CPT code 00220 describes anesthesia services provided for intracranial cerebrospinal fluid (CSF) shunting procedures. It is reported by the anesthesiologist or qualified anesthesia provider when general anesthesia is administered to a patient undergoing surgical placement, revision, or removal of a ventricular shunt system — most commonly for the management of hydrocephalus. With 10 CMS-assigned base units, this code sits in the mid-complexity range of the intracranial anesthesia family and carries distinct billing and documentation requirements that differ meaningfully from adjacent codes in the 00210–00222 series.
What Does CPT Code 00220 Mean?
CPT 00220 is defined by the AMA CPT code set as: “Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures.” It covers the complete anesthesia service — pre-induction preparation, intraoperative management, and immediate post-anesthesia monitoring — provided during neurosurgical procedures specifically involving the creation or revision of a pathway to divert excess CSF from the cranial vault.
Key attributes of this code at a glance:
- Category: Anesthesia / Procedures on the Head (AMA CPT range 00100–00222)
- CMS Base Units: 10
- Billable setting: Inpatient hospital (facility); anesthesia is not separately billable in the non-facility/office setting for intracranial surgery
- Provider type: Anesthesiologist (MD/DO), CRNA, or anesthesiologist assistant — modifier determines payment allocation
- Service type: Time-based; reported using the standard anesthesia formula
- Unilateral/bilateral distinction: Not applicable — the code covers the anesthesia encounter, not the anatomical target
What Services and Procedures Does CPT 00220 Cover?
CPT 00220 encompasses anesthesia rendered for any surgical intervention whose primary intent is the creation, revision, externalization, or removal of a CSF shunting system. The surgical CPT codes commonly paired with this anesthesia code include ventriculoperitoneal (VP) shunt placement, ventriculoatrial (VA) shunt placement, and lumboperitoneal shunt procedures accessed intracranially.
Clinical presentations and procedures appropriately covered under CPT 00220 include:
- Initial VP shunt placement for obstructive or communicating hydrocephalus
- Shunt revision surgery due to malfunction, obstruction, or fracture of the catheter or valve
- Shunt externalization in the setting of infection or emergency ICP management
- Complete shunt removal when endoscopic third ventriculostomy (ETV) replaces the shunt system
- Shunt exploration with or without component replacement (proximal, distal catheter, or valve)
- Lumboperitoneal shunt procedures involving an intracranial component
What Does CPT 00220 Specifically Exclude?
CPT 00220 should not be reported for the following:
- Anesthesia for endoscopic third ventriculostomy (ETV) performed without a shunt — this is more appropriately coded to CPT 00210 (intracranial NOS) absent a more specific code
- Anesthesia for VP shunt procedures performed with the patient in the sitting position — the sitting-position override rule requires CPT 00218 regardless of the underlying procedure type
- Anesthesia for burr hole procedures or ventriculography not involving shunt placement (CPT 00214)
- Anesthesia for lumboperitoneal shunt placement that does not involve an intracranial component — consider spinal procedure anesthesia codes
- Intracranial nerve electrocoagulation (CPT 00222)
- Moderate sedation or monitored anesthesia care (MAC) for minor neurosurgical interventions — MAC for intracranial procedures is exceedingly rare and payer-specific
When Is CPT 00220 the Right Code to Use?
Selecting CPT 00220 over adjacent intracranial anesthesia codes requires verifying both the procedure type and the intraoperative conditions documented on the anesthesia record. Follow this decision sequence:
- Confirm the surgical procedure involves CSF diversion. The operative note must describe a ventricular, lumboperitoneal, or related shunt placement, revision, or removal — not simply a craniotomy or burr hole.
- Verify the patient was NOT in the sitting position. If the neurosurgeon performed the shunting procedure with the patient seated upright or in a modified sitting position, the anesthesia provider must document this positioning explicitly — and the correct code becomes CPT 00218 (base units: 13), even if the surgical procedure itself would otherwise map to 00220.
- Confirm general anesthesia — not MAC — was administered. CSF shunting is universally performed under general anesthesia; MAC is not appropriate for these procedures.
- Confirm only one anesthesia code is reported. When multiple surgical procedures occur during a single anesthesia administration, only the code with the highest base unit value is reported. For example, if a VP shunt revision (00220, 10 units) is performed alongside a ventriculography (00214, 9 units) during the same anesthetic, only 00220 is reported.
