CPT 00873: Anesthesia for Extracorporeal Shock Wave Lithotripsy, No Water Bath
CPT code 00873 designates anesthesia services provided during extracorporeal shock wave lithotripsy (ESWL) performed without a water bath. The code captures anesthesia care for a commonly used noninvasive urologic procedure to fragment renal or ureteral calculi when monitored sedation or deeper anesthesia is required. Nationally, accurate reporting of this anesthesia code affects procedure-level documentation, facility billing, and aggregation of anesthesia utilization for urologic interventions.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of clinical context and typical sites of service, connections to related anesthesia and perioperative coding, and pointers to adjacent procedural codes used for comparable operative settings. The publication outlines typical coding considerations, associated clinical indications for ESWL without a water bath, and how this anesthesia code fits within broader anesthesia service lines.
This summary equips billing managers, anesthesiology departments, and revenue cycle teams with the clinical framing and payer landscape for CPT code 00873, enabling clearer mapping between operative documentation and payer submissions. Data not available in the input for specific reimbursement benchmarks or payer-specific policy differences is noted where applicable.
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Billing Code Overview
CPT code 00873 describes anesthesia services for lithotripsy, extracorporeal shock wave, without water bath. This service involves providing anesthesia support during extracorporeal shock wave lithotripsy (ESWL) procedures performed without use of a water bath. The service type is anesthesia for a noninvasive urologic procedure. The typical site of service is an outpatient procedural suite or ambulatory surgery center where ESWL is performed.
National Reimbursement Benchmarks
National commercial rates for CPT 00873 center around BUCA’s average commercial rate of $79.10, with notable variation across major payers. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $42.70, Cigna’s spread is $58.00, Aetna’s spread is $94.70, and UnitedHealth Group’s spread is $28.90. This places UnitedHealth Group as the tightest payer band and Aetna as the widest among the group, with BUCA’s interquartile span at $49.40, indicating a moderate level of dispersion relative to peers.
In absolute terms, mean rates cluster from $67.40 (UnitedHealth Group) up to $97.50 (Aetna), with BUCA’s $79.10 sitting near the middle of that range. Blue Cross Blue Shield and Cigna fall between those endpoints, and the varying interquartile ranges highlight that some payers maintain more consistent commercial rates while others exhibit broader pricing spread for this procedure.