CPT code 00860: Lower abdominal anesthesia, extraperitoneal, unspecified procedure2026 Medicare rate & RVUs in Missouri

CMS doesn’t publish an office rate for 00860 in Missouri.

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

What 00860 covers

00860 is the anesthesia category for qualifying operations in the lower abdomen approached outside the peritoneal cavity when a more specific anesthesia category does not identify the procedure. Anesthesia practitioners report it for services furnished in settings such as hospitals and ambulatory surgery centers. The operative approach and procedure, rather than the surgeon’s specialty alone, determine whether this general category fits.

Use 00840 for intraperitoneal lower-abdominal procedures, and use a more specific category for covered procedures such as renal operations, total cystectomy, prostatectomy, or adrenalectomy. The operative report should identify the procedure and approach; the anesthesia record should support the service and its start and end times. Medicare payment is (6 base units + time units) × the locality’s anesthesia conversion factor. Time runs from when anesthesia preparation begins until the practitioner is no longer in personal attendance and the patient can safely be placed under postoperative care; minutes convert to 15-minute units rounded to one decimal place.

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 00860 pays more and less in Missouri

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

How the 00860 rate is calculated

Each of 00860’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 00860

00860 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.

00860 compared with similar codes

How to choose

00840Intraperitoneal anesthesiaLower abdomen, other procedures

Choose 00840 for an intraperitoneal lower-abdominal procedure. Choose 00860 for a qualifying extraperitoneal operation.

00820Posterior abdominal anesthesiaLower posterior wall

00820 describes anesthesia for a procedure on the lower posterior abdominal wall; 00860 is for other qualifying extraperitoneal lower-abdominal surgery.

00830Hernia anesthesiaLower abdomen, unspecified

00830 is the category for lower-abdominal hernia repair. Use 00860 for other qualifying extraperitoneal procedures not identified by a more specific category.

00862Renal surgery anesthesiaExtraperitoneal, lower abdomen

Use 00862 for a lower-abdominal renal procedure. Use 00860 for qualifying extraperitoneal lower-abdominal operations not assigned a more specific category.

Codes related to 00860

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