CPT 00916: Anesthesia for Transurethral Bleeding Control
CPT code 00916 designates anesthesia services for procedures addressing bleeding control after removal of tissue accessed through the urethra. Nationally, this code captures perioperative anesthesia support during genitourinary procedures where hemorrhage control is required following transurethral tissue extraction. It is relevant to anesthesiology and perioperative service planning because these cases often demand tailored anesthetic techniques and intraoperative hemodynamic management.
Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise explanation of the clinical context for the code, typical sites of service, and how this code relates to nearby CPT anesthesia codes for genitourinary and endoscopic procedures. The publication outlines the clinical scenario captured by the code, common billing considerations, and comparisons to related anesthesia codes to aid coding accuracy and claims grouping.
This overview is intended for national audiences including billing professionals, anesthesiologists, and health policy analysts seeking clear context on when CPT code 00916 applies, which clinical situations it represents, and what to expect in terms of service setting and procedural intent.
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Billing Code Overview
CPT code 00916 describes anesthesia services provided for a patient who requires bleeding control following removal of tissue accessed through the urethra, the natural opening for urine outflow. This procedure involves managing anesthesia during a genitourinary operative intervention focused on controlling hemorrhage after tissue extraction.
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Service type: Anesthesia for genitourinary procedure addressing post-removal bleeding control
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Typical site of service: Operative suite or ambulatory surgical center where endoscopic or transurethral tissue removal procedures are performed
National Reimbursement Benchmarks
National commercial reimbursement for CPT 00916 centers around BUCA’s average commercial rate of $72.9, which provides a useful mid-market reference. Among named payers, Cigna posts the highest mean at $96.5 while Aetna and UnitedHealth Group sit lower at $62.9 and $67.4 respectively; Blue Cross Blue Shield averages $70.2. Payer medians are generally near their means for Blue Cross Blue Shield and UnitedHealth Group, indicating moderate symmetry in their distributions.
Dispersion measured as P75 minus P25 highlights variation: Cigna has the widest interquartile spread at $58.0 ($125.0 minus $68.4), signaling greater variability in commercial contract rates. Blue Cross Blue Shield’s spread is $36.5 and BUCA’s spread is $36.1, both tighter than Cigna. Aetna’s spread is $41.9 and UnitedHealth Group’s spread is $28.9, making UnitedHealth Group the tightest among these payers.