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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the PerineumCPT cpt-00942-anesthesia-for-vaginal-procedures
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    CPT 00942: Anesthesia for Procedures on Female Vagina and Associated Structures

    Commercial payers pay $85 on average nationally for this procedure.

    CPT code 00942 describes anesthesia services provided for procedures on the female vagina and associated structures, including biopsy, incision, repair of vaginal tear, excision of vaginal tissue, and open urethral procedures; the service type is anesthesia for gynecologic and peri-vaginal procedures and the typical site of service is an operating room or procedure suite where these invasive vaginal or urethral interventions 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

    For CPT 00942 the BUCA average commercial benchmark sits at $85.20, offering a mid-market reference across national commercial contracts. Among named payers, Aetna and Cigna show higher central tendencies with mean rates of $117.50 and $99.70 respectively, while Blue Cross Blue Shield and UnitedHealth Group center lower at $75.30 and $67.90. This positions BUCA roughly between the higher Cigna/Aetna cluster and the lower BCBS/UnitedHealth cluster.

    Dispersion measured as the interquartile range (P75 minus P25) highlights where rates are most and least concentrated: Aetna’s IQR is $110.10 ($155.60 − $45.00), Cigna’s is $61.70 ($131.70 − $70.00), Blue Cross Blue Shield’s is $41.70 ($95.40 − $53.70), BUCA’s is $54.40 ($109.10 − $54.70), and UnitedHealth Group’s is $29.10 ($81.10 − $52.00). UnitedHealth Group is the tightest payer by IQR and Aetna the widest, with BUCA and Cigna in the mid-range of dispersion.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 32-year-old female presents for vaginal repair after a second-degree obstetric laceration sustained during spontaneous vaginal delivery. The patient has requested regional anesthesia due to prior adverse reaction to general anesthesia. Preoperative evaluation by the anesthesiology team documents ASA physical status P2, informed consent for neuraxial block obtained, and standard fasting and antibiotic prophylaxis administered. In the operating room the anesthesiologist provides neuraxial anesthesia and intraoperative monitoring while the obstetrician performs incision and repair of the vaginal tear and any associated perineal structures. The anesthesia service is billed with 00942 to represent anesthesia for procedures on the female vagina and associated structures. Typical clinical workflow includes pre-anesthesia assessment, placement of regional block (or general anesthesia if indicated), intraoperative anesthetic management, postoperative recovery in PACU, and documentation of anesthesia type, airway management, start/stop times, and any intraoperative complications or additional services such as vasoactive drug administration.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    00940Under anesthesia for procedures on the perineumUsed for anesthesia services when procedures focus on the perineum; may be billed if primary operative site is perineum rather than vagina.

    Related Modifiers

    8 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…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    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…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    207LP2900XPain Medicine (Anesthesiology) PhysicianAn anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
    2080S0012XPediatric Sleep Medicine PhysicianA Pediatrician who practices Sleep Medicine is certified in the subspecialty of sleep medicine and specializes in the clinical assessment, physiologic…
    207VX0201XGynecologic Oncology PhysicianAn obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic an…
    246YR1600XRegistered Record AdministratorNone
    282NC2000XChildren's HospitalHospitals · General Acute Care Hospital
    208U00000XClinical Pharmacology PhysicianClinical pharmacology encompasses the spectrum of activities related to the discovery, development, regulation, and utilization of safe and effective …

    Related ICD-10-CM Codes

    32 rows

    ICD-10-CM CodeDescription
    C52Malignant neoplasm of vagina
    N50.0Atrophy of testis
    N50.1Vascular disorders of male genital organs
    N50.8
    N50.9Disorder of male genital organs, unspecified
    N72Inflammatory disease of cervix uteri
    N75.0Cyst of Bartholin's gland
    N75.1Abscess of Bartholin's gland
    N75.8Other diseases of Bartholin's gland
    N75.9Disease of Bartholin's gland, unspecified

    Showing 1–10 of 32

    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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    00944Under anesthesia for procedures on the perineumAlternate anesthesia code for perineal procedures; relevant when coding distinctions between perineum and vaginal structures affect anesthesia code selection.