Summary & Overview

CPT 00902: Anesthesia for Perineal Procedures, Not Otherwise Specified

CPT code 00902 covers anesthesia for perineal procedures that are not otherwise specified, playing a vital role in surgical care across outpatient hospital settings. This code is relevant for a variety of clinical scenarios where anesthesia is required for interventions involving the perineum, and it is commonly billed by anesthesiology and pain medicine specialists. Nationally, the code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for patients undergoing these procedures.

The publication provides a comprehensive overview of 00902, including payer coverage, typical clinical indications, and associated billing modifiers. Readers will gain insight into the clinical context for use of this code, common diagnoses such as urethrocele and uterovaginal prolapse, and related CPT codes for similar procedures. The analysis also highlights policy updates and benchmarks relevant to anesthesia billing, offering clarity on how this code fits within broader reimbursement and compliance frameworks. This summary is intended for healthcare administrators, billing professionals, and clinicians seeking to understand the national landscape for anesthesia services in perineal procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00902anesthesiaperineal proceduresoutpatient hospitalmedical billingclinical contextpolicy updatesbenchmarksanesthesiologypain medicine

CPT Code Overview

CPT code 00902 is designated for anesthesia services provided during perineal procedures that are not otherwise specified. This code is typically utilized in the context of outpatient hospital settings (Place of Service 22), where specialized anesthesia care is required for a range of perineal interventions. The service type is anesthesia, reflecting the critical role of anesthesiology professionals in ensuring patient comfort and safety during these procedures. This code serves as a catch-all for perineal procedures that do not fall under more specific anesthesia codes.

Clinical & Coding Specifications

Clinical Context

A patient presents to an outpatient hospital setting with a perineal condition such as a urethrocele, incomplete uterovaginal prolapse, or vaginal enterocele. The patient is scheduled for a perineal surgical procedure that does not fall under more specific anesthesia codes. An anesthesiologist or pain medicine specialist provides anesthesia services for the procedure, ensuring patient comfort and safety throughout the operation. The workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative recovery. The procedure is typically performed on patients who are otherwise healthy, as indicated by modifier P1.

Coding Specifications

Modifiers:

Modifier Code	Description	Usage
`QS`	Monitored anesthesia care service	Used when anesthesia is provided as monitored anesthesia care rather than general anesthesia.
`P1`	A normal healthy patient	Indicates the patient has no systemic disease and is otherwise healthy.

Provider Taxonomies:

Taxonomy Code Specialty
207L00000X Anesthesiology
207LA0401X Pain Medicine (Anesthesiology)
207LP2900X Pediatric Anesthesiology

Taxonomy Code	Specialty
`207L00000X`	Anesthesiology
`207LA0401X`	Pain Medicine (Anesthesiology)
`207LP2900X`	Pediatric Anesthesiology

These taxonomies represent providers specializing in anesthesia, pain management, and pediatric anesthesia.

Related Diagnoses

N81.0 - Urethrocele
- Relevant for perineal procedures addressing urethral prolapse or bulging.
N81.2 - Incomplete uterovaginal prolapse
- Indicates partial prolapse of the uterus and vagina, often requiring perineal surgical intervention.
N81.4 - Uterovaginal prolapse, unspecified
- Used when the type of uterovaginal prolapse is not specified, but perineal surgery is indicated.
N82.1 - Vaginal enterocele
- Refers to herniation of the vaginal wall, commonly treated with perineal procedures.
N99.89 - Other postprocedural complications and disorders of genitourinary system
- Used for patients experiencing complications after prior genitourinary procedures, necessitating further perineal surgery.

Related CPT Codes

00910 - Anesthesia for transurethral procedures
- Used for anesthesia during procedures involving the urethra. May be an alternative to 00902 if the procedure is specifically transurethral.
00920 - Anesthesia for procedures on male genitalia
- Used for anesthesia during surgical procedures on male genitalia. Related to 00902 but specific to male anatomy.
00930 - Anesthesia for procedures on perineum
- Used for anesthesia during perineal procedures. May overlap with 00902 but is more specific to perineal surgeries.
00932 - Anesthesia for rectal procedures
- Used for anesthesia during rectal surgeries. Related to 00902 when the procedure involves the rectal area.

These codes are commonly used as alternatives or in conjunction with 00902 depending on the exact anatomical site and procedure performed.

Summary & Overview

CPT 00902: Anesthesia for Perineal Procedures, Not Otherwise Specified

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00902anesthesiaperineal proceduresoutpatient hospitalmedical billingclinical contextpolicy updatesbenchmarksanesthesiologypain medicine

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifiers:

Modifier Code	Description	Usage
`QS`	Monitored anesthesia care service	Used when anesthesia is provided as monitored anesthesia care rather than general anesthesia.
`P1`	A normal healthy patient	Indicates the patient has no systemic disease and is otherwise healthy.

Provider Taxonomies:

Taxonomy Code Specialty
207L00000X Anesthesiology
207LA0401X Pain Medicine (Anesthesiology)
207LP2900X Pediatric Anesthesiology

Taxonomy Code	Specialty
`207L00000X`	Anesthesiology
`207LA0401X`	Pain Medicine (Anesthesiology)
`207LP2900X`	Pediatric Anesthesiology

These taxonomies represent providers specializing in anesthesia, pain management, and pediatric anesthesia.

