and anesthesia practices track claim status, flag missing required details before submission, and reconcile insurer payments across CPT code categories.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 class=\"wp-block-heading\">Applicable modifiers for CPT Code 00450<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Anesthesia modifier selection is the most consequential billing decision for CPT Code 00450. The modifier tells the payer who performed the anesthesia and under what supervisory arrangement. Selecting the wrong modifier is one of the top reasons for denied and down-coded claims.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Who uses it<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Scenario<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Medicare rate<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia personally performed by the physician anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100% of allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QK<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical direction of 2-4 CRNA\/AA concurrent procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QX<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA service with medical direction by a physician<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QY<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical direction of one CRNA by one anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QZ<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA service without medical direction<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100% of allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AD<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical supervision of more than 4 concurrent procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3 base units only<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">QK and QX are always billed as a pair: the supervising anesthesiologist bills QK, and the CRNA bills QX on a separate claim for the same case. Billing them separately on the same claim line triggers an automatic edit.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">ASA physical status and qualifying circumstances<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The ASA physical status classification documents the patient&rsquo;s pre-operative health status. It is required on every anesthesia claim and affects documentation, not the base unit calculation directly. However, qualifying circumstance add-on codes tied to patient characteristics do affect total reimbursable units.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ASA Class<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Patient description<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P1<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Normal healthy patient<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Patient with mild systemic disease<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Patient with severe systemic disease<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Patient with severe systemic disease that is a constant threat to life<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Moribund patient not expected to survive without the operation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P6<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Brain-dead patient; organ donor procedures<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The four qualifying circumstance add-on codes recognized by CMS and the AMA are:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>99100<\/strong> &#8211; Anesthesia for patient of extreme age (younger than 1 year or older than 70): +1 unit<\/li><li><strong>99116<\/strong> &#8211; Anesthesia complicated by utilization of total body hypothermia: +5 units<\/li><li><strong>99135<\/strong> &#8211; Anesthesia complicated by utilization of controlled hypotension: +5 units<\/li><li><strong>99140<\/strong> &#8211; Anesthesia complicated by emergency conditions: +2 units<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Never bill a qualifying circumstance code without clinical documentation to support it. 99116 (total body hypothermia) and 99135 (controlled hypotension) are distinct circumstances, so both can be reported on the same case if each is separately documented.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Billing either one without supporting documentation is an overbilling pattern CMS flags in audits. This is documented in the billing compliance requirements for medical offices.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">ICD-10 codes commonly used with CPT Code 00450<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The ICD-10 diagnosis code on the claim must support the medical necessity of both the surgical procedure and the anesthesia service. For CPT Code 00450, the most common pairings involve clavicle fractures, scapular injuries, and shoulder girdle conditions requiring surgery.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A cardiac comorbidity code such as I49.9 illustrates how a secondary diagnosis can also influence ASA physical status documentation. Bone-fragility conditions such as M83.8 are another comorbidity worth flagging when a pathological clavicle or scapula fracture is part of the surgical picture.