CPT code 00820: Posterior abdominal anesthesia, lower posterior wall2026 Medicare rate & RVUs in Massachusetts

CMS doesn’t publish an office rate for 00820 in Massachusetts.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 00820 covers

This service covers anesthesia for surgery directed at the lower posterior abdominal wall. An anesthesiologist or CRNA provides it while the surgeon operates on that region, typically in a hospital or ambulatory surgical setting. The operative site and procedure distinguish these cases from operations on the anterior abdominal wall or procedures classified as intraperitoneal, extraperitoneal, or hernia repair.

Select this code when the operation itself belongs to the lower posterior abdominal wall group, not simply because the patient is positioned prone or the incision is on the back. The operative report should identify the target site and procedure; the anesthesia record should support the practitioner’s service and start and stop times. This code has 5 base units; Medicare payment is (base units + time units) multiplied by the locality’s anesthesia conversion factor. Time is reported in minutes and converted to 15-minute units to one decimal place, from preparation for anesthesia until personal attendance ends and the patient can safely enter postoperative care; the conversion factor varies by locality.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 00820 pays more and less in Massachusetts

How the 00820 rate is calculated

Each of 00820’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 00820

00820 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

00820 compared with similar codes

How to choose

00800Abdominal wall anesthesiaOther lower anterior wall procedures

00800 applies to procedures on the lower anterior abdominal wall; 00820 applies to the lower posterior abdominal wall. Follow the operative target, not patient positioning.

00830Hernia anesthesiaLower abdomen, unspecified

00830 is the lower abdominal hernia-repair category. Use 00820 only when the operation is a lower posterior abdominal wall procedure rather than a hernia repair classified under 00830.

00840Intraperitoneal anesthesiaLower abdomen, other procedures

00840 covers intraperitoneal procedures in the lower abdomen. Choose 00820 for a lower posterior abdominal wall operation, not an intraperitoneal abdominal procedure.

00860Lower abdominal anesthesiaExtraperitoneal, unspecified procedure

00860 applies to lower abdominal procedures classified as extraperitoneal. Distinguish it from 00820 by the operation’s defined procedure category and operative target.

Codes related to 00820

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates