Summary & Overview

CPT 00936: Anesthesia for Perineal Procedures with Lymphadenectomy

CPT code 00936 represents anesthesia for procedures on the perineum, including extensive surgical removal of the penis with bilateral inguinal and iliac lymphadenectomy. This code is significant for hospitals and anesthesia providers, as it ensures proper billing and documentation for complex surgical cases requiring specialized anesthesia care. Nationally, the code is recognized by major payers such as Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting its broad applicability across the healthcare system.

This publication provides a comprehensive overview of CPT code 00936, including payer coverage, clinical context, and related billing practices. Readers will gain insights into typical sites of service, common modifiers, and associated provider taxonomies. The summary also highlights relevant ICD-10 diagnoses and related CPT codes, offering a clear understanding of how this anesthesia code fits within broader surgical and billing workflows. Policy updates and benchmarks are discussed to inform stakeholders about current trends and requirements for anesthesia services in perineal procedures. The information is designed to support healthcare professionals, administrators, and policy analysts in navigating the complexities of medical billing and coding for anesthesia in inpatient hospital settings.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00936anesthesiaperineum proceduresinpatient hospitalmedical billingsurgical removallymphadenectomyclinical codingpolicy updatesbenchmarks

CPT Code Overview

CPT code 00936 is used to report anesthesia services for procedures on the perineum, such as extensive surgical removal of the penis with bilateral inguinal and iliac lymphadenectomy. This code falls under the anesthesia service type and is typically performed in an inpatient hospital setting (Place of Service 21). The code is essential for accurately documenting and billing anesthesia care provided during complex surgical interventions involving the perineal region.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves a male patient admitted to an inpatient hospital for extensive surgical removal of the penis, often due to malignancy or severe disease. The procedure includes bilateral inguinal and iliac lymphadenectomy, indicating a need for comprehensive removal of affected tissues and lymph nodes. Anesthesia is administered by an anesthesiologist or a certified registered nurse anesthetist, ensuring the patient is safely sedated and monitored throughout the surgery. The clinical workflow includes preoperative assessment, induction and maintenance of anesthesia, intraoperative monitoring, and postoperative care in the hospital setting.

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when the anesthesia provider is present and monitoring the patient, but not providing general anesthesia.
- QX: CRNA service with medical direction by a physician. Used when a certified registered nurse anesthetist is providing anesthesia under the supervision of a physician.
Provider Taxonomies:

Taxonomy Code	Specialty Description
`207L00000X`	Anesthesiology
`367500000X`	Certified Registered Nurse Anesthetist
`207LC0200X`	Critical Care Medicine (Anesthesiology)

These taxonomies represent providers qualified to deliver anesthesia services for perineal procedures.

Related Diagnoses

N50.9: Disorder of male genital organs, unspecified
- Relevant for patients undergoing extensive removal of the penis due to unspecified disorders.
N81.4: Uterovaginal prolapse, unspecified
- May be relevant in cases where perineal procedures are performed for pelvic organ prolapse.
N76.0: Acute vaginitis
- Indicates acute inflammation of the vagina, potentially requiring perineal surgical intervention.
N89.8: Other specified noninflammatory disorders of vagina
- Used when perineal procedures address noninflammatory vaginal conditions.
N90.89: Other specified noninflammatory disorders of vulva and perineum
- Relevant for perineal procedures addressing noninflammatory disorders in the vulva or perineum.

Related CPT Codes

00940: Anesthesia for vaginal procedures. Related as both involve anesthesia for pelvic surgeries, but 00940 is specific to vaginal procedures.
00944: Anesthesia for vaginal hysterectomy. Used for anesthesia during removal of the uterus via the vaginal route; similar anatomical region but different surgical focus.
00952: Anesthesia for procedures on male genitalia. May be used for less extensive procedures than those covered by 00936.
00954: Anesthesia for radical perineal procedures. Closely related and may be used as an alternative or in conjunction with 00936 for more extensive perineal surgeries.

These codes are commonly used as alternatives or in similar clinical workflows depending on the specific surgical procedure performed.

Summary & Overview

CPT 00936: Anesthesia for Perineal Procedures with Lymphadenectomy

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00936anesthesiaperineum proceduresinpatient hospitalmedical billingsurgical removallymphadenectomyclinical codingpolicy updatesbenchmarks

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when the anesthesia provider is present and monitoring the patient, but not providing general anesthesia.
- QX: CRNA service with medical direction by a physician. Used when a certified registered nurse anesthetist is providing anesthesia under the supervision of a physician.
Provider Taxonomies:

Taxonomy Code	Specialty Description
`207L00000X`	Anesthesiology
`367500000X`	Certified Registered Nurse Anesthetist
`207LC0200X`	Critical Care Medicine (Anesthesiology)

These taxonomies represent providers qualified to deliver anesthesia services for perineal procedures.

Related Diagnoses

N50.9: Disorder of male genital organs, unspecified
- Relevant for patients undergoing extensive removal of the penis due to unspecified disorders.
N81.4: Uterovaginal prolapse, unspecified
- May be relevant in cases where perineal procedures are performed for pelvic organ prolapse.
N76.0: Acute vaginitis
- Indicates acute inflammation of the vagina, potentially requiring perineal surgical intervention.
N89.8: Other specified noninflammatory disorders of vagina
- Used when perineal procedures address noninflammatory vaginal conditions.
N90.89: Other specified noninflammatory disorders of vulva and perineum
- Relevant for perineal procedures addressing noninflammatory disorders in the vulva or perineum.

Related CPT Codes

00940: Anesthesia for vaginal procedures. Related as both involve anesthesia for pelvic surgeries, but 00940 is specific to vaginal procedures.
00944: Anesthesia for vaginal hysterectomy. Used for anesthesia during removal of the uterus via the vaginal route; similar anatomical region but different surgical focus.
00952: Anesthesia for procedures on male genitalia. May be used for less extensive procedures than those covered by 00936.
00954: Anesthesia for radical perineal procedures. Closely related and may be used as an alternative or in conjunction with 00936 for more extensive perineal surgeries.

These codes are commonly used as alternatives or in similar clinical workflows depending on the specific surgical procedure performed.

National Reimbursement Benchmarks

National mean rates for CPT code 00936 show that BUCA (average commercial) payers reimburse at $176.74, while Medicare rates are not available in the input. Among individual commercial payers, Cigna has the highest mean rate at $455.05, followed by Blue Cross Blue Shield at $405.87, and Aetna at $227.43. UnitedHealth Group is notably lower at $65.62.

Rate dispersion varies significantly across payers. Cigna exhibits the widest spread, with a difference of $603.50 between its 75th and 25th percentiles, indicating substantial variability in reimbursement. Blue Cross Blue Shield also shows a wide range of $335.78. In contrast, UnitedHealth Group has the tightest range at $25.33, suggesting more consistent rates. Aetna and BUCA display moderate dispersion.

The table and chart below present the full breakdown of national benchmarks for CPT code 00936 by payer.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska demonstrates a substantial rate spread for CPT code 00936, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $173.40 ($594.00 minus $420.60). Other payers, such as Aetna, Cigna, and UnitedHealth Group, show minimal rate spread, with their 25th, 50th, and 75th percentiles clustered closely together, indicating limited variability in reimbursement rates.

Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and Aetna are significantly higher, while Cigna and UnitedHealth Group are below their respective national benchmarks. The table and chart below present the full breakdown of payer-specific reimbursement rates in Alaska for CPT code 00936.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 00936 in Alaska, with a mean rate of $514.10.
UnitedHealth Group offers the lowest mean rate at $75.12, significantly below both the state and national averages.
Alaska's mean rates for most payers, especially Blue Cross Blue Shield, are notably higher than national benchmarks, except for Cigna and UnitedHealth Group, which are below national averages.

CPT 00924: Anesthesia for Undescended Testis Procedures

00940-ANESTHESIA-SERVICES-FOR-PROCEDURES-ON-THE-FEMALE-PERINEUM

CPT 00940: Anesthesia for Female Perineum Procedures

00952-ANESTHESIA-FOR-PROCEDURES-ON-THE

CPT 00952: Anesthesia for Procedures on the Perineum

00922-ANESTHESIA-FOR-PROCEDURES-ON-MALE-GENITALIA-INCLUDING-OPEN

CPT 00922: Anesthesia for Vasectomy Procedures on Male Genitalia

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

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

00916-ANESTHESIA-FOR-PROCEDURE-TO-CONTROL-URINARY-SYSTEM-BLEEDING

CPT 00916: Anesthesia for Urinary System Bleeding Procedures with Endoscope

00926-UNDER-ANESTHESIA-FOR-PROCEDURES-ON-THE

CPT 00926: Anesthesia for Procedures on the Perineum

00912-ANESTHESIA-FOR-TRANSURETHRAL-PROCEDURES-INCLUDING

CPT 00912: Anesthesia for Transurethral Resection of Bladder Tumor

00942-UNDER-ANESTHESIA-FOR-PROCEDURES-ON-THE-FEMALE-VAGINA-AND

CPT 00942: Anesthesia for Vaginal and Associated Procedures

00930-ANESTHESIA-FOR-PROCEDURES-ON-MALE-GENITALIA-INCLUDING-OPEN

CPT 00930: Anesthesia for Orchiopexy, Unilateral or Bilateral

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OpenPayer

Summary & Overview

CPT 00936: Anesthesia for Perineal Procedures with Lymphadenectomy

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

OpenPayer

Summary & Overview

CPT 00936: Anesthesia for Perineal Procedures with Lymphadenectomy

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