{"id":168466,"date":"2026-07-28T13:10:24","date_gmt":"2026-07-28T13:10:24","guid":{"rendered":"https:\/\/pabau.com\/?p=168466"},"modified":"2026-08-17T11:37:39","modified_gmt":"2026-08-17T11:37:39","slug":"cpt-code-00566","status":"publish","type":"post","link":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00566\/","title":{"rendered":"CPT Code 00566: Anesthesia for off-pump coronary artery bypass grafting"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 00566: Anesthesia for off-pump coronary artery bypass grafting\",\"description\":\"CPT code 00566 (Anesthesia for direct coronary artery bypass grafting without pump oxygenator) covers off-pump CABG anesthesia. Base units: 25. Learn modifiers, reimbursement, and ICD-10 pairings.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00566\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-07-28\",\"dateModified\":\"2026-07-28\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 00566 covers anesthesia for direct coronary artery bypass grafting without a pump oxygenator (off-pump CABG), classified under intrathoracic anesthesia procedures.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The ASA base unit value is 25, one of the highest in the anesthesia code set, reflecting the complexity of off-pump cardiac surgery.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Modifier selection (AA, QZ, QX\/QK) depends on whether a physician anesthesiologist provides personal care, a CRNA performs the service independently, or a supervised team arrangement applies.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau supports accurate anesthesia claim documentation, time unit tracking, and modifier assignment to reduce denials on high-complexity surgical codes.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT code 00566 is the anesthesia billing code for off-pump coronary artery bypass grafting (OPCAB), the bypass technique performed without a cardiopulmonary bypass pump. Off-pump CABG is one of the most complex procedures an anesthesia team manages. With no pump to fall back on, the anesthesiologist must maintain hemodynamic stability throughout a beating-heart procedure under significant physiological stress.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div>\n<\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 00566 is the specific billing code that captures this service. Anesthesiologists, CRNAs, and billing specialists need to understand exactly when this code applies. They also need to know how base units and time units combine to determine reimbursement, and which modifiers signal the correct provider arrangement to payers. Getting any one of those elements wrong on a high-value cardiac claim is an expensive mistake.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This reference covers everything billing teams and anesthesia providers need for accurate 00566 claim submission. That includes the code description, base unit calculation, modifier rules, qualifying circumstances, Medicare reimbursement, ICD-10 pairings, and the most common denial triggers.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">CPT code 00566: definition and clinical description<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 00566 is defined by the <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">American Medical Association<\/a> as: <em>Anesthesia for direct coronary artery bypass grafting without pump oxygenator.<\/em> It falls within the intrathoracic procedures section of the CPT code set (range 00500-00580).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The procedure it covers is off-pump coronary artery bypass grafting, commonly abbreviated OPCAB. In off-pump CABG, the surgeon grafts coronary vessels while the heart continues beating. Cardiopulmonary bypass (the &#8220;pump oxygenator&#8221;) is not used. This distinguishes CPT code 00566 from adjacent code 00567, which applies when a pump oxygenator <em>is<\/em> used.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Details<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CPT code 00566<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Short description<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for direct coronary artery bypass grafting without pump oxygenator<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code section<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for intrathoracic procedures (00500-00580)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Procedure type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Off-pump coronary artery bypass grafting (OPCAB)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">ASA base units<\/td>\n<td style=\"padding:12px 16px;color:#374151\">25<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billing providers<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist, CRNA, anesthesia care team<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Off-pump CABG carries higher hemodynamic complexity than many other cardiac procedures. The anesthesia team must manage a beating heart, potential for rapid deterioration, and conversion risk to on-pump bypass. That clinical complexity is reflected in the 25-unit base value, one of the highest assigned in the <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">CPT anesthesia code range<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Anesthesia base units for CPT code 00566<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The ASA Relative Value Guide assigns CPT code 00566 a base unit value of 25. This figure is consistent across all major reference sources and is confirmed by the American Society of Anesthesiologists as the standard value for off-pump CABG anesthesia.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Base units represent the inherent complexity of providing anesthesia for a specific procedure, independent of how long it takes. A higher base unit count means greater pre-procedure preparation, higher patient risk, and more intensive intraoperative monitoring requirements. For context, a simple upper extremity procedure like CPT code 01810 carries just 3 base units. The 25-unit value for CPT code 00566 sits near the ceiling of the anesthesia code set.