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10 Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S42.001A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of unspecified part of clavicle, right side, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Most common trauma pairing; use 7th character A for initial surgical encounter<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S42.002A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of unspecified part of clavicle, left side, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same fracture category, contralateral side<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S42.101A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of unspecified part of scapula, right side, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Scapula fracture requiring surgical repair<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S42.102A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of unspecified part of scapula, left side, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Contralateral scapula fracture<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M89.211<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Osteonecrosis due to drugs, right shoulder<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Shoulder girdle surgical context; verify payer LCD for coverage<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">C40.01<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malignant neoplasm of scapula and long bones, right upper limb<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Oncologic resection procedures; confirm surgical code selection<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M84.511A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Pathological fracture in neoplastic disease, right shoulder, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Pathological fracture with surgical indication<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Payer Local Coverage Determinations (LCDs) may restrict certain ICD-10\/CPT pairings. Always verify diagnosis-to-procedure pairing against the applicable MAC&rsquo;s LCD before submitting. The <a href=\"https:\/\/www.aapc.com\/codify\/icd-10-crosswalk.aspx\" target=\"_blank\" rel=\"nofollow noopener\">AAPC CPT-to-ICD-10 crosswalk tool<\/a> provides a starting point; payer-specific LCD acceptance is the final arbiter. For an example of diagnosis coding in complex oncologic cases.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Documentation requirements for billing CPT Code 00450<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Incomplete documentation is the second-most-cited reason for anesthesia claim denial after modifier errors. Every CPT Code 00450 claim needs a complete anesthesia record. Storing these records in Pabau&rsquo;s digital forms and documentation tools reduces the risk of missing paper-based records during audits.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00450\/digital-forms.webp\" alt=\"Digital forms\"\/><figcaption class=\"wp-element-caption\"><em>Digital forms<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Anesthesia start and stop times<\/strong> &#8211; exact times (hours and minutes) that anesthesia was initiated and discontinued; used to calculate time units<\/li><li><strong>Name and CPT code of the surgical procedure<\/strong> &#8211; must match the operative report exactly<\/li><li><strong>ASA physical status classification<\/strong> &#8211; P1 through P6, documented by the anesthesiologist pre-operatively<\/li><li><strong>Type of anesthesia administered<\/strong> &#8211; general, regional, MAC, or a combination<\/li><li><strong>Provider credentials<\/strong> &#8211; whether the service was personally performed (AA), medically directed (QK\/QX), or independently performed by a CRNA (QZ)<\/li><li><strong>Qualifying circumstances documentation<\/strong> &#8211; clinical evidence for any 99100, 99116, 99135, or 99140 add-on code billed<\/li><li><strong>Pre-anesthesia evaluation note<\/strong> &#8211; patient assessment, planned anesthetic technique, and risk discussion<\/li><li><strong>Post-anesthesia note<\/strong> &#8211; patient status at handoff to recovery<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">CMS requires that every element listed above be present in the medical record before the claim is submitted. See billing compliance requirements for how HIPAA intersects with billing documentation standards. The ADHD screening CPT code documentation framework illustrates how structured pre-service documentation reduces audit exposure across CPT categories.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">CRNA and medical direction billing rules<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Whether a CRNA can bill CPT Code 00450 independently depends on two factors: whether the state has opted out of the federal physician supervision requirement, and the payer&rsquo;s specific policy. CMS allows states to waive the federal supervision mandate for Medicare patients, and as of the most recent CMS policy update, over 20 states have exercised that opt-out.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Billing model<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Medicare reimbursement<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key requirement<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Physician-only (AA)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">AA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100%<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist personally performs and continuously present<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medically directed CRNA (team)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">QK (MD) + QX (CRNA)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% each<\/td>\n<td style=\"padding:12px 16px;color:#374151\">MD meets all 7 medical direction conditions per CMS<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Independent CRNA (opt-out state)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">QZ<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100%<\/td>\n<td style=\"padding:12px 16px;color:#374151\">State must have exercised CMS supervision opt-out<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medical supervision (5+ cases)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">AD<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3 