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    OpenPayerBilling CodesAnesthesia for Procedures on the PerineumCPT cpt-00920-anesthesia-for-male-genital-procedure-unspecified
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    CPT 00920: Anesthesia for Male Genitalia Procedure, Unspecified

    Commercial payers pay $104 on average nationally for this procedure.

    CPT code 00920 describes anesthesia services provided for a patient undergoing a procedure on the male genitalia that is not specified by other anesthesia codes; the service typically involves administration of general, regional, or monitored anesthesia care for procedures that may include incision of the urethra. Service type: anesthesia for male genital procedures. Typical site of service: operating room or ambulatory surgical center for urologic or penile procedures.

    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

    Across national commercial benchmarks for CPT 00920, BUCA’s average commercial rate sits at $104.40, which provides a mid-market reference point among national payers. Blue Cross Blue Shield’s distribution is relatively tight with a P75–P25 spread of $47.60, and UnitedHealth Group shows a similarly modest dispersion of $28.00, indicating more concentrated pricing bands. Cigna’s spread is $66.70 and Aetna’s spread is $174.30, reflecting progressively wider variability in negotiated commercial rates.

    Overall dispersion varies materially: Aetna exhibits the widest interquartile spread at $174.30, suggesting the most heterogeneity in commercial contract levels, while UnitedHealth Group is the tightest at $28.00, indicating more consistent reimbursement. Blue Cross Blue Shield and Cigna fall in between, and BUCA’s mean sits near the middle of these payers’ ranges, offering a convenient commercial average reference.

    National Payer Mean Reimbursement Rates

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    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 42-year-old male presents to the ambulatory surgery center with symptomatic phimosis and recurrent balanitis refractory to conservative therapy. After preoperative evaluation by the anesthesia team, the patient receives general endotracheal anesthesia for a circumcision. The anesthesiologist documents airway evaluation, ASA classification, intraoperative monitoring, induction agents, maintenance anesthetic, and perioperative analgesia. The procedure may involve incision of the prepuce and, if necessary, limited incision of the distal urethra for drainage or release of entrapment. Postoperative recovery occurs in the PACU with monitoring for pain, bleeding, urinary retention, and voiding prior to discharge. Billing uses anesthesia code 00920 for procedures on male genitalia not specified elsewhere; medical necessity is supported by diagnoses such as N47.1 (phimosis) or N48.1 (balanitis). Typical sites of service include ambulatory surgery centers and hospital outpatient operating rooms. The typical patient scenario includes preoperative consent, ASA physical status assessment (commonly P1–P3), intraoperative anesthetic care for a short urologic procedure, and routine postoperative recovery and discharge instructions.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    8 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…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    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…
    P1Modifier P1 indicates an ASA Physical Status I — a normal healthy patient — and is appended to anesthesia CPT codes (00100–01999) based on the anesthesiologist’s clinical assessment. It documents the…- When to apply: Use modifier P1 on anesthesia CPT codes (00100–01999) when the anesthesia provider assigns ASA Physical Status I — a normal healthy patient (non‑smoker, minimal or no alcohol use).…

    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…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    207LC0200XCritical Care Medicine (Anesthesiology) PhysicianAn anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
    261QF0400XFederally Qualified Health Center (FQHC)Ambulatory Health Care Facilities · Clinic/Center
    2278H0200XHome Health Certified Respiratory TherapistHome care fosters individual responsibility for self-management of chronic respiratory conditions. It includes individualized assessment based plans …
    207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the labora…
    332900000XNon-Pharmacy Dispensing SiteA site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. phy…
    2865X1600XOperational (Transportable) Military General Acute Care HospitalA Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "non-fixed" or deployed facilities. Entity is not…

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    A54.02Gonococcal vulvovaginitis, unspecified
    K62.5Hemorrhage of anus and rectum
    K62.89Other specified diseases of anus and rectum
    N34.0Urethral abscess
    N34.1Nonspecific urethritis
    N34.2Other urethritis
    N36.0Urethral fistula
    N36.9Urethral disorder, unspecified
    N40.1Benign prostatic hyperplasia with lower urinary tract symptoms
    N41.0Acute prostatitis

    Showing 1–10 of 29

    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-00918-ANESTHESIA-FOR-URETERAL-STONE-FRAGMENTATION-REMOVAL

    CPT 00918: Anesthesia for Ureteral Stone Fragmentation/Removal

    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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    00922Anesthesia for procedures on male genitalia sperm duct surgeryUsed for anesthesia when the surgical focus is sperm duct (vas deferens) and helps distinguish site-specific anesthesia billing from 00920.
    00918Anesthesia for stone removalUsed when anesthesia is provided for urologic stone extraction procedures; related when preoperative diagnosis or concurrent procedures involve stones.
    00921Anesthesia for procedures on male genitalia, vasectomyUsed for anesthesia specifically for vasectomy; differentiates routine vasectomy anesthesia from the unspecified male genitalia code 00920.