Summary & Overview

CPT 00810: Anesthesia for Lower Intestinal Endoscopic Procedures

CPT code 00810 covers anesthesia for lower intestinal endoscopic procedures, where the endoscope is introduced beyond the duodenum. This code is significant in the context of gastrointestinal diagnostics and interventions, ensuring patient comfort and procedural safety. The analysis focuses on Blue Cross Blue Shield as a key payer, providing insights into coverage and billing practices for this service.

Readers will gain an understanding of the clinical context for 00810, including its typical use in outpatient hospital settings and its relevance to anesthesiology. The publication also highlights common modifiers, associated provider taxonomies, and related CPT and ICD-10 codes, offering a comprehensive overview of coding and policy considerations. Benchmarks and policy updates are discussed to inform stakeholders about current trends and requirements in medical billing for anesthesia services during lower GI endoscopy. This summary is designed for a national audience, addressing the importance of accurate coding and payer coverage in the evolving landscape of procedural anesthesia.

Blue Cross Blue ShieldCPT 00810anesthesiologylower intestinal endoscopyoutpatient hospitalmedical billingprocedure codingmodifier codesprovider taxonomyICD-10 diagnosesclinical benchmarks

CPT Code Overview

CPT code 00810 is used to report anesthesia services for lower intestinal endoscopic procedures, specifically when an endoscope is introduced distal to the duodenum. This code falls under the Anesthesiology service type and is most commonly performed in an Outpatient Hospital setting (Place of Service 22). The procedure is essential for supporting patient comfort and safety during diagnostic and therapeutic endoscopic interventions in the lower gastrointestinal tract.

Clinical & Coding Specifications

Clinical Context

A patient presents to the outpatient hospital for a lower intestinal endoscopic procedure, such as a colonoscopy. The procedure is indicated for evaluation or treatment of conditions like colon polyps, gastrointestinal bleeding, or screening for colorectal cancer. An anesthesia provider, either an anesthesiologist or a certified registered nurse anesthetist (CRNA), administers anesthesia to ensure patient comfort and safety during the endoscope introduction distal to the duodenum. The clinical workflow involves pre-procedure assessment, administration of anesthesia, monitoring throughout the procedure, and post-procedure recovery. The anesthesia service is documented and coded separately from the endoscopic procedure itself.

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care (MAC) during the procedure.
- QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia services under the medical direction of an anesthesiologist.
Provider Taxonomies:

Taxonomy Code	Specialty Description
`207L00000X`	Anesthesiology Physician
`367500000X`	Certified Registered Nurse Anesthetist (CRNA)
`207RG0100X`	Gastroenterology Physician

Service Type:
- Anesthesiology
Typical Site of Service:
- Outpatient Hospital (POS 22)

Related Diagnoses

K63.5 — Polyp of colon
- Relevant for colonoscopy procedures to identify or remove polyps; anesthesia is required for patient comfort.
K52.9 — Noninfective gastroenteritis and colitis, unspecified
- Colonoscopy may be performed to evaluate unexplained gastrointestinal symptoms; anesthesia facilitates the procedure.
K92.2 — Gastrointestinal hemorrhage, unspecified
- Anesthesia is needed during endoscopic evaluation and management of GI bleeding.
Z12.11 — Encounter for screening for malignant neoplasm of colon
- Screening colonoscopies for colorectal cancer require anesthesia for patient tolerance.
R19.7 — Diarrhea, unspecified
- Colonoscopy may be indicated to investigate persistent diarrhea; anesthesia is used during the procedure.

Related CPT Codes

CPT Code	Description	Clinical Relationship
`45378`	Colonoscopy, flexible, proximal to splenic flexure; diagnostic	Commonly performed procedure for which anesthesia is provided; often paired with `00810`.
`45380`	Colonoscopy with biopsy, single or multiple	Used when biopsy is performed during colonoscopy; anesthesia code `00810` is used concurrently.
`45385`	Colonoscopy with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Therapeutic colonoscopy; anesthesia is required and coded with `00810`.
`99152`	Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service	Alternative to general anesthesia; used when moderate sedation is provided by the proceduralist.

Codes 45378, 45380, and 45385 are commonly used together with 00810 for anesthesia during colonoscopy procedures. Code 99152 is an alternative when moderate sedation is provided instead of separate anesthesia services.

Summary & Overview

CPT 00810: Anesthesia for Lower Intestinal Endoscopic Procedures

Blue Cross Blue ShieldCPT 00810anesthesiologylower intestinal endoscopyoutpatient hospitalmedical billingprocedure codingmodifier codesprovider taxonomyICD-10 diagnosesclinical benchmarks

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care (MAC) during the procedure.
- QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia services under the medical direction of an anesthesiologist.
Provider Taxonomies:

Taxonomy Code	Specialty Description
`207L00000X`	Anesthesiology Physician
`367500000X`	Certified Registered Nurse Anesthetist (CRNA)
`207RG0100X`	Gastroenterology Physician

Service Type:
- Anesthesiology
Typical Site of Service:
- Outpatient Hospital (POS 22)

Related Diagnoses

K63.5 — Polyp of colon
- Relevant for colonoscopy procedures to identify or remove polyps; anesthesia is required for patient comfort.
K52.9 — Noninfective gastroenteritis and colitis, unspecified
- Colonoscopy may be performed to evaluate unexplained gastrointestinal symptoms; anesthesia facilitates the procedure.
K92.2 — Gastrointestinal hemorrhage, unspecified
- Anesthesia is needed during endoscopic evaluation and management of GI bleeding.
Z12.11 — Encounter for screening for malignant neoplasm of colon
- Screening colonoscopies for colorectal cancer require anesthesia for patient tolerance.
R19.7 — Diarrhea, unspecified
- Colonoscopy may be indicated to investigate persistent diarrhea; anesthesia is used during the procedure.