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Base units alone do not determine final reimbursement. They combine with time units and any qualifying circumstance units, described in later sections, to produce a total unit count. That total is then multiplied by the applicable conversion factor.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How anesthesia time units are calculated<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Anesthesia billing uses a units-based formula rather than a flat fee. For CPT code 00566, the total billable units equal the sum of base units, time units, and any applicable qualifying circumstance units.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The standard formula:<\/strong> Total units = Base units + Time units + Qualifying circumstance units<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Time units are calculated at one unit per 15-minute interval of anesthesia time, as defined in the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule<\/a> and the CMS Claims Processing Manual (Publication 100-04, Chapter 12). Anesthesia time begins when the anesthesia provider starts preparing the patient and ends when the provider is no longer in personal attendance.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Anesthesia time<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;text-align:center\">Time units<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;text-align:center\">Base units (00566)<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;text-align:center\">Total units<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">2 hours (120 min)<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">8<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">25<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">33<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">3 hours (180 min)<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">12<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">25<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">37<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">4 hours (240 min)<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">16<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">25<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">41<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">5 hours (300 min)<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">20<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">25<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">45<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Off-pump CABG cases typically run 3 to 5 hours, which means most 00566 claims will carry 37-45 total units before qualifying circumstances are factored in. Accurate time documentation is critical. A 15-minute error in recorded anesthesia start or end time translates directly to one billable unit, worth roughly $20-$26 at average Medicare conversion rates.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Some payers apply their own rounding rules (rounding up at 8 minutes vs. the full 15-minute standard). Always verify the specific payer&#8217;s time calculation policy before billing. Pabau&#8217;s claims management software helps anesthesia practices document precise service times in the patient record, reducing the risk of time-unit discrepancies on complex cardiac claims like CPT code 00566.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00566\/fully-integrated-with-pabau-billing.webp\" alt=\"Fully Integrated with Pabau Billing\"\/><figcaption class=\"wp-element-caption\"><em>Pabau links claims data directly to the patient record, so anesthesia time entries and modifiers stay attached to the same case file used for CPT code 00566 billing.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Reduce claim denials on complex anesthesia codes                <\/h3>\n\n                <p class=\"description\">\n                    Pabau helps anesthesia practices track service times, assign correct modifiers, and submit accurate claims for high-complexity codes like CPT code 00566. See how it works in a live demo.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<p class=\"wp-block-paragraph\">Comparing <a href=\"https:\/\/pabau.com\/blog\/best-medical-practice-management-software\/\">practice management systems for medical teams<\/a> is worth the effort before anesthesia time-unit billing becomes a spreadsheet job.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">CPT code 00566 modifiers<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection for CPT code 00566 is determined by the provider arrangement, not the procedure itself. Payers use modifiers to identify whether a physician anesthesiologist provided personal care, a CRNA operated independently, or a supervision arrangement applied. Using the wrong modifier on a high-value cardiac claim is one of the most common denial triggers for this code.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Provider type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist provides personal, continuous care throughout the case<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QZ<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA (unsupervised)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA performs the service without physician supervision (opt-out state or unsupervised arrangement)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QX<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA (supervised)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA with physician supervision; CRNA bills QX, supervising physician bills QK<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QK<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician (medical direction)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician medically directs 2-4 concurrent CRNA\/AA cases<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QY<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician (single CRNA direction)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician medically directs one CRNA; CRNA bills QX<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AD<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician (medical supervision)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician supervises 5+ concurrent procedures (reduced payment applies)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">For cardiac surgery cases, the AA modifier is most common because off-pump CABG typically demands continuous physician anesthesiologist presence. The QX\/QK pairing applies when a CRNA and directing anesthesiologist operate as a care team. Note that independent CRNA billing under QZ has significant compliance implications that vary by state opt-out status and individual hospital bylaws. Confirm your state&#8217;s supervisory rules before billing CPT code 00566 with QZ.