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 for Procedures on the Head Anesthesia |
| 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 |
|---|---|---|---|---|---|---|
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 Codes
The CPT 00216 code is part of the Anesthesia for Procedures on the Head services used for Anesthesia. 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.
| Code | Complexity | Description |
|---|---|---|
| 00210-CPT | Moderate | Anes Intracranial; Nos |
| 00212-CPT | Low | Anesthesia For Brain Surgery, Anesthesia Services For Surgery Involving The Brain Surrounding Skull Cerebrospinal Fluid Cranial Nerves Or The Protective Sac Around The Brain. |
| 00214-CPT | Moderate | Anesthesia For Skull Procedure, Anesthesia Services For Surgery Involving The Brain Surrounding Skull Cerebrospinal Fluid Cranial Nerves Or The Protective Sac Around The Brain. |
| 00216-CPT | Moderate | Anesthesia For Skull Procedure, Anesthesia Services For Procedures Involving The Blood Vessels Of The Brain And The Inside Of The Skull. |
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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