- Apply qualifying circumstances codes as warranted (see Modifiers section below).
How Does CPT 00220 Differ From CPT 00210, 00218, and 00222?
The intracranial anesthesia code family is navigated by procedure type and patient positioning — not by anatomical location alone. The table below clarifies the key distinctions:
| CPT Code | Descriptor (Abbreviated) | CMS Base Units | Key Differentiator vs. 00220 |
|---|---|---|---|
| 00210 | Intracranial procedures, NOS | 11 | Catch-all for intracranial cases not described by a more specific code; higher base units than 00220 |
| 00211 | Craniotomy/craniectomy for hematoma evacuation | 10 | Specific to hematoma evacuation; same base units as 00220 |
| 00214 | Burr holes, including ventriculography | 9 | Limited to burr hole procedures and ventriculography; lower complexity |
| 00218 | Intracranial procedures in sitting position | 13 | Position-driven override — applies to ANY intracranial procedure, including CSF shunting, when patient is seated; supersedes 00220 |
| 00220 | CSF shunting procedures | 10 | Specific to shunt placement, revision, removal; supine/lateral positioning |
| 00222 | Electrocoagulation of intracranial nerve | 6 | Restricted to nerve electrocoagulation; lowest complexity in family |
In practice, the most common coding error among anesthesia billing teams is failing to upgrade from 00220 to 00218 when the patient is documented as being in the sitting position. This oversight costs 3 base units per case — a significant revenue impact in high-volume neurosurgical programs.
What Documentation Is Required to Support CPT 00220?
What Must the Provider Document in the Anesthesia Record?
The anesthesia record for CPT 00220 must contain all of the following elements to support both correct code assignment and claims adjudication:
- Patient identity and physical status (ASA PS classification) — document the assigned PS modifier (P1 through P5) with clinical rationale
- Pre-anesthesia evaluation — documented prior to induction; must include review of relevant medical history, current medications, airway assessment, and NPO status
- Anesthesia start time — the moment the anesthesiologist begins preparing the patient in the operating room (IV placement, monitor application, pre-induction sedation)
- Anesthesia end time — the moment care is transferred to the post-anesthesia care unit (PACU) team
- Type of anesthesia administered — general endotracheal anesthesia is standard; document induction agents, maintenance agents, and any neuroanesthesia-specific techniques (controlled hypocapnia, osmotherapy, etc.)
- Patient positioning — explicitly state supine, lateral, or prone; if sitting, code 00218 applies
- Intraoperative monitoring — document standard monitors plus any neuroanesthesia-specific modalities (arterial line, ICP monitor, neurophysiologic monitoring if applicable)
- Qualifying circumstances — if applicable, document the clinical basis for +99100 (extreme age), +99116 (hypothermia), +99135 (controlled hypotension), or +99140 (emergency)
- Post-anesthesia note — PACU assessment documenting patient condition at transfer
What Are the Documentation Standards for Facility vs. Non-Facility Settings?
| Element | Inpatient/Hospital Facility | Ambulatory Surgery Center (ASC) |
|---|---|---|
| Anesthesia record format | Full intraoperative record per JCAHO/hospital bylaws | ASC-specific record; same time/monitoring elements required |
| Pre-anesthesia evaluation timing | Must precede surgical incision; ideally completed day of or day before | Same requirement; same-day pre-op assessment common |
| Post-anesthesia note | Required before patient discharge from PACU | Required before discharge from ASC |
| Neurophysiologic monitoring documentation | Separate billing by monitoring provider; anesthesia record notes its use | Same; G0453 or 95940/95941 billed separately |
| Physical status modifier | Required on claim; document in record | Same |
Note: While VP shunt placement is rarely performed in the ASC setting due to complexity, shunt revision procedures in stable adult patients may occasionally occur in ASC environments. Billing teams should verify ASC coverage policies with individual payers before submission.
How Does CPT 00220 Affect Medical Billing and Reimbursement?
Anesthesia billing under CPT 00220 follows the standard time-based anesthesia payment formula used across the 00100–01999 code range. Unlike evaluation and management or surgical codes — which use RVU-based payment — anesthesia services are reimbursed by combining procedure complexity (base units) with case duration (time units), multiplied by a payer-specific conversion factor.
