CPT code 00864: Cystectomy anesthesia, extraperitoneal lower abdomen2026 Medicare rate & RVUs in Guam
Anesthesia for total cystectomy through an extraperitoneal lower-abdominal approach is reported when the anesthetized operation includes total bladder removal.
CMS doesn’t publish an office rate for 00864 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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.
00864 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
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.
How the rate is built · 00864
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
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.
Place of service · 00864
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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00864 isn’t priced in this setting.
00864 compared with similar codes
Compare codes · National
5 codes, side by side
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.
00864 billing questions
When should this code be chosen instead of 00860?
Use 00864 when the anesthetized procedure is total cystectomy. Code 00860 is for an extraperitoneal lower-abdominal procedure not otherwise specified.
Does an associated urinary diversion change the code selection?
The defining procedure for 00864 is total cystectomy. Document any urinary diversion performed as part of the operative plan.
What should the operative and anesthesia records show?
The operative report should identify total bladder removal and the surgical approach. The anesthesia record should support the anesthesia service and the minutes reported.
How are anesthesia units calculated for 00864?
The code has 8 base units. Medicare adds time units, calculated from anesthesia minutes in 15-minute increments to one decimal place, then applies the locality’s anesthesia conversion factor.
Is 00864 for partial bladder removal or bladder-stone surgery?
No. It is for total cystectomy; anesthesia for bladder-stone removal is represented by 00870.
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.
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