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Accurate modifier assignment on cardiac anesthesia claims is also tracked in Pabau&#8217;s client record system. Provider roles and supervision arrangements can be documented at the case level to support audit trails.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00566\/detailed-client-records-in-pabau.webp\" alt=\"Detailed client records in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Each client record logs the supervising physician and CRNA against the case, giving coders the modifier evidence auditors look for on a 00566 claim.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n\n<h2 class=\"wp-block-heading\">Qualifying circumstances for CPT 00566<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Qualifying circumstances are add-on codes that may be reported alongside CPT code 00566 when specific clinical conditions increase the difficulty of anesthesia services. Each code adds additional units to the total, increasing reimbursement. However, each requires documented clinical justification, not just appended to a claim because the case was complex.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>99100 &#8211; Anesthesia for patient under 1 year or over 70 years:<\/strong> Off-pump CABG in elderly patients (over 70) is a common scenario. Verify payer acceptance for cardiac cases specifically, as some commercial payers restrict this code to pediatric patients.<\/li><li><strong>99116 &#8211; Utilization of total body hypothermia:<\/strong> If controlled hypothermia is used as an anesthesia technique, this code adds 5 units. Document the specific temperature management protocol in the anesthesia record.<\/li><li><strong>99135 &#8211; Controlled hypotension:<\/strong> When deliberate hypotension is induced and maintained during the procedure, this code adds 5 units. Requires documentation of the indication and technique.<\/li><li><strong>99140 &#8211; Emergency conditions:<\/strong> Applies when the procedure is classified as an emergency. The clinical basis for emergency designation must appear in the record. Adds 2 units.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">For most elective off-pump CABG cases, 99100 (for elderly patients) is the qualifying circumstance most likely to apply. Always verify that the payer&#8217;s policy explicitly permits qualifying circumstance add-on codes for cardiac anesthesia procedures before including them on the claim.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>When billing qualifying circumstances with CPT code 00566, print the anesthesia record and confirm the specific qualifying condition (age, hypothermia, hypotension, emergency) is explicitly documented before appending any add-on code. Auditors look for the documented clinical basis, not just the code on the claim.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Medicare reimbursement for CPT code 00566<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare reimburses anesthesia services using a unit-based formula rather than a procedure-specific fee. The calculation is: <strong>Total units x Conversion factor = Allowable payment.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Medicare anesthesia conversion factor is set nationally by CMS and adjusted annually. CMS publishes the official conversion factor values by geographic locality; practices can also cross-check current rates using <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">a third-party RVU lookup tool<\/a>, though it is not produced by CMS. Nationally, the conversion factor has ranged approximately $21-$26 per anesthesia unit in recent years, though exact values differ by MAC (Medicare Administrative Contractor) jurisdiction. Always verify the current rate for your locality before projecting 00566 reimbursement.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Scenario<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;text-align:center\">Total units<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;text-align:center\">Rate at $22\/unit<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;text-align:center\">Rate at $25\/unit<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">2-hour case (no QC)<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">33<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">$726<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">$825<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">3-hour case (no QC)<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">37<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">$814<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">$925<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">4-hour case (no QC)<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">41<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">$902<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">$1,025<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">5-hour case (no QC)<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">45<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">$990<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">$1,125<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">These figures are illustrative examples using approximate conversion factor ranges. Actual Medicare payment depends on your locality&#8217;s conversion factor, whether the AA or QK modifier applies, and any applicable GPCI adjustments. The AA\/QK split also affects the payment percentage for team arrangements. Use the <a href=\"https:\/\/chipsblog.pcc.com\/free-and-legal-2026-rvu-calculator\" target=\"_blank\" rel=\"nofollow noopener\">CMS-based RVU calculator<\/a> to generate locality-specific figures.