Summary & Overview

CPT 00928: Anesthesia for Radical Inguinal Orchiectomy

CPT code 00928 represents anesthesia services for radical inguinal orchiectomy with removal of one or both testes, the spermatic cord, and adjacent abdominal lymph nodes, typically performed for testicular malignancy through a lower abdominal incision. This code is relevant nationally for anesthesiology and urologic surgery practices because it captures perioperative anesthesia resource use for a definitive oncologic procedure that may occur in inpatient or ambulatory surgical settings. Primary payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of the clinical context for the code, comparisons to related anesthesia codes for male genital procedures, and typical billing considerations such as applicable service setting and common modifiers observed for complex or emergent cases. The publication also outlines expected diagnosis groupings tied to orchiectomy and situates 00928 among nearby anesthesia codes for male genital and pelvic oncologic procedures to clarify coding selection. National stakeholders—anesthesiologists, urologists, coding professionals, and payers—can use this summary to align clinical documentation with the appropriate anesthesia code and to understand where 00928 fits within anesthetic service categories for urologic oncology.

AetnaBlue Cross Blue ShieldCigna HealthUnited HealthcareMedicare00928CPTAnesthesiaUrologyOrchiectomySurgical oncologyInguinal approachHospital outpatientAmbulatory surgery

Billing Code Overview

CPT code 00928 describes anesthesia services provided for surgical removal of one or both testes (orchiectomy) typically performed for malignancy. The procedure includes excision of the testis(es), spermatic cord, and regional abdominal lymph nodes through a lower abdominal incision.

Service type: Surgical anesthesia for radical inguinal orchiectomy with lymphadenectomy.

Typical site of service: Inpatient or outpatient surgical suite located in a hospital or ambulatory surgery center where lower abdominal open urologic oncologic procedures are performed.

Clinical & Coding Specifications

Clinical Context

A 62-year-old male with a history of a painless testicular mass is diagnosed with a suspected malignant tumor on scrotal ultrasound and elevated tumor markers. The urologic surgical team schedules a radical orchiectomy via an inguinal (lower abdominal/groin) approach with removal of the affected testis, spermatic cord, and regional lymph nodes for staging and oncologic control. The patient is evaluated preoperatively in the ambulatory surgical center; anesthesia assessment documents ASA physical status, airway, comorbidities (e.g., cardiovascular disease, diabetes), and perioperative medication management. On the day of surgery, the anesthesia team provides general endotracheal anesthesia with appropriate monitoring, intraoperative analgesia, and hemodynamic support. Postoperative care includes recovery in PACU with pain control, monitoring for bleeding or scrotal swelling, and handoff to the surgical team for pathology and discharge planning or inpatient admission if indicated.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when anesthesia management required substantially greater effort or time due to complexity beyond typical for orchiectomy (document rationale).
`23`	Unusual anesthesia	Use when a procedure is emergency but patient is not fully recovered from the effects of anesthesia (rare for this elective oncologic case).
`50`	Bilateral procedure	Use if bilateral orchiectomy is performed (both testes removed).
`52`	Reduced services	Use when the planned procedure is partially reduced or not completed but anesthesia services were provided.
`53`	Discontinued procedure	Use when procedure is terminated for patient safety after anesthesia initiation.
`54`	Surgical care only	Use when billing separates surgical care; anesthesia provider documents intraoperative only per payer rules.
`55`	Postoperative management only	Use when anesthesia provider is only responsible for postoperative pain management or consult.
`56`	Preoperative evaluation only	Use when anesthesia service limited to preoperative evaluation and patient did not proceed to anesthesia for surgery.
`62`	Two surgeons	Use when two surgeons of different specialties are required simultaneously (e.g., urologic oncology and general surgeon for complex lymphadenectomy).
`78`	Unplanned return to OR	Use when patient returns to the operating room for a related procedure during the global period due to complications.
`AA`	Anesthesia services performed personally by anesthesiologist	Use when the named anesthesiologist personally performs the anesthesia services.
`AD`	Medical supervision by a physician; more than four concurrent anesthesia procedures	Use when supervising anesthesiologist oversees more than four concurrent anesthetizing procedures.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist service for anesthesia	Use when a qualified non-physician anesthesia provider delivers the anesthesia service under supervision.

Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology	Primary providers of procedural anesthesia and intraoperative management.
`207V00000X`	Urology	Surgical specialty performing orchiectomy and lymph node dissection.
`208800000X`	Urological Surgery	Subspecialty focus on surgical management of male genital malignancy and complex inguinal procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N50.0`	Atrophy of testis	May be an indication for evaluation and potential orchiectomy if associated with tumor or symptomatic disease.
`N50.1`	Vascular disorders of male genital organs	Vascular compromise or persistent ischemia can necessitate surgical intervention including orchiectomy in severe cases.
`N50.8`	Other specified disorders of male genital organs	Miscellaneous non-neoplastic disorders that may lead to decision for orchiectomy depending on severity and symptoms.
`Z30.2`	Encounter for sterilization	Relevant when surgical history or counseling intersects with elective bilateral orchiectomy or sterilization discussions.
`Z98.52`	Vasectomy status	Documented prior vasectomy does not preclude orchiectomy; included for completeness of genitourinary surgical history.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`00930`	Anesthesia for procedures on male genitalia (including open urethral procedures); orchiopexy, unilateral or bilateral	Anesthesia code for less extensive genital procedures; related by anatomical region and alternative anesthesia reporting for non-radical surgeries.
`00932`	Anesthesia for procedures on male genitalia (including open urethral procedures); complete amputation of penis	Related as another major genitourinary oncologic procedure requiring specialized anesthesia considerations.
`00934`	Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal lymphadenectomy	More extensive genital oncologic surgery with bilateral lymphadenectomy; similar anesthetic complexity when lymph node dissection is performed.
`00936`	Anesthesia for procedures on male genitalia (including open urethral procedures); radical amputation of penis with bilateral inguinal and iliac lymphadenectomy	Comparable high-complexity anesthesia service when pelvic lymphadenectomy is required in urologic oncology.
`00938`	Anesthesia for procedures on male genitalia (including open urethral procedures); insertion of penile prosthesis (perineal approach)	Related by anatomic site and anesthesia considerations for male genital surgery; typically elective but informs billing choices for genital procedures.