CPT code 00864: Cystectomy anesthesia, extraperitoneal lower abdomen2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 00864 in California.

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

What 00864 covers

This service covers anesthesia for total removal of the urinary bladder through an extraperitoneal lower-abdominal approach. An anesthesiologist or CRNA typically provides and reports it in a hospital operating room for cystectomy. Urinary diversion may form part of the operative plan.

Choose this code for total cystectomy rather than anesthesia for renal procedures, prostatectomy, or an unspecified extraperitoneal lower-abdominal procedure. The operative report should establish total cystectomy and document the approach; the anesthesia record supports the anesthesia service and reported time. Medicare payment is (8 base units + time units) × the locality’s anesthesia conversion factor. Time is reported in minutes, beginning when the anesthesia practitioner starts preparing the patient and ending when the practitioner is no longer in personal attendance and the patient can safely be placed under postoperative care; CMS converts minutes to 15-minute units to one decimal place, and 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 00864 pays more and less in California

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

29 of 29 payment localities

How the 00864 rate is calculated

Each of 00864’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 00864

00864 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.

00864 compared with similar codes

How to choose

00860Lower abdominal anesthesiaExtraperitoneal, unspecified procedure

00864 identifies anesthesia for total cystectomy. Use 00860 for an extraperitoneal lower-abdominal procedure that is not otherwise specified.

00862Renal surgery anesthesiaExtraperitoneal, lower abdomen

00862 is for extraperitoneal lower-abdominal renal procedures; 00864 is the specific choice for total cystectomy.

00865Prostatectomy anesthesiaExtraperitoneal lower abdomen

00865 is for prostatectomy, while 00864 is for total bladder removal.

00870Cystolithotomy anesthesiaExtraperitoneal approach

00870 is for bladder-stone surgery; 00864 is for total cystectomy, not stone removal.

Codes related to 00864

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