CPT 01966: Anesthesia for Induced Abortion Procedure
CPT code 01966 designates anesthesia services rendered during an induced abortion procedure. Nationally, accurate coding for this service affects billing consistency, care coordination, and coverage determinations for reproductive health services provided in outpatient surgical settings. The code captures anesthesiologist or nurse anesthetist involvement in procedural abortion care and is distinct from codes for incomplete or missed abortion (see related codes).
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, typical payer coverage considerations, and related billing concepts. The publication outlines commonly-relevant benchmarks and policy points for payers and providers, clarifies code relationships, and highlights operational factors affecting claims processing and authorization for anesthesia during induced abortion procedures.
This summary targets a national audience and provides practical reference material for coding, billing, and policy teams seeking to align clinical documentation and reimbursement workflows for anesthesia services in reproductive care.
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Billing Code Overview
CPT code 01966 describes anesthesia services provided for an induced abortion procedure. This service typically involves administration and management of anesthesia care during a procedural termination of pregnancy. The service type is anesthesia for a surgical reproductive health procedure, and the typical site of service is an outpatient surgical or ambulatory care setting where induced abortions are performed.
National Reimbursement Benchmarks
For CPT 01966, the BUCA average commercial benchmark sits at $85.90, serving as a mid-market reference point across national commercial rates. Blue Cross Blue Shield shows a lower central tendency (median $69.10) while Aetna and Cigna record higher central tendencies (medians $99.70 and $84.30 respectively). UnitedHealth Group centers near the lower end with a median of $64.00. Maximums and minimums vary by carrier but are not repeated here beyond what’s already summarized.
Examining dispersion using the interquartile range (P75 minus P25) highlights where rates are most and least variable: Aetna’s IQR is $118.00 (P75 $169.00 − P25 $50.70), indicating the widest spread among payers; Cigna’s IQR is $40.60 (P75 $107.60 − P25 $67.00) and Blue Cross Blue Shield’s IQR is $55.50 (P75 $107.60 − P25 $52.10), showing moderate dispersion. UnitedHealth Group is the tightest with an IQR of $29.10 (P75 $81.10 − P25 $52.00).