CPT 00216 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • AA - Anesthesia by anesthesiologist • P3 - A patient with severe systemic disease • None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 00216 |
National average anesthesia conversion factor for CPT 00216 by major payers:
$52.99
$54.10
$57.63
$56.29
| 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 00216 | ||||||
United | 00216 | $44.00 | 1255346979 - HUNTLEY PAIN SPECIALISTS A MEDICAL CORPORATION | 204323503 - (CA) HUNTLEY PAIN SPECIALISTS, A MEDI | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00216 | $52.00 | 1336646785 - WENLI MA | 271876899 | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $62.00 | 1215978150 - ASHISH SINHA | 852611756 - (CA) OAK CREEK ANESTHESIA SERVICES INC | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $45.00 | 1689913873 - BENJAMIN ILLUM | 870737749 | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $128.69 | 1235195173 - JOHN FEINER | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $70.00 | 1467742700 - ROBERT KONG | 260089066 | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $121.22 | 1538104401 - BARBARA VANDEWIELE | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $93.01 | 1942225057 - MARK JAMIESON | 834708723 - (CA) G2 ANESTHESIA, PC | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $86.00 | 1255726881 - SAMUEL HONG | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $56.00 | 1962664847 - NAHID NASR | 263060258 - (CA) NAHID NASR MD INC | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $121.22 | 1710921457 - ROBERT KOPEL | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $113.00 | 1700073830 - ETHAN MCKENZIE | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $60.00 | 1366778227 - ANESTHESIA SERVICES OF SAN JOAQUIN, P.C. | 270958416 - (CA) ANESTHESIA SERVICES OF SAN JOAQUIN PC | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $65.00 | 1376543975 - SHAOXIONG LIU | 272777455 | CA | Anesthesiology Physician (207L00000X) |
United | 00216 | $90.00 | 1790016772 - NEHA PATEL | 133884168 - WESTCHESTER MEDICAL GROUP, P.C. D/B/A WESTMED MEDICAL GROUP | 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 |
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CPT 00216 vs. Other Anesthesia for Procedures on the Head Codes
The CPT 00216 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 00216 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00216. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00216 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.
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