CPT 00126 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Anesthesia • Anesthesia for Procedures on the Head |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • AA - Anesthesia by anesthesiologist • P1 - A normal healthy patient |
| Complexity Level | Low |
National average anesthesia conversion factor for CPT 00126 by major payers:
$52.51
$55.71
$56.15
$54.25
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 00126 | ||||||
United | 00126 | $57.50 | 1902301070 - JONATHAN VARGHESE | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $57.50 | 1972368892 - AMELIE DELAPORTE | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $38.00 | 1093032252 - EDOUARD RIVERA | 832283258 - (CA) MINIMALLY INVASIVE MEDICAL GROUP | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00126 | $40.00 | 1477516466 - SCOTT & WHITE MEMORIAL HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE | 742958277 - SCOTT & WHITE CLINIC | TX | General Acute Care Hospital (282N00000X) |
United | 00126 | $55.00 | 1942292255 - TEXAS SPINE AND JOINT HOSPITAL, LLC, BAYLOR SCOTT & WHITE TX SPINE & JOINT HOS SUR CTR | 752951355 - (TX) TEXAS SPINE AND JOINT HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 00126 | $40.00 | 1477609568 - BOSE MANDAVA | 956000944 | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $61.00 | 1366408841 - ELIZABETH DONEGAN | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $121.22 | 1982638839 - NOEL CHUN | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $56.00 | 1477840999 - JASMINE A. BOWERS, M.D. INC. | 954518920 - (CA) JASMINE A BOWERS MD INC | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $36.00 | 1740478502 - VALERY D. TARASENKO, MD, INC., ADVANCED PAIN MANAGEMENT INSTITUTE | 201241336 - (CA) VALERY D TARASENKO MD INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00126 | $128.69 | 1154505774 - JOHN TURNBULL | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $78.00 | 1831119700 - PHILLIP LAU | 954656412 - (CA) PACIFIC VALLEY MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $55.00 | 1932100856 - MICHAEL NUSSBAUM | 237064656 - HEALING THE SOUL | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $113.00 | 1225079304 - SHANTHALA KESHAVACHARYA | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00126 | $83.00 | 1770014466 - CEP AMERICA, VITUITY | 471884235 - CEP AMERICA | CA | Anesthesiology Physician (207L00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 00126 vs. Other Anesthesia for Procedures on the Head Codes
The CPT 00126 code is part of the Anesthesia services used for Anesthesia for Procedures on the Head. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 00126 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 00120-CPT | Moderate | Anesthesia For Procedures On External,Middle And Inner Ear Including Biopsy; Not Other- Wise Specified |
| 00124-CPT | Low | Anes External/Mid/Inner Ear W Biopsy Oto |
| 00126-CPT | Low | Anes External/Mid/Inner Ear W Biopsy Tym |
| 00160-CPT | Moderate | Anesthesia For Procedures On Nose And Accessory Sinuses; Not Otherwise Specified |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00126. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00126 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 00126) and we'll show you how you compare in 15 minutes or less.