CPT 00920: Anesthesia for Male Genital Procedures, NOS - OpenPayer

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Summary & Overview

CPT 00920: Anesthesia for Male Genital Procedures, NOS

Headline: CPT 00920: Anesthesia for Male Genital Procedures, NOS

Lead: CPT 00920 denotes anesthetic services for procedures on male genitalia when no more specific anesthesia code applies. It is relevant across outpatient hospital settings and by anesthesiology teams managing perioperative care for a range of genitourinary interventions.

What this code represents and why it matters nationally: CPT 00920 captures anesthesia delivery for male genital procedures that lack a dedicated anesthesia code. Nationally, accurate use of this code affects billing consistency, procedural reporting, and resource tracking for anesthesiology services in ambulatory surgical environments.

Key payers covered: The analysis covers major commercial payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, providing a broad view of payer recognition and coverage considerations for anesthesiology billing in outpatient hospitals.

Overview of what readers will learn: Readers will find a concise explanation of the code’s clinical and billing scope, comparisons to adjacent anesthesia codes for related male genital procedures, common clinical contexts that map to the code, and practical notes on site of service classification. Where input data is incomplete, the publication flags missing metadata. The content is intended to support coding accuracy, payer communications, and administrative clarity for anesthesia teams and billing staff.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00920AnesthesiologyOutpatient HospitalMale Genital ProceduresClinical CodingBilling GuidancePerioperative CareProcedure Coding

CPT Code Overview

CPT 00920 describes anesthesia for procedures on male genitalia, not otherwise specified. This code is used for anesthetic management during surgical or procedural interventions on the male genital organs when a more specific male genitalia anesthesia code does not apply.

Service type: Anesthesiology

Typical site of service: Outpatient Hospital (POS 22)

Clinical & Coding Specifications

Clinical Context

A middle-aged male presents to an outpatient hospital surgical suite for a procedure on the external male genitalia (for example, circumcision for persistent phimosis or surgical drainage/repair for balanitis-related complications). Pre-procedure evaluation by anesthesia is completed in the pre-op area, including assessment of airway, medical history, and baseline vital signs. Anesthesia is administered in the operating room or procedure room. Monitored anesthesia care or regional/general anesthesia may be provided depending on procedure complexity and patient status. After the procedure, the patient is recovered in the same outpatient hospital setting and discharged when recovery criteria are met. Documentation includes the anesthetic technique, agents used, monitoring, ASA physical status, and any intraoperative events.

Coding Specifications

Modifiers
QS: Monitored anesthesia care service — Use when monitored anesthesia care is provided for the procedure on male genitalia and documentation supports MAC rather than general or regional anesthesia.
P1: A normal healthy patient — Use to indicate the patient’s ASA physical status is I when reported by the anesthesia provider.
Provider Taxonomies
207L00000X: Anesthesiology — Physicians specialized in anesthesiology who provide perioperative anesthesia care.

National Reimbursement Benchmarks

National commercial mean rates for CPT 00920 show a marked difference between Medicare and the average commercial cohort represented by BUCA (Blue Cross/United Commercial Average). Medicare’s mean is not provided in the input, while BUCA’s mean rate is $134.69, indicating that commercial averages are substantially higher than Medicare would typically be for similar services.

Rate dispersion (P75 minus P25) varies notably across payers. Aetna shows the widest spread (P75 $302.00 minus P25 $42.33 = $259.67), followed by Cigna (spread $173.42) and BUCA (spread $130.50). UnitedHealth Group is the tightest (spread $25.47), with Blue Cross Blue Shield also relatively tight (spread $116.00) compared with the widest payers. The table and chart below present the full breakdown.

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Alaska displays a wide spread in reimbursement rates for CPT code 00920, with Blue Cross Blue Shield's 75th percentile ($268.67) notably higher than UnitedHealth Group's 25th percentile ($72.00). The difference between the highest and lowest 25th and 75th percentiles among payers highlights significant variability in payment levels across the state. This rate spread (P75 minus P25) is especially pronounced for Blue Cross Blue Shield, where the gap is $87.00, and for BUCA, where it is $88.83.

Compared to national averages, Alaska's mean rates for most payers are higher, except for Cigna and UnitedHealth Group, which fall below their respective national benchmarks. The table and chart below present the full breakdown of payer-specific reimbursement rates in Alaska, illustrating these disparities.

Key Insights for Alaska

Blue Cross Blue Shield offers the highest mean reimbursement rate for CPT 00920 in Alaska at $220.98, while UnitedHealth Group is the lowest at $75.12.
Cigna's mean rate in Alaska ($89.33) is significantly below its national average ($197.79), indicating a notable deviation.
The rate spread among payers in Alaska is substantial, with BCBS's 75th percentile ($268.67) far exceeding the lowest 25th percentiles, highlighting wide variability.

Related Codes

00926

CPT 00926: Anesthesia for Procedures on the Perineum

00904

CPT 00904: Anesthesia for Male Genitalia Procedures

00936

CPT 00936: Anesthesia for Perineal Procedures with Lymphadenectomy

01170

CPT 01170: Anesthesia for Open Symphysis Pubis or Sacroiliac Joint Procedures

01140

CPT 01140: Anesthesia for Interpelviabdominal (Hindquarter) Amputation

01180

CPT 01180: Anesthesia for Lower Leg, Ankle, and Foot Procedures

00934

CPT 00934: Anesthesia for Lower Abdominal Hernia Repairs

00921

CPT 00921: Anesthesia for Vasectomy Procedures on Male Genitalia

01112

CPT 01112: Anesthesia for Bone Marrow Aspiration or Biopsy, Iliac Crest

01190

CPT 01190: Anesthesia Services in Inpatient Hospital (Deleted Code)

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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.

National Reimbursement Benchmarks

National Mean Rates for CPT `00920` by Payer

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Mean Reimbursement Rates by Payer in Alaska for CPT 00920

Key Insights for Alaska

Blue Cross Blue Shield offers the highest mean reimbursement rate for CPT 00920 in Alaska at $220.98, while UnitedHealth Group is the lowest at $75.12.
Cigna's mean rate in Alaska ($89.33) is significantly below its national average ($197.79), indicating a notable deviation.
The rate spread among payers in Alaska is substantial, with BCBS's 75th percentile ($268.67) far exceeding the lowest 25th percentiles, highlighting wide variability.