CPT 00220 Base Unit Value and Reimbursement Calculation
| Component | Value / Description |
|---|---|
| CMS Base Units | 10 |
| Time Units | Total anesthesia minutes ÷ 15 (Medicare/Medicaid); some commercial payers round to nearest whole unit |
| Anesthesia Start | When provider begins patient preparation in OR |
| Anesthesia End | When care is transferred to PACU team |
| Medicare Formula | (Base Units + Time Units) × Locality-Specific Conversion Factor = Allowance |
| Medicare Conversion Factor (CY 2026, APM participants) | $20.6754 per unit (non-APM rate differs; verify via CMS Anesthesiologists Center) |
| Illustrative Calculation (90-min case) | (10 base + 6.0 time) × $20.68 ≈ $330.88 (Medicare, AA modifier, illustrative) |
| Commercial Payer Median CF | Approximately $78.00/unit (2022 ASA survey benchmark); commercial allowance for same case ≈ $1,248.00 |
Important: Medicare does not recognize or reimburse additional units for Physical Status modifiers. Commercial payers generally do pay physical status units — the P3 modifier (1 additional unit) and P4 modifier (2 additional units) are commonly applicable in hydrocephalus patients with significant comorbidities. Verify physical status coverage within each commercial contract per the ASA Relative Value Guide (RVG) recommendations.
For complete locality-specific conversion factor tables, reference the CMS Medicare Claims Processing Manual, Chapter 12, Section 50 and the applicable Medicare Administrative Contractor (MAC) fee schedule tool.
What Modifiers Are Commonly Used With CPT 00220?
Every anesthesia claim must carry a provider/staffing modifier in the first modifier field. Physical status modifiers and qualifying circumstances are added in subsequent positions. The table below covers the modifiers most frequently appended to CPT 00220:
| Modifier | Type | Description | Billing Impact |
|---|---|---|---|
| AA | Staffing (pricing) | Anesthesia personally performed by the anesthesiologist | 100% of allowance |
| QK | Staffing (pricing) | Medical direction of 2–4 concurrent CRNA/AA cases | 50% of allowance per case |
| QY | Staffing (pricing) | Medical direction of one CRNA by anesthesiologist | 50% of allowance |
| QX | Staffing (pricing) | CRNA service with physician medical direction | 50% of allowance |
| QZ | Staffing (pricing) | CRNA service without physician medical direction | 100% of allowance (CRNA) |
| AD | Staffing (pricing) | Medical supervision of more than 4 concurrent procedures | Restricted payment: 3 base units + CF only |
| P1–P6 | Physical status | ASA physical status classification (P3 = 1 unit; P4 = 2 units; P5 = 3 units) | Additional units (commercial payers only; Medicare does not pay) |
| +99100 | Qualifying circumstance | Extreme age (patient <1 year or >70 years) | +1 base unit; list separately on second claim line |
| +99116 | Qualifying circumstance | Utilization of total-body hypothermia | +5 base units; rare in shunt cases but applies when hypothermia is induced |
| +99135 | Qualifying circumstance | Utilization of controlled hypotension | +5 base units; rare in routine shunting but may apply in complex revision cases |
| +99140 | Qualifying circumstance | Emergency conditions | +2 base units; requires clinical documentation of emergency justification |
Staffing modifiers must always appear first in the modifier field. Failure to lead with the staffing modifier is among the top reasons for anesthesia claim denial, per Medicare Administrative Contractor guidance.
Are There Prior Authorization, Coverage Restrictions, or LCD Requirements?
- Prior authorization is generally not required for the anesthesia service itself. However, the underlying surgical procedure (e.g., CPT 62220 for VP shunt creation or CPT 62230 for revision) may require prior authorization from the payer — and that determination indirectly affects anesthesia coverage.
- Medicare National Coverage Determinations (NCDs) do not impose procedure-specific coverage limitations on CPT 00220. Medical necessity for anesthesia is tied to the covered surgical indication (hydrocephalus, CSF diversion).
- NCCI/CCI bundling: CPT 00220 is not subject to direct CCI edit pairs with most commonly co-billed codes, but neurophysiologic monitoring codes (e.g., G0453, 95940, 95941) are billed by the monitoring provider — not the anesthesiologist — and should not appear on the anesthesiologist’s claim.
- Global period: Anesthesia codes carry a 0-day global period; pre- and post-anesthesia visits are included in the base unit value and are not separately billable by the anesthesia provider.
