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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the PerineumCPT cpt-00921-anesthesia-vasectomy
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    CPT 00921: Anesthesia for Vasectomy

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

    CPT code 00921 describes anesthesia services for a vasectomy, covering anesthetic management when the surgical provider excises the vas deferens either unilaterally or bilaterally; service type: anesthesia for minor male genital surgical procedure; typical site of service: ambulatory surgery center or hospital outpatient surgical unit where vasectomy procedures are 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 rates for CPT 00921 cluster around BUCA’s average commercial rate of $85.60, with notable variance across named payers. Blue Cross Blue Shield shows a moderate interquartile spread of $37.75 (P75 $103.40 minus P25 $56.50), while Cigna’s spread is wider at $61.90 (P75 $139.00 minus P25 $73.10). Aetna exhibits a spread of $70.00 (P75 $120.30 minus P25 $50.00), and UnitedHealth Group is relatively tight with a spread of $30.90 (P75 $81.60 minus P25 $52.70). BUCA’s own interquartile range is $47.50 (P75 $108.50 minus P25 $57.50), sitting between the tighter and wider payers.

    Payer maxima and minima further accentuate dispersion: Aetna reaches as high as $308.20 and as low as $31.00, while Cigna tops at $176.80 and UnitedHealth Group peaks at $122.70. Blue Cross Blue Shield’s maximum is $230.00. These differences highlight that contractual positions vary substantially by payer, with UnitedHealth Group the tightest IQR and Aetna the widest IQR among the listed commercial 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 healthy adult male elects to undergo a vasectomy for permanent sterilization. The patient presents to an outpatient ambulatory surgery center or urology clinic with procedure consent completed and preoperative assessment confirming fitness for monitored anesthesia care or local/regional anesthesia. Typical pre-op evaluation includes review of medical history, medications, allergies, and focused genitourinary exam; pertinent diagnosis may be Z30.2 (Encounter for sterilization) or a concurrent testicular condition such as N50.0 (Atrophy of testis).

    On the day of service the anesthesia provider documents airway assessment, ASA physical status (P1–P4 as applicable), and plans monitored anesthesia care with local infiltration or a spermatic cord block. The surgical urologist performs a unilateral or bilateral vasectomy (55250 as the surgical procedure). Intraoperative documentation includes anesthetic agents, monitoring, any airway device, and any unusual events or additional procedures. Postoperative recovery occurs in the PACU or same-day observation with discharge instructions and follow-up arranged. Typical sites of service are outpatient ambulatory surgery centers and hospital outpatient departments; the procedure may also occur in office-based surgical suites equipped for minor operative procedures.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    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…

    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…
    208800000XUrology PhysicianA urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has compreh…
    207V00000XObstetrics & Gynecology PhysicianAn obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproducti…
    207VX0201XGynecologic Oncology PhysicianAn obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic an…
    302R00000XHealth Maintenance Organization(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory ca…
    1835P0200XPediatric PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the delivery of patient care services by pharmacists that ensures the sa…
    207XX0004XOrthopaedic Foot and Ankle Surgery PhysicianRecognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult recons…
    261QM0855XAdolescent and Children Mental Health Clinic/CenterAn entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disord…

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

    CPT 00920: Anesthesia for Male Genitalia Procedure, Unspecified

    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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    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    55250Vasectomy, unilateral or bilateral (separate procedure)The definitive surgical procedure for which 00921 anesthesia services are reported; documents the operative work.
    00920Anesthesia for procedures on male genitalia; not otherwise specifiedAlternative anesthesia code for male genital procedures when 00921 specificity is not applicable.
    00922Anesthesia for procedures on male genitalia; orchiectomyRelated anesthesia code used for orchiectomy rather than vasectomy; useful for distinguishing different male genital surgeries.
    00924Anesthesia for procedures on male genitalia; circumcisionRelated anesthesia code for circumcision; included for clinical context of anesthesia coding for male genital procedures.