Billing for Hospital Anesthesia Services

How are anesthesia services billed?

Your anesthesiologist will bill separately for his or her professional services, as will your surgeon and the other physicians who provide services for you while you are hospitalized. The hospital will issue a separate bill for all of the services and items the hospital provided during your hospitalization and that bill will include charges for the hospital’s role in the delivery of anesthesia services. For more information about hospital billings, you may contact your hospital’s financial counseling office. They can provide you with detailed information about billings for hospital services, including providing estimates of the expected cost of most surgeries and procedures.

How does Sutter Health charge for the hospital's role in providing anesthesia services?

Sutter hospitals charge for the hospital’s role in providing anesthesia services based on the specific type of anesthesia services a patient receives.

General Anesthesia
There are two levels of general anesthesia in the operating room – complex and standard general anesthesia. We charge one flat amount for complex general anesthesia services for cases lasting up to and including 180 minutes. For cases lasting longer than 180 minutes, there is a different, higher charge. We use the same basic approach for standard general anesthesia – we charge a flat amount for cases lasting up to and including 180 minutes, and another, higher charge for standard general anesthesia cases that last longer than 180 minutes. This charge structure is designed to take into account that cases lasting over 180 minutes require more hospital resources. If general anesthesia is administered outside of an operating room suite, there is a single flat charge for the service, regardless of where it takes place in the hospital. There is a separate pharmacy charge for the anesthetic gas and any other specific drugs used. To find out the amounts of these charges, or any other charges at the hospital where your surgery or procedure will take place, you should contact the financial counseling office at that hospital.

Regional Anesthesia
For monitored anesthesia care/regional anesthesia provided in the operating room, Sutter hospitals have a single flat-rate charge. There are no charges for anesthetic gases, because they are not used, but there are separate pharmacy charges for the drugs used, including the epidural block and the drugs used to sedate the patient.

Conscious Sedation
For conscious sedation, whether in the operating room or elsewhere in the hospital, there is a single flat charge for the service, regardless of where it takes place in the hospital. There are no charges for anesthetic gases, because they are not used, but there are separate pharmacy charges for the drugs used, including the drugs used to sedate the patient.

Epidurals
For epidurals with minimal sedation in the operating room, there will be pharmacy charges for the drugs used, including the epidural block and the drugs used to sedate the patient, but there will not be a separate anesthesia service charge. The exception to this rule is in the labor and delivery area, where there may be a flat epidural management charge in certain situations.

• For more details about these charges, and any other hospital charges, you may contact the patient financial counselor or at your hospital.
• For more information about how Sutter Health bills for the hospital’s role in providing anesthesia services, you can call Sutter’s Anesthesia Information Line at (916) 297-9940.

What is the hospital's role in delivering anesthesia services?
The hospital supplies the equipment, supplies and staff required to safely and effectively deliver anesthesia services in the hospital. The specific resources the hospital provides varies depending upon the type of anesthesia and your particular medical condition. The hospital also provides the anesthesia gases and other drugs, which, as noted above, are charged separately through the hospital’s pharmacy. Information about the hospital resources that are directly related to the provision of general anesthesia and regional anesthesia is generally summarized in the  Equipment and Service Descriptions within the next section.

How do Sutter's costs of providing anesthesia relate to the price Sutter charges for anesthesia?

Sutter’s charges for anesthesia services, and for almost all hospital services, exceed the hospital’s allocated costs for those services. We encourage patients to review the table on this page to compare Sutter’s costs to the prices you or your insurer are charged.

Who can I contact for more information regarding Sutter's charges for a Sutter hospital's role in providing anesthesia services?

You may call our Anesthesia Information Line at (916) 297-9940.

Sutter Health identifies the following equipment, supplies and staff that are directly related to the new, flat-charge structure for complex general anesthesia, standard general anesthesia, and monitored anesthesia care/regional anesthesia.

Complex General Anesthesia (Cmplx Gen Anes)

• Anesthesia equipment, including but not limited to the anesthesia workstation and all components (e.g., gas induction components, ventilator, O2 monitor, CO2 monitor, BIS monitor, EKG, esophageal monitor, blood pressure monitor, and pulse rate monitor), Smart IV pumps, rapid infusion pumps, fluid warmers, medical gas tanks, pumps, piping, gas flow monitors, and alarms, and maintenance and upkeep
• Oxygen (excludes all other anesthesia gases billed under Revenue Code 25x)
• Instruments used by the anesthesiologist, including but not limited to regular intubation instruments and scopes, and also those needed for difficult intubations, heated circuit
• Anesthesia-related supplies that are not billed separately, including but not limited to breathing circuit, sterile and other supplies
• Anesthesia department staff, including but not limited to anesthesia medical device technicians
• Anesthesia-related quality review/assurance staff and resources
• Anesthesia-related patient medical records and records review
• Anesthesia hazardous waste removal

Standard General Anesthesia (Stnd Gen Anes)

• Anesthesia equipment, including but not limited to the anesthesia workstation and all components (e.g., gas induction components, ventilator, O2 monitor, CO2 monitor, BIS monitor, EKG, esophageal monitor, blood pressure monitor, and pulse rate monitor), Smart IV pumps, fluid warmers, medical gas tanks, pumps, piping, gas flow monitors, and alarms, and maintenance and upkeep
• Oxygen (excludes all other anesthesia gases billed under Revenue Code 25x)
• Instruments used by the anesthesiologist, including but not limited to intubation instruments and scopes
• Anesthesia-related supplies that are not billed separately, including but not limited to breathing circuit, nasal mask, sterile and other supplies
• Anesthesia department staff, including but not limited to anesthesia medical device technicians
• Anesthesia-related quality review/assurance staff and resources
• Anesthesia-related patient medical records and records review
• Anesthesia hazardous waste removal

Monitored Anesthesia Care/ Regional Anesthesia (Mon Anes Care/ Regional)

• Anesthesia equipment, including but not limited to the anesthesia workstation and components (e.g., ventilator, O2 monitor, CO2 monitor, EKG, blood pressure monitor, and pulse rate monitor), Smart IV pumps, fluid warmers, and other anesthesia equipment items
• Oxygen
• Instruments used by the anesthesiologist
• Anesthesia-related supplies that are not billed separately, including but not limited to breathing circuit, nasal mask, sterile and other supplies
• Anesthesia department staff, including but not limited to anesthesia medical device technicians
• Anesthesia-related quality review/assurance staff and resources
• Anesthesia-related patient medical records and records review
• Anesthesia hazardous waste removal

New Revenue Code 370 Charge Descriptions

• Complex General Anesthesia 3 hours or less — Cmplx Gen Anes < =3Hr
• Complex General Anesthesia more than 3 hours — Cmplx Gen Anes > 3 Hrs
• Standard General Anesthesia 3 hours or less — Stnd Gen Anes <=3Hr
• Standard General Anesthesia more than 3 hours — Stnd Gen Anes > than 3 Hrs
• Monitored anesthesia care/ regional anesthesia — Mon Anes Care/Regional

These are new descriptions for the specified services in the OR only