base units only<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician oversees more than 4 concurrent procedures; significant reimbursement reduction<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Medical direction requires the anesthesiologist to meet seven specific CMS conditions for each case:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Performing the pre-anesthesia evaluation<\/li><li>Prescribing the anesthesia plan<\/li><li>Being present for induction<\/li><li>Being available throughout the procedure<\/li><li>Providing post-anesthesia care<\/li><li>Not concurrently directing more than four procedures<\/li><li>Not performing any other services during the case<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Failure to document any one of these conditions reduces the claim to the AD supervision rate or triggers denial.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related anesthesia CPT codes<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">When 00450 does not precisely describe the procedure performed, check these adjacent codes. Selecting a more specific code when available is always preferable to the NOS descriptor. Browse coaching CPT codes for an example of how to navigate adjacent code families.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For anesthesia on immediately adjoining anatomy.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Base units<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00400<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for procedures on the integumentary system of the extremities, anterior trunk, and perineum; not otherwise specified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00410<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for procedures on the integumentary system; electrical conversion of arrhythmias<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00470<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for partial rib resection; not otherwise specified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">6<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01630<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01638<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for open or surgical arthroscopic procedures on humeral head and neck; total shoulder replacement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">10<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01710<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; not otherwise specified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01730<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for all closed procedures on humerus and elbow<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\">Common billing errors and compliance tips for CPT Code 00450<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">These are the patterns most likely to trigger a payer audit or claim denial for CPT Code 00450.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Using 00450 when a more specific code exists:<\/strong> The NOS descriptor is a last resort. If the procedure involves the glenohumeral joint or acromioclavicular joint as the primary site, 01630 or 01638 is likely more appropriate. Defaulting to 00450 for all shoulder-region cases is a coding error.<\/li><li><strong>Mismatched modifier pairs:<\/strong> QK must always appear on the physician&rsquo;s claim when QX appears on the CRNA&rsquo;s claim for the same case. Submitting QX alone or QK alone triggers an edit.<\/li><li><strong>Stacking qualifying circumstances without documentation:<\/strong> Billing 99100 for a patient over age 70 requires the chart to confirm the patient&rsquo;s age. Billing 99140 for an emergency requires documentation that the emergency existed. Unsupported add-ons are a RAC (Recovery Audit Contractor) audit target.<\/li><li><strong>Wrong ICD-10 seventh character:<\/strong> For fracture repair at an initial surgical encounter, the 7th character must be A. Using D (subsequent encounter) or S (sequela) on a fresh surgical case will deny.<\/li><li><strong>Time unit rounding errors:<\/strong> Round time units down, not up, unless your payer explicitly allows rounding up. Rounding up 58 minutes to 4 units (60 minutes) instead of 3 units is overbilling under most payer policies.<\/li><li><strong>Missing pre-anesthesia evaluation note:<\/strong> CMS requires a pre-anesthesia evaluation documented before the procedure begins for medical direction claims. Post-dated notes are a compliance risk.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Practices billing a high volume of orthopedic anesthesia cases should use claims management software to flag missing documentation fields and track claim status before submission. Proactive checks at the claim level catch most of these errors before they become denials or audits.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00450\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Automate claims and billing with Pabau<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run a quarterly audit of all CPT Code 00450 claims: pull denied and downcoded claims, group by denial reason code, and identify the top two failure patterns. A small number of recurring documentation issues typically account for most denials, so fixing those in your intake workflow prevents the same denials from recurring.