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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the PerineumCPT cpt-00926-inguinal-orchiectomy-anesthesia-services
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    CPT 00926: Anesthesia for Inguinal Orchiectomy with Spermatic Cord Removal

    Commercial payers pay $82 on average nationally for this procedure.

    CPT code 00926 describes anesthesia services provided for a surgical inguinal orchiectomy with removal of one or both testes and the spermatic cord; service type: operative/anesthesia for open inguinal orchiectomy; typical site of service: inpatient or outpatient surgical suite/operating room in the groin (inguinal) region.

    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 00926 center around BUCA’s average commercial rate of $82.10, with payer-specific means ranging from $68.00 (UnitedHealth Group) to $99.70 (Cigna). Blue Cross Blue Shield’s mean is $75.30 and Aetna’s mean is $98.60. These averages suggest most commercial reimbursements cluster near BUCA’s midpoint while Cigna and Aetna sit noticeably above UnitedHealth Group and Blue Cross Blue Shield.

    Rate dispersion (P75 minus P25) highlights where variability is greatest: Aetna’s interquartile range is $80.60 (P75 $124.90 minus P25 $42.30) and Cigna’s is $61.90 (P75 $131.90 minus P25 $70.00), indicating the widest spreads. UnitedHealth Group is the tightest at $29.40 (P75 $81.40 minus P25 $52.00), with Blue Cross Blue Shield at $39.30 (P75 $94.80 minus P25 $54.50) and BUCA at $48.30 (P75 $103.80 minus P25 $54.70).

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old male with a primary diagnosis of a right inguinal hernia (K40.90) is scheduled for surgical repair with orchiectomy via an inguinal incision for a suspected testicular malignancy with removal of the spermatic cord. The patient presents to the preoperative anesthesia clinic for evaluation. Past medical history includes well-controlled hypertension and Type 2 diabetes. Preoperative assessment documents airway, fasting status, medications, allergies, and ASA physical status of P2.

    On the day of surgery, the patient is taken to the operating room. General endotracheal anesthesia is induced by the anesthesiologist (taxonomy 207L00000X) or a certified provider (taxonomies 367500000X or 367H00000X) depending on staffing and state law. Standard monitors are applied and prophylactic antibiotics are administered per surgical protocol. Anesthesia is maintained during an open inguinal approach for unilateral or bilateral orchiectomy with removal of the spermatic cord. Intraoperative events (for example, unexpected bleeding requiring transfusion or an unplanned extension of operative time for tumor control) are documented and may influence modifier selection. Postoperative handoff to PACU includes anesthesia record, blood loss, fluids, pain control, and any intraoperative complications. Billing uses anesthesia code 00926 for anesthesia services during surgical removal of one or both testes via an inguinal incision with removal of the spermatic cord.

    Related CPT Codes

    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…
    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…
    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…
    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…
    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…

    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…
    367H00000XAnesthesiologist AssistantAn individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants …
    261QM1200XMagnetic Resonance Imaging (MRI) Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    2251E1200XErgonomics Physical TherapistA licensed physical therapist who has demonstrated specialized knowledge and skills pertaining to the workplace, occupational demands, prevention of w…
    221700000XArt Therapist(1) An individual who uses art to achieve the therapeutic goals of symptom relief, emotional integration, and recovery from or adjustment to illness o…
    111NT0100XThermography ChiropractorThe NUCC recommends this code not be used. Choose a more appropriate code.
    111NN1001XNutrition ChiropractorChiropractic Nutrition is that specialty within the chiropractic profession that deals with the overall factors that affect the patient's ability to m…

    Related ICD-10-CM Codes

    5 rows

    ICD-10-CM CodeDescription
    K43.9Ventral hernia without obstruction or gangrene
    K44.9Diaphragmatic hernia without obstruction or gangrene
    K40.90Unilateral inguinal hernia, without obstruction or gangrene, not specified as recurrent
    K42.9Umbilical hernia without obstruction or gangrene
    K41.90Unilateral femoral hernia, without obstruction or gangrene, not specified as recurrent

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    9 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
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    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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    CPT Code
    Description
    Relationship to This Procedure
    49505Repair initial inguinal hernia, age 5 years or older; reducibleMay be performed in the same operative field when hernia repair is indicated concurrently or as the primary surgical indication in the inguinal region.
    49585Repair umbilical hernia, age 5 years or older; reducibleRepresents other hernia repairs in the abdominal wall; listed for context when multiple hernia repairs occur during the same encounter.
    49650Laparoscopy, surgical; repair initial inguinal herniaLaparoscopic alternative for inguinal hernia repair; contrasts with the open inguinal approach described for 00926.
    00840Anesthesia for intraperitoneal procedures in lower abdomenRelated anesthesia code used for intraperitoneal lower abdominal surgeries; may be appropriate when the procedure extends into the intraperitoneal space.
    00830Anesthesia for procedures in lower abdomen, not otherwise specifiedAlternative anesthesia code for lower abdominal procedures when intraperitoneal-specific code is not applicable.