CPT 01966: Anesthesia for Induced Abortion Procedures - OpenPayer

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Summary & Overview

CPT 01966: Anesthesia for Induced Abortion Procedures

Headline: New Focus on Anesthesia Reporting for Induced Abortion Procedures

Lead: CPT 01966 designates anesthesia services for induced abortion procedures and is a critical coding element for documenting peri-procedural anesthetic care. Accurate use of this code affects clinical communication, billing integrity, and payer adjudication nationally.

What this code represents and why it matters: CPT 01966 captures anesthesiology services specific to induced abortion procedures. Nationally, clear reporting supports appropriate clinical records, resource allocation within hospital settings, and consistent payer processing. Anesthesia documentation linked to this code can influence care coordination and facility planning for inpatient services.

Key payers covered: This publication covers Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare and how CPT 01966 is recognized across major commercial payers.

What readers will learn: The piece provides benchmarks for coding frequency where available, summarizes payer coverage patterns, clarifies common clinical settings and service expectations, and outlines related billing considerations. Also included will be context on associated clinical scenarios and comparisons to related anesthesia codes.

Limitations: Data not available in the input for certain service line details and utilization metrics. The content is intended to inform coding and policy understanding rather than provide clinical guidance.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 01966AnesthesiologyInduced AbortionInpatient HospitalProcedure CodingClinical DocumentationBilling Compliance

CPT Code Overview

CPT 01966 describes anesthesia services provided for induced abortion procedures. This code is used to report the anesthesiology care associated with termination of pregnancy when anesthesia is administered to facilitate the procedure.

Service Type: Anesthesiology

Typical Site of Service: Inpatient Hospital (POS 21)

Clinical & Coding Specifications

Clinical Context

A 28-year-old patient presents to the inpatient hospital for a planned induced abortion procedure with anesthesia provided in the operating room. The patient had preoperative evaluation by the anesthesiology team, informed consent documented, and standard monitoring initiated. General or regional anesthesia is administered based on gestational age, patient factors, and surgical requirements. The anesthesiologist or CRNA documents airway management, anesthetic agents, hemodynamic stability, and postoperative recovery in the PACU prior to discharge or admission.

Coding Specifications

Modifiers
AA: Anesthesia services performed personally by anesthesiologist — used when the anesthesiologist personally performs all anesthesia services for the procedure.
QX: CRNA service with medical direction by a physician — used when a Certified Registered Nurse Anesthetist provides anesthesia under the medical direction of a physician, and reporting requires the CRNA’s service code with this modifier.
Provider Taxonomies

Taxonomy Code	Specialty

National Reimbursement Benchmarks

National commercial averages sit well above Medicare for this code; BUCA (average commercial) has a mean rate of $125.78 compared with Medicare, which is not provided in the input (reported here as unavailable). Aetna, Blue Cross Blue Shield, and Cigna report higher mean rates than BUCA, while UnitedHealth Group reports a substantially lower mean.

Dispersion measured as the difference between the 75th and 25th percentiles varies across payers. Cigna and Aetna show the widest spreads (Cigna: $258.00 range; Aetna: $284.00 range), indicating greater variability in contracted rates, while UnitedHealth Group and BUCA are the tightest (UHC: $25.08 range; BUCA: $131.00 range). The table and chart below present the full percentile and mean-rate breakdown.

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Alaska displays a significant spread in reimbursement rates for CPT code 01966, with Blue Cross Blue Shield showing the widest range between the 25th and 75th percentiles ($298.50 minus $225.80 = $72.70). In contrast, Aetna, Cigna, and UnitedHealth Group have much narrower spreads, each with only a few dollars difference between their percentiles. This indicates that Blue Cross Blue Shield's rates are not only the highest but also more variable compared to other payers in the state.

Compared to national averages, Alaska's mean rates for most payers are substantially higher, particularly for Blue Cross Blue Shield and BUCA. The table and chart below present the full breakdown of payer-specific reimbursement rates, highlighting the differences in payment levels and variability across the major commercial payers in Alaska.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 01966, with a mean rate of $267.22.
UnitedHealth Group offers the lowest mean rate at $74.78.
Alaska's mean rates for most payers are notably higher than national averages, especially for Blue Cross Blue Shield and BUCA.

Related Codes

01930

CPT 01930: Anesthesia for Peripheral Venous and Lymphatic Interventions

01951

CPT 01951: Anesthesia for Burn Excision or Debridement (<4% Body Surface)

01932

CPT 01932: Anesthesia for Interventional Radiology Procedures (Venous/Lymphatic)

01936

CPT 01936: Anesthesia for Image-Guided Spine Procedures

01962

CPT 01962: Anesthesia for Urgent Post-Delivery Hysterectomy

01990

CPT 01990: Anesthesia for Physiological Support During Organ Procurement

01991

CPT 01991: Anesthesia for Nerve Blocks and Injections (Non-Prone Position)

01933

CPT 01933: Anesthesia for Intracranial Interventional Radiological Procedures

01925

CPT 01925: Anesthesia for Carotid or Coronary Interventional Radiology

01935

CPT 01935: Anesthesia for Percutaneous Image-Guided Spine Diagnostic Procedures

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