What CPT or HCPCS Codes Are Commonly Billed Alongside CPT 00220?
The surgical team, hospital facility, and ancillary providers each bill their own codes for the same encounter. Understanding which codes commonly appear alongside 00220 — and which create bundling risk — is essential for anesthesia billing teams reviewing operative reports.
| Code | Description | Typical Pairing Context | Bundling Risk for Anesthesia Claim |
|---|---|---|---|
| 62220 | VP shunt creation | Initial shunt placement; primary pairing for 00220 | None — surgical code, different provider |
| 62230 | VP shunt replacement/revision | Shunt revision; most common pairing in practice | None — surgical code, different provider |
| 62256 | VP shunt removal | Shunt removal without replacement | None — surgical code, different provider |
| 62258 | VP shunt replacement (complete system) | Full system revision | None — surgical code, different provider |
| G0453 | Continuous intraoperative neurophysiologic monitoring (remote) | Neurophysiologic monitoring during cranial procedures | Risk: Must NOT appear on anesthesiologist’s claim; billed by monitoring provider |
| 95940 | Continuous intraoperative neuromonitoring (in OR, per hour) | Same as above | Risk: Same — separate provider billing |
| +99100 | Extreme age qualifying circumstance | Pediatric or elderly patients | No bundling risk; add-on to 00220 on same claim |
| 01996 | Daily hospital management of epidural/subarachnoid drug administration | Post-op pain management; separate from anesthesia care | No bundling risk with 00220; different service |
Which Code Combinations Trigger NCCI or CCI Edits?
- Billing G0453 or 95940/95941 on the anesthesiologist’s claim when a separate neuromonitoring provider was present will trigger a NCCI bundling edit or claim denial.
- Reporting two anesthesia CPT codes (e.g., 00220 and 00214) for the same anesthetic episode violates the ASA rule that only the single highest base unit code is reported; this is a common audit flag.
- Appending modifier AD while simultaneously claiming full anesthesia time with multiple concurrent cases is inconsistent documentation that raises payer scrutiny.
- Billing 01996 (daily epidural management) on the same date of service as 00220 when a single anesthesia episode is documented may draw review if the clinical record does not separately support epidural catheter management as a distinct service.
What Coding Errors Should You Avoid With CPT 00220?
The following errors appear repeatedly in anesthesia billing audits involving the intracranial code family. Ranked by audit frequency and compliance risk:
- Failing to upgrade to CPT 00218 when the patient is documented in the sitting position. This is the single most revenue-impacting error in intracranial anesthesia coding — three lost base units per case, invisible unless the anesthesia record is reviewed against the operative note.
- Reporting multiple anesthesia CPT codes for a single anesthetic episode. When a VP shunt revision also involves ventriculography, only the code with the highest base unit value (00220) is reported. Reporting both codes creates a duplicate/overlapping service denial.
- Missing or incorrect staffing modifier in the first modifier position. Omitting AA, QK, QX, or QZ causes claim rejection at adjudication.
- Submitting claims without documented anesthesia start and stop times. Time is the variable component of payment; a claim without exact start/stop times will either deny or be subject to downward adjustment.
- Billing physical status modifier units to Medicare. Medicare does not reimburse physical status units; billing them to Medicare creates an overpayment liability.
- Applying qualifying circumstance codes without supporting documentation. Reporting +99140 (emergency) without a documented clinical rationale on the anesthesia record or CMS-1500 Block 19 is an audit flag highlighted in OIG guidance on anesthesia billing.
- Incorrectly billing 00220 for an ETV (endoscopic third ventriculostomy) without a shunt component. The procedure must involve an actual shunt device; an ETV alone does not meet the code descriptor.
What Do Auditors and RAC Reviewers Look for When Reviewing Claims With CPT 00220?
Recovery Audit Contractors (RACs) and Medicare Administrative Contractors reviewing anesthesia claims for CPT 00220 typically examine:
- Anesthesia record vs. operative note consistency: Does the surgical procedure documented by the neurosurgeon (a shunting procedure) match the anesthesia code reported?
- Patient positioning documentation: If the anesthesia record is silent on positioning and 00218 is not reported, auditors may question whether the sitting position was used but not captured
- Time entry accuracy: Discrepancies between anesthesia record start/stop times and OR log timestamps are a primary RAC target
- Concurrent case management documentation: For QK/QY modifier claims, auditors verify the anesthesiologist completed all seven CMS-required medical direction steps for each concurrent case
- Qualifying circumstance justification: Claims with +99140 (emergency) must have supporting clinical documentation; “urgency” does not meet the CPT definition of emergency (defined as a delay that would lead to significant increase in threat to life or body part)
How Does CPT 00220 Relate to Other CPT Codes?
| Related Code | Relationship Type | Key Distinction |
|---|---|---|
| 00210 | Sibling (NOS) | Catch-all for intracranial procedures not described by a specific code; 1 more base unit than 00220; do not use when 00220 applies |
| 00211 | Sibling | Hematoma evacuation only; same base unit value as 00220 |
| 00214 | Sibling | Burr holes and ventriculography; lower complexity; 1 fewer base unit |
| 00218 | Sibling / override | Patient-position trigger: any intracranial procedure in sitting position; supersedes 00220 when applicable; 3 additional base units |
| 00222 | Sibling | Electrocoagulation of intracranial nerve only; significantly lower complexity |
| 62220 | Surgical companion | The most common surgical CPT co-billed with 00220 by the neurosurgeon |
| 62230 | Surgical companion | VP shunt revision; second most common surgical companion |
| +99100 | Add-on companion | Pediatric or elderly patient qualifying circumstance; billed as second line item |
What Is the Correct Code Sequencing or Reporting Order When CPT 00220 Appears With Other Codes?
- Report the primary anesthesia code (00220) on the first line of the CMS-1500 claim (Box 24D), with the required staffing modifier in the first modifier position.
- Report the physical status modifier (P1–P6) in the second modifier position on the same line as 00220.
- If a qualifying circumstance applies (+99100, +99116, +99135, +99140), list it on a separate claim line with its own charge. Document the clinical basis in Box 19 (or electronic equivalent) for +99140.
- Anesthesia time in minutes is entered in Box 24G (or the units field); Medicare MACs convert minutes to units internally.
- Do not report a second anesthesia CPT code on the same claim for the same anesthetic episode.
Real-World Coding Scenario — How CPT 00220 Is Applied in Practice
Clinical Scenario: A 67-year-old patient with a history of normal pressure hydrocephalus (NPH) presents for elective VP shunt revision due to valve malfunction documented on MRI. The neurosurgeon performs a shunt revision (surgical CPT 62230) with the patient in the supine position. The case runs 78 minutes from anesthesia start to PACU handoff. The anesthesiologist personally performs the anesthesia (no CRNA involved). The patient has mild-to-moderate systemic disease (controlled hypertension and Type 2 diabetes) — ASA PS P2. No qualifying circumstances apply.
Correct Code Application
- Anesthesia code: CPT 00220 (CSF shunting procedure; supine position confirmed on record)
- Staffing modifier: AA (personally performed by anesthesiologist) — first modifier position
- Physical status modifier: P2 (mild systemic disease) — second modifier position (0 additional units; P2 adds no units)
- Time units: 78 minutes ÷ 15 = 5.2 units (Medicare calculation)
- Total anesthesia units: 10 base + 5.2 time = 15.2 units
- Qualifying circumstance codes: None applicable (patient is 67, below the >70 threshold for +99100)
- Illustrative Medicare allowance: 15.2 × ~$20.68 ≈ $314.34
Common Mistake in This Scenario
- Error: Coder reports CPT 00210 (NOS) instead of 00220, assuming NOS is the safer choice when unfamiliar with the code family.
- Why it fails: CPT 00210 has 11 base units but is the catch-all code used only when no more specific code applies. Since 00220 precisely describes CSF shunting, 00220 is the required code. Reporting 00210 in this scenario is upcoding, creates audit exposure, and may trigger a RAC overpayment finding.
- Second common error: Coder fails to note that if the neurosurgeon had used the sitting position, the correct code would be 00218 (13 base units) — yielding $165–$620 more reimbursement depending on payer, per case, while also being the accurate code.
Frequently Asked Questions About CPT Code 00220
Is CPT Code 00220 Still Valid for Use in 2025 and 2026?
CPT code 00220 remains a valid, active code with no changes to its descriptor or base unit value through the current code year. Anesthesia billing teams should verify annually against the AMA CPT Professional Edition and the CMS Physician Fee Schedule lookup tool to confirm that no revisions to the code description, base unit value, or coverage status have been implemented for the applicable date of service.
