CPT 00940: Anesthesia for Female Perineum Procedures - OpenPayer

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Summary & Overview

CPT 00940: Anesthesia for Female Perineum Procedures

CPT 00940 covers anesthesia services for procedures on the female perineum, including biopsies of the labia, vagina, cervix, or endometrium, and serves as the designated anesthesia code when no other specific anesthesia code applies. This code is relevant across outpatient hospital settings where short gynecologic procedures are performed and is used by major national payers. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.

Readers will find a concise overview of clinical contexts in which CPT 00940 is applied, common procedural pairings that may affect billing and bundling, and typical sites of service. The publication outlines payer coverage considerations and common modifiers associated with anesthesia reporting to clarify coding practice and claim submission. It also provides links between typical ICD-10 diagnoses that often accompany perineal procedures and notes on related procedure codes that may bundle with anesthesia services.

This summary aims to inform billing staff, anesthesia providers, and practice administrators about the code’s scope and operational implications at a national level, emphasizing how CPT 00940 fits within anesthesia coding frameworks and common outpatient procedural workflows. Data not available in the input: service line details metadata.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00940AnesthesiaGynecologic ProceduresOutpatient HospitalPerineum BiopsyBilling and CodingProcedure Bundling

CPT Code Overview

CPT 00940 describes anesthesia services for procedures on the female perineum, including biopsy of the labia, vagina, cervix, or endometrium. The code is intended for anesthesia care for procedures not specified by any other anesthesia code.

Service type: Anesthesia

Typical site of service: Outpatient Hospital (POS 22)

Clinical & Coding Specifications

Clinical Context

A 45-year-old female presents to the outpatient hospital procedural suite with symptomatic uterovaginal prolapse and associated pelvic floor defects. After preoperative assessment, an anesthesia team provides regional or monitored anesthesia care for procedures on the female perineum such as biopsy of the cervix or endometrium, or surgical repair of pelvic support defects. The clinical workflow includes pre-anesthesia evaluation, intraoperative anesthetic management specific to perineal procedures, and post-anesthesia recovery in the outpatient setting. Anesthesia documentation notes the reason for anesthesia, monitored anesthesia care or CRNA involvement, and the specific perineal procedure performed.

Coding Specifications

Modifiers:
QS: Monitored anesthesia care service — use when anesthesia is provided as monitored anesthesia care for procedures on the female perineum covered by this anesthesia code.
QX: CRNA service with medical direction by a physician — use when a Certified Registered Nurse Anesthetist performs the anesthesia under medical direction by a physician as defined by payer policy.
Associated provider taxonomies:
207L00000X: Anesthesiology — specialty representing physician anesthesiologists who provide anesthesia services.
367500000X: — specialty representing CRNAs who deliver anesthesia care.

National Reimbursement Benchmarks

National mean commercial rates exceed Medicare-level reimbursement when comparing BUCA (average commercial) to Medicare. BUCA’s mean rate is $132.32 versus Medicare data not available in the input, indicating commercial averages are higher than the absent Medicare benchmark here. The table and chart below present the full breakdown.

Rate dispersion varies across payers. Aetna and Cigna show wide spreads (Aetna P75–P25 = $267.00; Cigna P75–P25 = $172.67), while UnitedHealth Group is the tightest (P75–P25 = $25.47). Blue Cross Blue Shield and BUCA have moderate dispersion. The table and chart below present the full breakdown.

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Alaska exhibits a wide spread in reimbursement rates for CPT code 00940, with Blue Cross Blue Shield offering the highest mean rate at $220.72 and UnitedHealth Group the lowest at $75.12. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($87.53), indicating substantial variability in payments within this payer. Cigna and UnitedHealth Group show much narrower spreads, suggesting more consistent rates across providers.

Compared to national averages, Blue Cross Blue Shield in Alaska pays above the national mean, while Cigna and UnitedHealth Group pay well below their respective national benchmarks. The table and chart below present the full breakdown of payer-specific rates and percentiles for Alaska, highlighting the significant differences in reimbursement across payers.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 00940 in Alaska, with a mean rate of $220.72.
UnitedHealth Group is the lowest paying payer, with a mean rate of $75.12.
Cigna and UnitedHealth Group rates in Alaska are significantly below their respective national averages, while Blue Cross Blue Shield rates are notably higher than the national mean.

Related Codes

01150

CPT 01150: Anesthesia for Radical Pelvic Tumor Procedures

00922

CPT 00922: Anesthesia for Vasectomy Procedures on Male Genitalia

00938

CPT 00938: Anesthesia for Vasectomy Procedures

00950

CPT 00950: Anesthesia for Culdoscopy Including Biopsy

01130

CPT 01130: Anesthesia for Body Cast Procedure

00942

CPT 00942: Anesthesia for Vaginal and Associated Procedures

00920

CPT 00920: Anesthesia for Male Genital Procedures, NOS

01173

CPT 01173: Anesthesia for Pelvic Procedures (Except Hip)

01112

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

01170

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

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