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Qualifying circumstance add-on codes like 99100 add units under the ASA relative value system, but CMS assigns them status indicator B (bundled), so traditional Medicare does not reimburse them separately from the base anesthesia service. Some commercial payers do pay qualifying circumstances separately. In that case, 99100 adds 1 unit, not 2, to the total. Confirm the payer&#8217;s policy before including a qualifying circumstance code on a non-Medicare claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For practices managing cardiac anesthesia billing across multiple providers. It builds a claims performance view that helps identify underpayments and conversion factor discrepancies by payer and locality.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">ICD-10 codes commonly billed with CPT code 00566<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">ICD-10 diagnosis codes on an anesthesia claim must reflect the patient&#8217;s documented diagnoses, not just the procedure being performed. The codes below represent the most common ICD-10-CM diagnoses paired with CPT code 00566 in cardiac surgery billing, based on typical OPCAB patient presentations. This list is for reference only; always code from the documented clinical record.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Clinical context<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">I25.10<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Atherosclerotic heart disease of native coronary artery without angina pectoris<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Most common primary diagnosis for elective CABG<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">I25.110<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Atherosclerotic heart disease with unstable angina pectoris<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CABG for unstable\/refractory angina<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">I21.09<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ST elevation MI involving other coronary artery<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Urgent\/emergent CABG following acute MI<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">I21.19<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ST elevation MI involving other sites<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Alternative STEMI code when multi-vessel disease documented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">I25.5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Ischemic cardiomyopathy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CABG for refractory ischemic cardiomyopathy<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">I25.2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Old myocardial infarction<\/td>\n<td style=\"padding:12px 16px;color:#374151\">History of prior MI as secondary diagnosis<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Multi-vessel coronary artery disease (typically I25.10 as the primary) is the most common diagnostic scenario for elective off-pump CABG. Practices managing ICD-10 coding for cardiac anesthesia will also find Pabau&#8217;s digital forms useful for capturing structured pre-anesthesia evaluation data that feeds accurate diagnosis documentation.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00566\/digital-forms.webp\" alt=\"Digital forms\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s digital forms capture structured pre-anesthesia evaluation data, so the diagnosis documentation behind a 00566 claim is ready before the patient reaches the OR.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n\n<p class=\"wp-block-paragraph\">For further reference on codes that often appear alongside cardiac anesthesia claims, the Pabau team has also published guides on ICD-10 code I34.9 and CPT code 01999 for practices managing complex multi-code claims.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related CPT codes: intrathoracic anesthesia<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Correct code selection within the intrathoracic anesthesia section requires understanding the procedural differentiators between adjacent codes. The most common source of misassignment is the pump\/no-pump distinction between CPT code 00566 and 00567.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;text-align:center\">Base units<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key differentiator<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00560<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for intrathoracic procedures without cardiopulmonary bypass<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">15<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Non-CABG intrathoracic procedures without bypass<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00562<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for intrathoracic procedures with cardiopulmonary bypass<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">20<\/td>\n<td style=\"padding:12px 16px;color:#374151\">On-pump intrathoracic (non-CABG) with pump<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00566<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for direct coronary artery bypass grafting without pump oxygenator<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">25<\/td>\n<td style=\"padding:12px 16px;color:#374151\"><strong>Off-pump CABG specifically<\/strong><\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00567<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for direct coronary artery bypass grafting with pump oxygenator<\/td>\n<td style=\"padding:12px 16px;color:#374151;text-align:center\">18<\/td>\n<td style=\"padding:12px 16px;color:#374151\">On-pump CABG; 7 fewer base units than 00566<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h3 class=\"wp-block-heading\">What is the difference between CPT 00566 and CPT 00567?<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Both codes describe anesthesia for direct coronary artery bypass grafting, but they carry different base unit values. CPT code 00566 carries 25 base units for the off-pump approach, while CPT code 00567 carries 18 base units for the on-pump approach. The single distinguishing factor is the use of a pump oxygenator (cardiopulmonary bypass circuit).<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>CPT code 00566:<\/strong> The surgeon performs the bypass on a beating heart without using a cardiopulmonary bypass circuit. This is off-pump CABG (OPCAB).