What Does CPT Code 00214 Mean?

CPT code 00214 describes anesthesia services provided for burr hole procedures that include ventriculography. This code covers the creation of one or more burr holes in the skull specifically for the purpose of accessing the cerebral ventricles for contrast injection and radiographic imaging.

Ventriculography is an imaging technique in which contrast medium is injected directly into the cerebral ventricles through a burr hole or catheter to visualize the ventricular system. While largely supplanted by CT and MRI in modern practice, ventriculography remains relevant in certain intraoperative contexts, stereotactic procedures, and settings where advanced imaging is unavailable. The addition of ventriculography distinguishes 00214 from simpler burr hole codes (00210, 00211) and reflects the additional complexity and monitoring requirements.

Key Code Attributes:

• Billable Status: Fully billable as a standalone anesthesia service
• Base Units (CMS 2026): 9
• Primary Setting: Hospital operating room or interventional neurosurgery suite
• Provider Type: Anesthesiologist (MD/DO) or CRNA with physician supervision
• Service Category: General anesthesia
• Effective Status: Active CPT code with no planned retirement (verified through 2026)
• Typical Patient Population: Patients requiring intraoperative ventricular access for imaging, shunt evaluation, or stereotactic navigation

What Services and Procedures Does CPT Code 00214 Cover?

CPT 00214 covers anesthesia for burr hole procedures that include ventriculography. The burr hole provides access to the lateral ventricles, allowing injection of contrast material for radiographic evaluation of the ventricular system.

Covered Procedures and Surgical Indications:

• Burr hole with ventriculography for evaluation of ventricular anatomy
• Burr hole with contrast injection for shunt function assessment
• Burr hole with ventriculography for stereotactic frame-based navigation
• Burr hole with ventriculography prior to third ventriculostomy
• Burr hole with intraventricular catheter placement under x-ray guidance
• Burr hole with ventriculography for localization of intraventricular lesions

What Does CPT Code 00214 Specifically Exclude?

CPT 00214 does not cover anesthesia for:

• Simple burr hole without ventriculography (use 00210)
• Subdural tap through fontanelle (use 00212)
• Craniotomy for tumor resection or aneurysm clipping (use 00210-00220)
• Ventriculoperitoneal shunt placement or revision without ventriculography (use 00220)
• Cranioplasty or elevation of depressed skull fracture (use 00215)

When Is CPT Code 00214 the Right Code to Use?

Use CPT 00214 when the surgical procedure involves creating one or more burr holes AND performing ventriculography (contrast injection into the ventricular system).

Step-by-Step Code Selection:

1. Confirm the surgical plan includes burr hole creation
2. Verify that ventriculography (contrast injection into ventricles) is performed
3. If no ventriculography, use 00210 (simple burr hole) instead
4. If the procedure is a subdural tap in an infant, use 00212

How Does CPT Code 00214 Differ From Other Cranial Anesthesia Codes?

| Code | Procedure | Base Units | |---

---|-----------|------------| | 00210 | Burr hole(s) or twist drill (not otherwise specified) | 11 | | 00211 | Simple cranial biopsy | 10 | | 00212 | Subdural tap | 5 | | 00214 | Burr holes including ventriculography | 9 | | 00215 | Cranioplasty or elevation of depressed skull fracture | 9 |

What Documentation Is Required to Support CPT 00214?

Required Documentation Elements:

• ASA Physical Status Classification
• Start and stop times
• Type and dosage of anesthetic agents
• Airway management technique
• Ventilation parameters
• Monitoring of intracranial pressure if applicable
• Management of positioning (supine, head turned, Mayfield pins)
• Documentation of any antibiotic or corticosteroid administration
• Postoperative neurologic assessment

Key Takeaways for Billing and Coding CPT 00214

• CPT 00214 covers anesthesia for burr hole procedures with ventriculography
• Base units are 9 under the 2026 CMS Physician Fee Schedule
• The distinguishing factor from 00210 is the performance of ventriculography
• General anesthesia is typical with close hemodynamic monitoring

Additional Resources and References

• CMS Physician Fee Schedule: Official source for base units and conversion factors
• ASA Relative Value Guide: The American Society of Anesthesiologists annual RVG
• AMA CPT Professional Edition: The official CPT code set