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Related CPT codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00400\/\">CPT code 00400 \u2014 Anesthesia for integumentary system procedures<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00454\/\">CPT code 00450 \u2014 Anesthesia for clavicle and scapula procedures<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00472\/\">CPT Code 00472 \u2014 Anesthesia for partial rib resection and thoracoplasty<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00474\/\">CPT code 00474 \u2014 Anesthesia for radical partial rib resection<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 00450 draws payer scrutiny because of its NOS descriptor, and the anesthesia modifier framework is strict enough that one missing documentation detail can convert a full AA claim into a 3-unit AD payment. Getting the base units, time calculation, modifier pair, and ICD-10 7th character right every time requires a consistent, auditable workflow.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&rsquo;s claims management software gives surgical and anesthesia practices a structured way to track claim status, flag missing required fields before submission, and reconcile insurer payments from one dashboard. To see how it works for your billing workflow, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a>.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing a therapeutic injection alongside an anesthesia claim?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-96372\/\" target=\"_blank\" rel=\"noopener\">96372<\/a> covers the billing rules and modifiers for that service.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding a related surgical procedure?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-10080\/\" target=\"_blank\" rel=\"noopener\">10080<\/a> covers the billing guide for pilonidal cyst incision and drainage.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need a diagnosis code for a related bone fracture?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s02101b\/\" target=\"_blank\" rel=\"noopener\">S02.101B<\/a> covers the ICD-10 code for a base-of-skull fracture.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Documenting the pre-anesthesia physical exam?<\/strong> The <a href=\"https:\/\/pabau.com\/templates\/chest-exam\/\" target=\"_blank\" rel=\"noopener\">chest exam template<\/a> gives a structured way to record findings.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1784874596612\"><h3 class=\"schema-faq-question\">What is CPT code 00450 used for?<\/h3> <p class=\"schema-faq-answer\">CPT Code 00450 is used to bill anesthesia services for surgical procedures performed on the clavicle and scapula that have no more specific anesthesia code. It applies to procedures including clavicle fracture ORIF, scapular fracture repair, clavicle resection, and scapulectomy, where the anesthesia provider delivers general, regional, or monitored anesthesia care (MAC).<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784874596613\"><h3 class=\"schema-faq-question\">How many base units does CPT code 00450 have?<\/h3> <p class=\"schema-faq-answer\">CPT Code 00450 carries 5 base units as assigned by the ASA Relative Value Guide. These 5 units are the fixed starting point for every reimbursement calculation; time units and qualifying circumstance units are added on top before multiplying by the conversion factor.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784874596614\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT code 00450?<\/h3> <p class=\"schema-faq-answer\">The applicable anesthesia modifiers for CPT Code 00450 are AA (anesthesiologist personally performs), QK (medical direction of 2-4 CRNAs, billed by the physician), QX (CRNA under medical direction), QY (one anesthesiologist directing one CRNA), QZ (independent CRNA without medical direction), and AD (medical supervision of more than 4 concurrent cases). QK and QX must always be submitted as a pair on separate claims for the same case.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784874596615\"><h3 class=\"schema-faq-question\">How is anesthesia reimbursement calculated for CPT 00450?<\/h3> <p class=\"schema-faq-answer\">The formula is: (Base Units + Time Units + Qualifying Circumstance Units) x Conversion Factor. For CPT Code 00450, base units are always 5. Time units are typically calculated at 1 unit per 15 minutes of anesthesia time (though some payers use 10-minute increments). The CMS anesthesia conversion factor changes annually and varies by Medicare locality.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784874596616\"><h3 class=\"schema-faq-question\">Can a CRNA bill CPT code 00450 independently?<\/h3> <p class=\"schema-faq-answer\">Yes, in states that have opted out of the CMS physician supervision requirement for CRNAs. In those states, the CRNA bills CPT Code 00450 with modifier QZ and receives 100% of the allowed amount. In states without the opt-out, a supervising physician is required, and the QX modifier (with QK on the physician&rsquo;s claim) applies instead. Always verify your state&rsquo;s opt-out status before billing QZ.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784874596617\"><h3 class=\"schema-faq-question\">What is the difference between CPT 00450 and CPT 00400?<\/h3> <p class=\"schema-faq-answer\">CPT 00400 covers anesthesia for procedures on the integumentary system of the extremities and trunk, with 3 base units. CPT Code 00450 is specific to surgical procedures on the clavicle and scapula, with 5 base units, reflecting the greater complexity of shoulder girdle surgery versus surface-level integumentary procedures. Select 00450 when the operative report documents a procedure on the bony clavicle or scapula itself.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>CPT Code 00450 is the anesthesia code for surgical procedures on the clavicle and scapula that don&rsquo;t have a more specific code assigned. It carries 5 base units and covers a broad range of shoulder-girdle surgeries, from clavicle fracture repair to scapulectomy, delivered as general anesthesia, regional anesthesia, or monitored anesthesia care (MAC). This reference [&hellip;]<\/p>\n","protected":false},"author":81,"featured_media":163338,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"","_yoast_wpseo_content_score":"","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[],"class_list":["post-163339","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.3 (Yoast SEO v28.