CPT code 00904: Perineal anesthesia, radical procedures2026 Medicare rate & RVUs

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

What 00904 covers

Code 00904 covers anesthesia for radical operations performed through the perineum, including radical perineal prostatectomy. The surgeon’s operative report identifies the approach and radical procedure; an anesthesia practitioner provides and reports the anesthesia service. Select this code for the radical perineal operation, not simply because another procedure involves the perineum or pelvic organs.

Choose 00904 rather than 00908 when the perineal prostate operation is radical; 00908 applies to perineal prostatectomy outside that radical category. Anorectal procedures and vulvectomy are classified under different anesthesia codes, 00902 and 00906. The operative report should establish the procedure and approach, and the anesthesia record should document service times. Medicare assigns 7 base units; 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, from when the practitioner begins preparing the patient for anesthesia until personal attendance ends and the patient can safely be placed under 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 00904 pays more and less

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

109 of 109 payment localities

00904 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 00904 rate is calculated

Each of 00904’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 00904

00904 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.

00904 compared with similar codes

How to choose

00908Prostatectomy anesthesiaPerineal approach

00904 is for radical operations through the perineum, such as radical perineal prostatectomy. 00908 applies to perineal prostatectomy outside that radical category.

00902Anorectal anesthesiaAnorectal procedures

00902 is selected for anorectal procedures. 00904 is for radical operations performed through the perineum.

00906Vulvectomy anesthesiaVulvar excision

00906 covers anesthesia for vulvectomy. 00904 is selected for radical perineal surgery, not based solely on proximity to the vulva.

Codes related to 00904

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