<\/li><li><strong>CPT 00567:<\/strong> Cardiopulmonary bypass is employed. The heart is stopped and the pump oxygenator assumes circulatory function during the grafting.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 00567 carries 7 fewer base units than CPT code 00566, a real difference of roughly $150 to $180 per case at typical conversion factors. Off-pump CABG is reimbursed at a meaningfully higher rate than the on-pump approach. The clinical record must still clearly document the presence or absence of cardiopulmonary bypass to justify whichever code is billed, since auditors specifically review operative notes for this distinction. Patients recovering from either procedure typically move into cardiac rehabilitation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Additional procedure-code references for practices handling anesthesia billing include Pabau&#8217;s guides to CPT code 01992 and CPT code 01968 for practices managing diverse anesthesia code sets.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Common billing errors and denial prevention for CPT code 00566<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Off-pump CABG anesthesia claims have a higher denial rate than many surgical specialties. Modifier rules, time documentation requirements, and the specificity of code selection all add complexity. The errors below account for the majority of avoidable 00566 denials.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Wrong code selection (00566 vs 00567):<\/strong> Billing 00566 when cardiopulmonary bypass was actually used (or vice versa) is the most common audit trigger. The operative note must document &#8220;off-pump&#8221; or &#8220;without pump oxygenator&#8221; to support 00566. If the case converted from off-pump to on-pump mid-procedure, consult your payer&#8217;s guidance on mid-procedure conversion coding before billing either code.<\/li><li><strong>Incorrect modifier:<\/strong> Common errors include using QZ in a non-opt-out state, billing QK without meeting the 2-4 concurrent case requirement, or omitting modifier AA when the anesthesiologist provided personal continuous care.<\/li><li><strong>Time documentation gaps:<\/strong> Missing or inconsistent anesthesia start and end times on the claim vs. the anesthesia record create unit discrepancies. Both times must appear in the medical record and match the units billed.<\/li><li><strong>Unsupported qualifying circumstances:<\/strong> Appending 99100 to an adult case under 70 years old, or 99116 without documentation of deliberate hypothermia, will trigger denial. Every qualifying circumstance code needs a documented clinical basis.<\/li><li><strong>Missing ICD-10 specificity:<\/strong> Using an unspecified coronary artery disease code when the operative report documents a specific vessel is a credentialing red flag. I25.10 is appropriate for native vessel CAD; use more specific codes when the record supports them.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Anesthesia practices using Pabau&#8217;s automated workflow tools can build pre-submission checklists that flag missing time entries, modifier mismatches, and unsupported add-on codes before claims leave the practice. This reduces the cost of cardiac anesthesia claim rework. For broader billing compliance guidance.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00566\/automated-communication-in-pabau.webp\" alt=\"Automated communication in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Automated reminders keep the anesthesia team and billing staff aligned on documentation deadlines, cutting the missing time entries that trigger 00566 denials.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n\n<p class=\"wp-block-paragraph\">For practices managing multiple CPT code categories alongside cardiac anesthesia. It reduces the manual coordination burden across high-complexity claim types.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related CPT codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00731\/\">CPT code 00731 \u2014 Anesthesia billing for upper GI endoscopy<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00580\/\">CPT Code 00580 \u2014 Anesthesia for heart\/lung transplant<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00600\/\">CPT code 00600 \u2014 Anesthesia for cervical spine and cord procedures<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00604\/\">CPT Code 00604 \u2014 Cervical spine anesthesia in sitting position<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How Pabau supports accurate cardiac anesthesia billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Many anesthesia practices still track case times on a paper anesthesia record, then re-key them into a separate billing system before a claim goes out. Each hand-off is a chance for a time entry, modifier, or qualifying circumstance to fall out of sync with what the OR actually documented.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau keeps the case record, the anesthesia time entries, and the claims data in one system. Pabau&#8217;s claims management software pulls documented start and end times straight from the patient record, so the units on a CPT code 00566 claim match what the anesthesia team recorded. Client records capture the supervising physician and CRNA at the case level, giving coders the modifier evidence a cardiac claim needs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That means fewer claims returned for missing time entries or unsupported modifiers, and less time spent reconciling the OR record against the bill before submission.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Keep cardiac anesthesia billing and documentation in sync                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&#8217;s claims management software ties anesthesia time entries, modifiers, and client records to the same case file, so CPT code 00566 claims match the OR record before they go out.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau clinic management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 00566 is a high-value, high-complexity code. Getting the base unit, time documentation, modifier, and ICD-10 pairing right on every claim requires a disciplined workflow at the point of documentation, not just at submission.