Related CPT Codes

CPT Code	Description	Clinical Relationship
`45378`	Colonoscopy, flexible, proximal to splenic flexure; diagnostic	Commonly performed procedure for which anesthesia is provided; often paired with `00810`.
`45380`	Colonoscopy with biopsy, single or multiple	Used when biopsy is performed during colonoscopy; anesthesia code `00810` is used concurrently.
`45385`	Colonoscopy with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Therapeutic colonoscopy; anesthesia is required and coded with `00810`.
`99152`	Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service	Alternative to general anesthesia; used when moderate sedation is provided by the proceduralist.

Codes 45378, 45380, and 45385 are commonly used together with 00810 for anesthesia during colonoscopy procedures. Code 99152 is an alternative when moderate sedation is provided instead of separate anesthesia services.

National Reimbursement Benchmarks

For CPT code 00810, the national mean rate for Blue Cross Blue Shield and BUCA (average commercial) is $332.07. Medicare rates are not available in the input for comparison. The commercial mean rates are consistent across both Blue Cross Blue Shield and BUCA.

Rate dispersion, measured by the difference between the 75th and 25th percentiles, is $18.00 for both Blue Cross Blue Shield and BUCA, indicating a relatively tight range in commercial reimbursement rates nationally. This suggests limited variability in payment amounts for this code among commercial payers.

The table and chart below present the full breakdown of national benchmarks for CPT code 00810 by payer.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

For CPT code 00810, the rate spread in Alaska is zero, as the 75th and 25th percentiles are both $80.00 for Blue Cross Blue Shield and BUCA. This indicates no variation in reimbursement rates among reported payers in the state. Compared to the national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA ($82.49) are substantially lower than the national mean rate of $332.07 for these payers.

The table and chart below present the full breakdown of payer reimbursement rates for CPT code 00810 in Alaska, including mean rates and percentile values for each payer with available data.

Key Insights for Alaska

Blue Cross Blue Shield and BUCA are tied as the highest and lowest paying payers for CPT 00810 in Alaska, both with a mean rate of $82.49.
All reported rates in Alaska are significantly lower than the national mean rate for Blue Cross Blue Shield ($332.07).
There is no rate spread among payers in Alaska; all percentiles and mean rates are identical.

CPT 00800: Anesthesia for Lower Abdominal Procedures

00882-UNDER-ANESTHESIA-FOR-PROCEDURES-ON-THE-LOWER

CPT 00882: Anesthesia for Lower Abdomen Procedures

CPT-00873-ANESTHESIA-FOR-EXTRACORPOREAL-SHOCK-WAVE-LITHOTRIPSY-NO-WATER-BATH

CPT 00873: Anesthesia for Extracorporeal Shock Wave Lithotripsy, No Water Bath

CPT-00832-ANESTHESIA-LOWER-ABDOMEN-HERNIA-REPAIR

CPT 00832: Anesthesia for Lower Abdominal Hernia Repair

CPT-00836-ANESTHESIA-INFANT-LOWER-ABDOMINAL-HERNIA-REPAIR

CPT 00836: Anesthesia for Infant Lower Abdominal Hernia Repair

CPT-00770-ANESTHESIA-FOR-MAJOR-ABDOMINAL-VASCULAR-PROCEDURE

CPT 00770: Anesthesia for Major Abdominal Vascular Procedures

CPT-00702-ANESTHESIA-UPPER-ANTERIOR-ABDOMINAL-WALL-LIVER-BIOPSY

CPT 00702: Anesthesia for Upper Anterior Abdominal Wall Procedures, Including Liver Biopsy

00873-UNDER-ANESTHESIA-FOR-LITHOTRIPSY-EXTRACORPOREAL-SHOCK

CPT 00873: Anesthesia for Extracorporeal Shock Wave Lithotripsy

00700-ANESTHESIA-FOR-PROCEDURES-ON-UPPER-ANTERIOR-ABDOMINAL

CPT 00700: Anesthesia for Upper Anterior Abdominal Wall Procedures

00880-ANESTHESIA-FOR-PROCEDURES-ON-MAJOR-LOWER-ABDOMINAL-VESSELS

CPT 00880: Anesthesia for Major Lower Abdominal Vessel Procedures

Showing 1–10 of 77

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.

OpenPayer

Summary & Overview

CPT 00810: Anesthesia for Lower Intestinal Endoscopic Procedures

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

OpenPayer

Summary & Overview

CPT 00810: Anesthesia for Lower Intestinal Endoscopic Procedures

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes