Anesthesia for a kidney transplant in the recipient when the surgeon works through a lower abdominal approach that stays outside the peritoneal cavity.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Anesthesia start and stop times
- Recipient renal transplant performed with extraperitoneal approach
- ASA physical status
- Personal performance or medical direction details with concurrency
- Separately performed lines or monitoring procedures with their own notes
- Pre-anesthesia evaluation and post-anesthesia handoff
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
00868 covers anesthesia for the recipient side of a renal transplant done through an extraperitoneal incision in the lower abdomen. It is a hospital anesthesia code, billed by the anesthesiologist or CRNA on base units plus time.
An orthopedic practice will not bill this code. It matters only to multispecialty groups or management companies where one billing team covers anesthesia across every service line. If you see it in an ortho work queue, check that the claim landed in the right practice.
The rules that cause problems are the standard anesthesia ones. Time must be documented to the minute. The personnel modifier has to match who actually did the case, and medical direction claims fall apart if the anesthesiologist was directing more than four rooms. Lines such as arterial lines, central lines, and TEE are separately reportable when documented, but they cannot be counted inside anesthesia time if you bill them separately. The donor side of the transplant uses a different anesthesia code.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
Common denial reasons
The recurring reasons claims for CPT 00868 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Donor nephrectomy anesthesia billed with the recipient code
- Personnel modifier does not match the anesthesia record
- Time units overlap with separately billed line placement
- Missing physical status modifier for payers that require it
- Medical direction requirements not documented
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is 00868 for the kidney donor or the recipient?
02Can arterial line placement be billed with 00868?
03Would an orthopedic practice ever bill 00868?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures the procedure, approach, and timing details in the note so the anesthesia claim is supported without chasing the provider for addenda.
See how Mira captures CPT 00868 documentation