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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Obstetric ProceduresCPT cpt-01969-cesarean-hysterectomy-after-neuraxial-anesthesia
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    CPT 01969: Anesthesia for Cesarean Hysterectomy After Neuraxial Anesthesia

    CPT code 01969 describes anesthesia services provided when a patient undergoes a cesarean hysterectomy performed after neuraxial anesthesia; the service type is anesthesia for cesarean hysterectomy and the typical site of service is inpatient or hospital operating room where a cesarean delivery is converted to or includes hysterectomy following neuraxial blockade.

    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

    National commercial rates for CPT 01969 cluster around BUCA’s average commercial benchmark of $73.10, while individual payers show meaningful differences in central tendency. Blue Cross Blue Shield posts a median near $59.60 and a mean of $71.40, Cigna’s mean is higher at $96.50 with a median of $86.00, Aetna’s mean sits at $60.60 with a median of $48.00, and UnitedHealth Group’s mean is $67.20 with a median of $63.70. The presence of Cigna’s larger mean and higher median pushes the upper end of the market beyond BUCA’s average.

    Dispersion measured by the interquartile range (P75 minus P25) highlights variability: Blue Cross Blue Shield’s IQR is $45.90, Cigna’s IQR is $58.60, BUCA’s IQR is $44.50, Aetna’s IQR is $36.00, and UnitedHealth Group’s IQR is $28.50. Cigna shows the widest IQR at $58.60, indicating the greatest middle-50% spread, while UnitedHealth Group is the tightest at $28.50, indicating relatively concentrated commercial reimbursements.

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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 G2P1 at 39 weeks gestation with a prior low transverse cesarean presents in active labor with inadequate contractions (O62.0) and maternal exhaustion (O75.82). She had a previous cesarean documented as a low transverse scar (O34.211) and underwent a trial of labor after cesarean that becomes nonreassuring, resulting in a failed trial of labor after previous cesarean delivery (O66.5). The obstetric team decides to proceed with cesarean delivery; intraoperatively, extensive uterine atony and uncontrolled hemorrhage necessitate conversion to a cesarean hysterectomy after initial neuraxial anesthesia is in place.

    The clinical workflow: upon diagnosis of labor dystocia and failed TOLAC, neuraxial labor analgesia or spinal/epidural anesthesia is already established. The anesthesia provider documents conversion from neuraxial labor anesthesia to surgical anesthesia for cesarean delivery, then provides ongoing anesthetic management when the case escalates to cesarean hysterectomy. Services include airway and hemodynamic management, blood product coordination, invasive monitoring as indicated, and emergence/hand-off planning. Documentation should note timing of neuraxial block, indication for hysterectomy, intraoperative events, and any concurrent procedures or complications.

    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…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    207V00000XObstetrics & Gynecology PhysicianAn obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproducti…
    261QE0800XEndoscopy Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    207SG0207XMedical Biochemical GeneticsA medical biochemical geneticist specializes in the diagnosis, evaluation, prevention, and treatment of patients with biochemical genetic disorders, d…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    163WX0800XOrthopedic Registered NurseNursing Service Providers · Registered Nurse
    235500000XSpeech/Language/Hearing Specialist/TechnologistGeneral classification identifying individuals who are trained on a specific piece of equipment or technical procedure.

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    N83.9Noninflammatory disorder of ovary, fallopian tube and broad ligament, unspecified
    N92.6Irregular menstruation, unspecified
    N97.9Female infertility, unspecified
    O34.211Maternal care for low transverse scar from previous cesarean delivery
    O34.219Maternal care for unspecified type scar from previous cesarean delivery
    O62.0Primary inadequate contractions
    O66.0Obstructed labor due to shoulder dystocia
    O66.2Obstructed labor due to unusually large fetus
    O66.5Attempted application of vacuum extractor and forceps
    O67.0Intrapartum hemorrhage with coagulation defect

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 2

    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-01958-ANESTHESIA-EXTERNAL-CEPHALIC-VERSION

    CPT 01958: Anesthesia for External Cephalic Version

    CPT-01960-ANESTHESIA-FOR-VAGINAL-DELIVERY

    CPT 01960: Anesthesia for Vaginal Delivery

    CPT-01961-ANESTHESIA-FOR-CESAREAN-DELIVERY

    CPT 01961: Anesthesia for Cesarean Delivery

    CPT-01962-URGENT-POSTPARTUM-HYSTERECTOMY-ANESTHESIA

    CPT 01962: Anesthesia for Urgent Postpartum Hysterectomy

    CPT-01963-CESAREAN-HYSTERECTOMY-ANESTHESIA

    CPT 01963: Anesthesia for Cesarean Hysterectomy

    CPT-01965-ANESTHESIA-FOR-INCOMPLETE-MISSED-ABORTION

    CPT 01965: Anesthesia for Incomplete or Missed Abortion

    CPT-01966-ANESTHESIA-FOR-INDUCED-ABORTION

    CPT 01966: Anesthesia for Induced Abortion Procedure

    CPT-01967-NEURAXIAL-ANESTHESIA-PLANNED-VAGINAL-DELIVERY

    CPT 01967: Neuraxial Anesthesia for Planned Vaginal Delivery

    CPT-01968-CESAREAN-DELIVERY-ANESTHESIA-AFTER-NEURAXIAL

    CPT 01968: Anesthesia for Cesarean Delivery After Neuraxial Anesthetic

    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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    01967Neuraxial labor analgesia/anesthesia for planned vaginal deliveryRepresents initial neuraxial labor analgesia that may be present before conversion to cesarean hysterectomy; documents labor neuraxial services.
    59514Cesarean delivery onlyRepresents the cesarean delivery portion; used when billing cesarean without hysterectomy. Distinguishes primary cesarean from more extensive cesarean hysterectomy.
    01968Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia with additional proceduresRelated when additional procedures accompany cesarean (e.g., bilateral tubal ligation); differentiates added complexity from conversion to hysterectomy.
    01960Anesthesia for vaginal delivery onlyRepresents anesthesia services limited to vaginal delivery; used for comparison to services when cesarean or hysterectomy is performed.