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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the PerineumCPT cpt-00918-anesthesia-for-ureteral-stone-fragmentation-removal
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    CPT 00918: Anesthesia for Ureteral Stone Fragmentation/Removal

    Commercial payers pay $86 on average nationally for this procedure.

    CPT code 00918 describes anesthesia services provided while the surgical team performs fragmentation, manipulation, and/or removal of a ureteral calculus accessed through the urethra; the service type is anesthesia for endoscopic ureteral stone procedures and the typical site of service is an operating room or ambulatory surgical center where endoscopic urologic stone treatment is performed.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    National Reimbursement Benchmarks

    Commercial reimbursements for CPT 00918 cluster around BUCA’s average commercial rate of $85.90, with notable variation across major payers. Aetna’s distribution skews higher with a mean of $132.40 and a wide spread between the 25th and 75th percentiles ($84.80 to $169.00), while Blue Cross Blue Shield (BCBS) centers lower with a mean of $73.10 and interquartile points at $52.50 and $95.20. Cigna’s mean sits above BUCA at $96.50 and shows a broad middle range from $68.40 to $125.00. UnitedHealth Group is more tightly clustered, with an interquartile span from $52.00 to $80.90 and a mean of $67.40.

    Comparing interquartile dispersion (P75 minus P25) highlights who is tightest and widest: UnitedHealth Group’s IQR is $28.90, the tightest among listed payers, indicating relatively consistent commercial rates. Blue Cross Blue Shield’s IQR is $42.70 and Cigna’s is $56.60, while Aetna exhibits the widest IQR at $84.20, reflecting the greatest mid‑range variability in commercial payments for this code. BUCA’s average of $85.90 provides a mid‑market reference point across these payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 48-year-old male presents to the urology clinic with acute right flank pain, hematuria, and radiographic evidence of a 6 mm distal ureteral stone causing hydronephrosis. Conservative measures and medical expulsive therapy fail and the urologist schedules ureteroscopic stone fragmentation and extraction under general anesthesia. Preoperative evaluation documents a history of controlled hypertension (ASA P2) and no prior anesthesia complications. On the day of surgery the patient is admitted to an ambulatory surgery unit; anesthesia personnel perform pre-induction evaluation, induce general anesthesia with endotracheal intubation, provide intraoperative monitoring and analgesia, and manage emergence and immediate postoperative care. The urologist accesses the ureter via the urethra, fragments the calculus with a laser lithotripsy device, retrieves fragments with a basket, and places a ureteral stent. The anesthetic service is reported with 00918 for anesthesia for fragmentation, manipulation, and/or removal of a ureteral calculus via transurethral ureteroscopy. Typical site of service is the ambulatory surgery center or hospital operating room. Common perioperative workflow steps include preoperative evaluation, induction of general anesthesia or monitored anesthesia care as indicated, intraoperative anesthetic and hemodynamic management, postoperative recovery in PACU, and handoff to urology for discharge instructions or inpatient admission if complications occur.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    364SP0813XGeropsychiatric Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    207RC0001XClinical Cardiac Electrophysiology PhysicianA field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical proc…
    3416A0800XAir AmbulanceTransportation Services · Ambulance
    2279E1000XEducational Registered Respiratory TherapistThe focus of patient and family education activities is to promote knowledge of disease process, medical therapy, and self help. Respiratory therapis…
    1041S0200XSchool Social WorkerBehavioral Health & Social Service Providers · Social Worker

    Related ICD-10-CM Codes

    32 rows

    ICD-10-CM CodeDescription
    E83.51Hypocalcemia
    E87.5Hyperkalemia
    N10Acute pyelonephritis
    N11.1Chronic obstructive pyelonephritis
    N11.8Other chronic tubulo-interstitial nephritis
    N13.2Hydronephrosis with renal and ureteral calculous obstruction
    N13.6Pyonephrosis
    N20.0Calculus of kidney
    N20.1Calculus of ureter
    N20.2Calculus of kidney with calculus of ureter

    Showing 1–10 of 32

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    7 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-00902-ANESTHESIA-FOR-ANUS-RECTUM-PROCEDURES

    CPT 00902: Anesthesia for Procedures Involving Anus or Rectum

    CPT-00904-ANESTHESIA-RADICAL-PERINEAL-PROCEDURE

    CPT 00904: Anesthesia for Radical Perineal Procedure

    CPT-00906-ANESTHESIA-FOR-VULVECTOMY

    CPT 00906: Anesthesia for Vulvectomy

    CPT-00908-ANESTHESIA-PERINEAL-PROSTATECTOMY

    CPT 00908: Anesthesia for Perineal Prostatectomy

    CPT-00910-ANESTHESIA-TRANSURETHRAL-URETHROCYSTOSCOPY

    CPT 00910: Anesthesia for Transurethral Procedures including Urethrocystoscopy

    CPT-00912-TRANSURETHRAL-BLADDER-TUMOR-EXCISION-ANESTHESIA

    CPT 00912: Anesthesia for Transurethral Excision of Bladder Tumor

    CPT-00914-ANESTHESIA-TRANSURETHRAL-PROSTATE-REMOVAL

    CPT 00914: Anesthesia for Transurethral Prostate Procedure

    CPT-00916-ANESTHESIA-FOR-TRANSURETHRAL-BLEEDING-CONTROL

    CPT 00916: Anesthesia for Bleeding Control After Transurethral Tissue Removal

    CPT-00920-ANESTHESIA-FOR-MALE-GENITAL-PROCEDURE-UNSPECIFIED

    CPT 00920: Anesthesia for Male Genitalia Procedure, Unspecified

    CPT-00921-ANESTHESIA-VASECTOMY

    CPT 00921: Anesthesia for Vasectomy

    Showing 1–10 of 25

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    00910
    Anesthesia for procedures on male genitalia
    Used when the anesthetic is for primary procedures on the male genitalia rather than ureteral stone work; select when the primary surgical site is male genitalia.
    00920Anesthesia for procedures on the perineum, perianal areaRelevant if the surgical approach or concurrent procedures involve the perineum or perianal region.
    00921Anesthesia for procedures on the perineum, perianal area, with rectal involvementUse when rectal involvement is present in the operative field and affects anesthetic management.
    00924Anesthesia for procedures on the perineum, perianal area, with urethral involvementClosely related when urethral instrumentation is a central component; choose based on primary operative site and documentation.