CPT code 00865: Prostatectomy anesthesia, extraperitoneal lower abdomen2026 Medicare rate & RVUs in Guam
Anesthesia for prostatectomy through an extraperitoneal lower-abdominal approach, reported by the anesthesia professional for the operative anesthetic.
CMS doesn’t publish an office rate for 00865 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 00865 covers
This service covers anesthesia for prostate removal through an extraperitoneal approach in the lower abdomen. A urologist typically performs the operation, often to treat prostate cancer, while an anesthesiologist or CRNA provides and reports the anesthetic in an operating room.
Choose this code for prostatectomy rather than the broader extraperitoneal lower-abdominal category or codes specific to renal surgery, total cystectomy, adrenalectomy, or renal transplantation. The operative report should identify the prostatectomy and extraperitoneal approach; the anesthesia record should support the service and document its start and end times. This code has 7 base units. Medicare payment is (base units + time units) × the locality’s anesthesia conversion factor; time is reported in minutes and converted to 15-minute units to one decimal place, starting when the anesthesia practitioner begins preparing the patient and ending when the practitioner is no longer in personal attendance and the patient can safely be placed under postoperative care.
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.
00865 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
How the 00865 rate is calculated
Each of 00865’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 · 00865
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 00865
00865 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 · 00865
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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00865 isn’t priced in this setting.
00865 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 00860Lower abdominal anesthesiaExtraperitoneal, unspecified procedure
- Choose 00865 when the operation is a prostatectomy. Code 00860 covers other extraperitoneal lower-abdominal procedures.
- 00862Renal surgery anesthesiaExtraperitoneal, lower abdomen
- Code 00862 is for renal procedures in the extraperitoneal lower abdomen; 00865 is for prostatectomy.
- 00864Cystectomy anesthesiaExtraperitoneal lower abdomen
- Code 00864 applies to total cystectomy, not prostatectomy.
00865 billing questions
When should this code be chosen instead of 00860?
Use 00865 for an extraperitoneal lower-abdominal prostatectomy. Code 00860 is the broader category for other extraperitoneal lower-abdominal procedures.
How does this differ from 00862 or 00864?
Code 00862 is for extraperitoneal lower-abdominal renal procedures, while 00864 is for total cystectomy. The operation documented in the operative report determines which procedure-specific anesthesia code fits.
What should the records establish?
The operative report should identify the prostatectomy and its extraperitoneal lower-abdominal approach. The anesthesia record should support the anesthesia service and document its start and end times.
How are Medicare anesthesia units calculated?
This code has 7 base units. Medicare adds time units, calculated from anesthesia minutes in 15-minute units to one decimal place, and applies the conversion factor for the payment locality.
How is medically directed anesthesia reported when a CRNA participates?
When an anesthesiologist medically directs a CRNA, Medicare pays each professional 50% of the allowance for the personally performed service.
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
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