What Is the Base Unit Value for CPT 00220?
CPT 00220 carries a CMS-assigned base unit value of 10 units, reflecting the moderate-to-high procedural complexity of CSF shunting anesthesia. This is the same base unit value as CPT 00211 (hematoma evacuation craniotomy) and is lower than CPT 00210 (NOS, 11 units) and CPT 00218 (sitting position, 13 units), reinforcing that code selection must follow the procedure type and positioning — not simply be defaulted to the highest unit value in the family.
Can CPT 00220 Be Used for a Shunt Revision as Well as Initial Shunt Placement?
Yes. CPT 00220 applies to anesthesia for any CSF shunting procedure — including initial placement, revision of a malfunctioning shunt, replacement of individual components (proximal catheter, distal catheter, or valve), externalization, and complete shunt removal. The anesthesia service is the same category of care regardless of whether this is the patient’s first shunt or a revision, and the code does not distinguish between these scenarios.
Should CPT 00220 or CPT 00218 Be Reported When the Patient Is in the Sitting Position During a VP Shunt Revision?
CPT 00218 must be reported when the patient is in the sitting position, even if the underlying procedure is a CSF shunting procedure. Per AMA CPT coding guidance clarified in the 2016 ASA/AMA update, CPT 00218 (“procedures in the sitting position”) functions as a position-driven override that takes precedence over the procedure-specific code when the patient is seated. The anesthesia record must explicitly document the sitting position to support the use of 00218 over 00220.
Does Medicare Pay Physical Status Modifier Units for CPT 00220?
Medicare does not recognize or pay additional units for physical status modifiers (P1–P6) for any anesthesia code, including CPT 00220. Physical status modifiers are informational for Medicare and should be included on the claim for completeness, but no additional payment is generated. Most commercial payers do recognize physical status units — confirm coverage within each payer contract using the ASA Annual Commercial Conversion Factor Survey and individual contract terms.
How Is the Pediatric Patient Coded With CPT 00220?
When CPT 00220 is reported for a patient younger than one year of age, add-on code +99100 (qualifying circumstance — extreme age, younger than 1 year or older than 70) should be listed on a separate claim line. This adds 1 anesthesia base unit and reflects the additional complexity and vigilance required for neonatal or infant neuroanesthesia. Note that some payers exclude +99100 when the primary anesthesia code is inherently pediatric-specific (e.g., 00326) — but CPT 00220 has no age restriction in its descriptor, making +99100 appropriate for pediatric patients when payer policy supports it.
What Is the Difference Between CPT 00220 and CPT 00210 for Intracranial Anesthesia?
CPT 00210 is the “not otherwise specified” code for intracranial anesthesia — it applies when the specific type of intracranial procedure does not match any of the more precisely defined codes in the 00210–00222 family. CPT 00220, by contrast, is specifically defined for CSF shunting procedures. When a shunting procedure is performed, 00220 is the required code; reporting 00210 for a shunting case constitutes upcoding (since 00210 carries 11 base units vs. 00220’s 10) and creates compliance risk. Always select the most specific code that accurately describes the anesthetic service rendered.
Key Takeaways for Billing and Coding CPT 00220
- CPT 00220 covers anesthesia for all CSF shunting procedures — initial placement, revision, and removal — with a CMS base unit value of 10 units
- The most consequential code selection decision is patient positioning: if the patient is in the sitting position, CPT 00218 (13 base units) must be reported instead, regardless of the procedure type
- Every claim must carry a staffing modifier (AA, QK, QY, QX, QZ, or AD) in the first modifier position — omitting it is among the leading causes of anesthesia claim denial
- Medicare does not pay physical status modifier units; commercial payers generally do — verify within each contract
- Qualifying circumstance add-on codes (+99100, +99116, +99135, +99140) are listed on separate claim lines and require clinical documentation support, particularly for +99140 (emergency)
- Report only one anesthesia CPT code per anesthetic episode — when multiple procedures occur, report the code with the highest base unit value only
- Neurophysiologic monitoring codes (G0453, 95940, 95941) are billed by the monitoring provider — they must not appear on the anesthesiologist’s claim
- For complete anesthesia billing and payment details, reference the CMS Medicare Claims Processing Manual, Chapter 12, Section 50 and the ASA Relative Value Guide (RVG)