Related Diagnoses

N81.0 - Urethrocele
- Relevant for perineal procedures addressing urethral prolapse or bulging.
N81.2 - Incomplete uterovaginal prolapse
- Indicates partial prolapse of the uterus and vagina, often requiring perineal surgical intervention.
N81.4 - Uterovaginal prolapse, unspecified
- Used when the type of uterovaginal prolapse is not specified, but perineal surgery is indicated.
N82.1 - Vaginal enterocele
- Refers to herniation of the vaginal wall, commonly treated with perineal procedures.
N99.89 - Other postprocedural complications and disorders of genitourinary system
- Used for patients experiencing complications after prior genitourinary procedures, necessitating further perineal surgery.

Related CPT Codes

00910 - Anesthesia for transurethral procedures
- Used for anesthesia during procedures involving the urethra. May be an alternative to 00902 if the procedure is specifically transurethral.
00920 - Anesthesia for procedures on male genitalia
- Used for anesthesia during surgical procedures on male genitalia. Related to 00902 but specific to male anatomy.
00930 - Anesthesia for procedures on perineum
- Used for anesthesia during perineal procedures. May overlap with 00902 but is more specific to perineal surgeries.
00932 - Anesthesia for rectal procedures
- Used for anesthesia during rectal surgeries. Related to 00902 when the procedure involves the rectal area.

These codes are commonly used as alternatives or in conjunction with 00902 depending on the exact anatomical site and procedure performed.

National Reimbursement Benchmarks

National mean rates for CPT code 00902 show that Blue Cross Blue Shield, Cigna, and Aetna all reimburse at similar levels, with mean rates around $287–$300. UnitedHealth Group is notably lower, with a mean rate of $65.57. The BUCA average commercial benchmark is $185.83, which is substantially higher than UnitedHealth Group but lower than the other major commercial payers. Medicare data is not available in the input.

Rate dispersion varies significantly across payers. Blue Cross Blue Shield has the tightest range between the 25th and 75th percentiles ($157.93), indicating more consistent reimbursement. Aetna displays the widest dispersion ($426.00), suggesting greater variability in rates. Cigna and BUCA also show substantial ranges, while UnitedHealth Group's rates are tightly clustered ($25.30).

The table and chart below present the full breakdown of national benchmarks for CPT code 00902 by payer.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska demonstrates a significant rate spread for CPT code 00902 across commercial payers. Blue Cross Blue Shield shows the widest spread, with a 75th percentile rate of $371.50 and a 25th percentile rate of $274.60, resulting in a $96.90 difference. Aetna, Cigna, and UnitedHealth Group all have much narrower spreads, with their 25th and 75th percentiles differing by less than $5.00. This indicates that Blue Cross Blue Shield's rates are both higher and more variable compared to other payers in the state.

Compared to national averages, Alaska's mean rates for Aetna and Blue Cross Blue Shield are substantially higher, while Cigna and UnitedHealth Group are below their national benchmarks. The table and chart below present the full breakdown of payer rates for CPT code 00902 in Alaska.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 00902 in Alaska, with a mean rate of $330.26.
UnitedHealth Group is the lowest paying payer, with a mean rate of $75.12.
Mean rates for Aetna and Blue Cross Blue Shield in Alaska are notably higher than their respective national averages, while Cigna and UnitedHealth Group are below national benchmarks.

CPT 00922: Anesthesia for Vasectomy Procedures on Male Genitalia

00934-ANESTHESIA-FOR-HERNIA-REPAIRS-IN-THE-LOWER-ABDOMEN-NOT

CPT 00934: Anesthesia for Lower Abdominal Hernia Repairs

00952-ANESTHESIA-FOR-PROCEDURES-ON-THE

CPT 00952: Anesthesia for Procedures on the Perineum

00944-ANESTHESIA-FOR-PROCEDURES-ON-MALE-GENITALIA-INCLUDING-OPEN

CPT 00944: Anesthesia for Vasectomy Procedures

00914-ANESTHESIA-FOR-PROCEDURES-ON-MALE-GENITALIA-INCLUDING-OPEN

CPT 00914: Anesthesia for Vasectomy Procedures

00908-ANESTHESIA-FOR-PROCEDURES-ON-THE-MALE-GENITALIA-INCLUDING

CPT 00908: Anesthesia for Male Genitalia Procedures, Not Otherwise Specified

00948-UNDER-ANESTHESIA-FOR-PROCEDURES-ON-THE

CPT 00948: Anesthesia for Procedures on the Perineum

00904-ANESTHESIA-FOR-PROCEDURES-ON-MALE-GENITALIA-INCLUDING-OPEN

CPT 00904: Anesthesia for Male Genitalia Procedures

00921-ANES-PX-MALE-GENITALIA-VASECTOMY

CPT 00921: Anesthesia for Vasectomy Procedures on Male Genitalia

00910-ANESTHESIA-FOR-TRANSURETHRAL-PROCEDURES-INCLUDING

CPT 00910: Anesthesia for Transurethral Procedures

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OpenPayer

Summary & Overview

CPT 00902: Anesthesia for Perineal Procedures, Not Otherwise Specified

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

OpenPayer

Summary & Overview

CPT 00902: Anesthesia for Perineal Procedures, Not Otherwise Specified

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