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&#8217;s claims management tools help cardiac anesthesia practices build that discipline into the workflow itself, flagging missing data and modifier inconsistencies before claims are submitted. To see how Pabau handles complex anesthesia billing documentation, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a> with the team.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing anesthesia for a common post-CABG reoperation?<\/strong> CPT code <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00550\/\">00550<\/a> covers anesthesia for sternal debridement, a frequent complication after bypass surgery.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need the code for the surgical side of a cardiac repair?<\/strong> CPT code <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-33321\/\">33321<\/a> covers suture repair of the aorta or great vessels with shunt bypass.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Working an on-pump intrathoracic case instead?<\/strong> CPT code <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00562\/\">00562<\/a> covers anesthesia for intrathoracic procedures performed with cardiopulmonary bypass.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1785234760101\"><h3 class=\"schema-faq-question\">What is CPT code 00566 used for?<\/h3> <p class=\"schema-faq-answer\">CPT code 00566 is used to bill anesthesia services for direct coronary artery bypass grafting without a pump oxygenator, also known as off-pump CABG or OPCAB. It is reported by the anesthesiologist or CRNA providing anesthesia during a beating-heart cardiac bypass procedure, and it falls within the CPT intrathoracic anesthesia section (codes 00500-00580).<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234760102\"><h3 class=\"schema-faq-question\">What are the base units for CPT code 00566?<\/h3> <p class=\"schema-faq-answer\">The ASA base unit value for CPT code 00566 is 25 units. This is one of the highest base unit values in the anesthesia CPT code set, reflecting the complexity and clinical risk of off-pump cardiac surgery. Base units are added to time units to calculate total billable anesthesia units.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234760103\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT code 00566?<\/h3> <p class=\"schema-faq-answer\">The applicable modifiers are AA (physician anesthesiologist, personal care), QZ (CRNA without supervision), and QX (CRNA with physician direction). Additional modifiers include QK (physician directing 2-4 concurrent cases), QY (physician directing one CRNA), and AD (physician supervising 5 or more concurrent procedures). The correct modifier depends on the provider arrangement and payer contract, not the procedure itself.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234760104\"><h3 class=\"schema-faq-question\">How is anesthesia time calculated for CPT 00566?<\/h3> <p class=\"schema-faq-answer\">Anesthesia time for CPT code 00566 is calculated at one unit per 15-minute interval. Anesthesia time begins when the provider starts preparing the patient and ends when the provider is no longer in personal attendance. Total billable units equal base units (25) plus time units plus any qualifying circumstance units. Most OPCAB cases run 3-5 hours, producing 37-45 total units before qualifying circumstances.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234760105\"><h3 class=\"schema-faq-question\">What is the difference between CPT 00566 and CPT 00567?<\/h3> <p class=\"schema-faq-answer\">CPT 00566 covers anesthesia for off-pump CABG (no cardiopulmonary bypass), while CPT 00567 covers the same procedure performed with a pump oxygenator (on-pump CABG). CPT 00566 carries 25 base units, 7 more than the 18 base units assigned to CPT 00567. The distinction must be documented in the operative note, and the billing code must match the documented approach.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234760106\"><h3 class=\"schema-faq-question\">Can a CRNA bill CPT code 00566?<\/h3> <p class=\"schema-faq-answer\">Yes, a CRNA can bill CPT code 00566. The correct modifier depends on the supervision arrangement. QZ applies when the CRNA works without physician supervision, which is permitted only in states that have opted out of Medicare physician supervision requirements, while QX applies when a physician provides medical direction. Independent CRNA billing on cardiac cases carries significant compliance implications that vary by state and hospital policy.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>CPT code 00566 is the anesthesia billing code for off-pump coronary artery bypass grafting (OPCAB), the bypass technique performed without a cardiopulmonary bypass pump. Off-pump CABG is one of the most complex procedures an anesthesia team manages. With no pump to fall back on, the anesthesiologist must maintain hemodynamic stability throughout a beating-heart procedure under [&hellip;]<\/p>\n","protected":false},"author":81,"featured_media":168462,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"","_yoast_wpseo_content_score":"","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[4162,1162,2776],"class_list":["post-168466","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-anesthesia-billing","tag-cpt-codes","tag-cpt-coding"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.3 (Yoast SEO v28.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT Code 00566: Anesthesia for off-pump coronary artery bypass grafting<\/title>\n<meta name=\"description\" content=\"CPT code 00566 covers off-pump CABG anesthesia, carrying 25 base units and requiring AA, QZ, or QX\/QK modifiers by provider arrangement.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00566\/\" \/>\n<meta property=\"og:locale\" content=\"nl_NL\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT Code 00566: Anesthesia for off-pump coronary artery bypass grafting\" \/>\n<meta property=\"og:description\" content=\"CPT code 00566 covers off-pump CABG anesthesia, carrying 25 base units and requiring AA, QZ, or QX\/QK modifiers by provider arrangement.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00566\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta 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