CPT 00918: Anesthesia for Ureteral Stone Fragmentation/Removal
CPT code 00918 designates anesthesia services provided during endoscopic procedures to fragment, manipulate, or remove ureteral calculi. This code is used when the surgical team accesses the ureter via the urethra to break and/or extract stones, and it captures the anesthetic component of those urologic interventions. Nationally, accurate use of this code supports appropriate billing for anesthesia in common urologic stone procedures and influences anesthesiology service reporting and resource allocation.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of the clinical context for 00918, how it relates to anesthesia service lines for endoscopic ureteral stone management, and its placement among related anesthesia codes for genital and perineal procedures. The publication outlines common billing considerations, typical sites of service, and the clinical scenarios that prompt use of this code. It also situates 00918 alongside neighboring anesthesia codes to clarify coding choices for urologic endoscopic stone procedures.
The content is intended for billing professionals, anesthesiologists, and health policy analysts seeking clear, nationally applicable information on the purpose and clinical setting for CPT code 00918.
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Billing Code Overview
CPT code 00918 describes anesthesia services for fragmentation, manipulation, and/or removal of a ureteral calculus. The service covers anesthesia provided while the surgical provider accesses the ureter through the urethra to break, manipulate, and possibly extract ureteral stones.
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Service type: Anesthesia for urologic endoscopic stone management
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Typical site of service: Operating room or ambulatory surgical center for endoscopic ureteral stone procedures
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.