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT Code 00450: Anesthesia for clavicle and scapula procedures<\/title>\n<meta name=\"description\" content=\"CPT Code 00450 covers anesthesia for clavicle and scapula surgery, carrying 5 base units under Medicare&#039;s reimbursement formula.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT Code 00450: Anesthesia for clavicle and scapula procedures\" \/>\n<meta property=\"og:description\" content=\"CPT Code 00450 covers anesthesia for clavicle and scapula surgery, carrying 5 base units under Medicare&#039;s reimbursement formula.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-07-27T11:53:35+00:00\" \/>\n<meta property=\"article:modified_time\" 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It applies to procedures including clavicle fracture ORIF, scapular fracture repair, clavicle resection, and scapulectomy, where the anesthesia provider delivers general, regional, or monitored anesthesia care (MAC).","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596613","position":2,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596613","name":"How many base units does CPT code 00450 have?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT Code 00450 carries 5 base units as assigned by the ASA Relative Value Guide. These 5 units are the fixed starting point for every reimbursement calculation; time units and qualifying circumstance units are added on top before multiplying by the conversion factor.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596614","position":3,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596614","name":"What modifiers apply to CPT code 00450?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The applicable anesthesia modifiers for CPT Code 00450 are AA (anesthesiologist personally performs), QK (medical direction of 2-4 CRNAs, billed by the physician), QX (CRNA under medical direction), QY (one anesthesiologist directing one CRNA), QZ (independent CRNA without medical direction), and AD (medical supervision of more than 4 concurrent cases). QK and QX must always be submitted as a pair on separate claims for the same case.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596615","position":4,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596615","name":"How is anesthesia reimbursement calculated for CPT 00450?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The formula is: (Base Units + Time Units + Qualifying Circumstance Units) x Conversion Factor. For CPT Code 00450, base units are always 5. Time units are typically calculated at 1 unit per 15 minutes of anesthesia time (though some payers use 10-minute increments). The CMS anesthesia conversion factor changes annually and varies by Medicare locality.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596616","position":5,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596616","name":"Can a CRNA bill CPT code 00450 independently?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes, in states that have opted out of the CMS physician supervision requirement for CRNAs. In those states, the CRNA bills CPT Code 00450 with modifier QZ and receives 100% of the allowed amount. In states without the opt-out, a supervising physician is required, and the QX modifier (with QK on the physician's claim) applies instead. Always verify your state's opt-out status before billing QZ.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596617","position":6,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-00450\/#faq-question-1784874596617","name":"What is the difference between CPT 00450 and CPT 00400?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 00400 covers anesthesia for procedures on the integumentary system of the extremities and trunk, with 3 base units. CPT Code 00450 is specific to surgical procedures on the clavicle and scapula, with 5 base units, reflecting the greater complexity of shoulder girdle surgery versus surface-level integumentary procedures. Select 00450 when the operative report documents a procedure on the bony clavicle or scapula itself.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"}]}},"yoast":{"focus_keyword":"CPT code 00450","seo_title":"CPT Code 00450: Anesthesia for clavicle and scapula procedures","meta_description":"CPT Code 00450 covers anesthesia for clavicle and scapula surgery, carrying 5 base units under Medicare's reimbursement formula.","content_score":"","is_cornerstone":"","related_keyphrases":[{"keyword":"anesthesia base units","synonyms":["CPT 00450","00450 CPT code description","anesthesia CPT code 00450","00450 anesthesia"]},{"keyword":"CPT 00450 modifiers","synonyms":["CPT 00450","00450 CPT code description","anesthesia CPT code 00450","00450 anesthesia"]},{"keyword":"medicare anesthesia reimbursement","synonyms":["CPT 00450","00450 CPT code description","anesthesia CPT code 00450","00450 anesthesia"]}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/163339","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/users\/81"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/comments?post=163339"}],"version-history":[{"count":4,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/163339\/revisions"}],"predecessor-version":[{"id":182023,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/posts\/163339\/revisions\/182023"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media\/163338"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/media?parent=163339"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/categories?post=163339"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/fr\/wp-json\/wp\/v2\/tags?post=163339"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}