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See a sample rate comparisonCPT 00402 Fee Schedule
Last Verified: September 2026
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.
Anes Integ Sys Rcnstv Breast, Anesthesia For Procedures On The Integumentary System On The Extremities Anterior Trunk And Perineum; Reconstructive Procedures On Breast (Eg Reduction Or Augmentation Mammoplasty Muscle Flaps)
| Key Fact | Detail |
|---|---|
| Service Type | Anesthesia Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle) |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center 21 - Inpatient Hospital |
| Common Modifiers | None AA - Anesthesia by anesthesiologist QX - Qualified nonphysician anesthetist service: With medical direction by a physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 00402 |
| Medicaid Fee Schedule | View Medicaid rates for 00402 |
National average anesthesia conversion factor for CPT 00402 by major payers:
$57.41
$55.75
$56.22
$54.39
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CPT 00402
5 of 25 sample ratesHigher to lower in this preview
Andrew Vargas
$128.69Published rateAline Toukhtarian
$99.00Published rateJonay Hill
$70.00Published rateBrian Park
Healing The Soul
$55.00Published rateCorry Kucik
$30.59Published rate
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See a sample payer proposalCPT 00402 vs. Other Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle) Codes
The CPT 00402 code is part of the Anesthesia services used for Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle). 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 00402 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 |
|---|---|---|
| 00400-CPT | Low | Anesth Skin Ext Per Atrunk, Anesthesia For Procedures On The Integumentary System On The Extremities Anterior Trunk And Perineum Not Otherwise Specified |
| 00402-CPT | Moderate | Anes Integ Sys Rcnstv Breast, Anesthesia For Procedures On The Integumentary System On The Extremities Anterior Trunk And Perineum; Reconstructive Procedures On Breast (Eg Reduction Or Augmentation Mammoplasty Muscle Flaps) |
| 00404-CPT | Moderate | Anesthesia For Breast Surgery, Anesthesia Services For Surgery To Remove Abnormal Tissue From A Breast Or To Remove All Or Part Of A Breast. Procedures May Involve The Interior Structure Of A Breast As Well As Nearby Tissues. |
| 00406-CPT | Moderate | Anesthesia For Breast Surgery, Anesthesia Services For Surgery To Remove Abnormal Tissue From A Breast Or To Remove All Or Part Of A Breast. Procedures May Involve The Interior Structure Of A Breast As Well As Nearby Tissues. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00402. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00402 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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