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See a sample rate comparisonCPT 00404 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.
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.
| 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 21 - Inpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None AA - Anesthesia by anesthesiologist P3 - A patient with severe systemic disease |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 00404 |
| Medicaid Fee Schedule | View Medicaid rates for 00404 |
National average anesthesia conversion factor for CPT 00404 by major payers:
$57.64
$55.74
$56.85
$54.41
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CPT 00404
5 of 25 sample ratesHigher to lower in this preview
Ali Mehdizadeh
Faculty Physicians And Surgeons Of Llusm
$135.50Published rateMark Brown
El Camino Anesthesia
$80.00Published rateAmy Lu
$61.00Published rateGary Grimes
$52.00Published rateMonique Tu
Alvarado Physicians Medical Group
$34.00Published rate
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See a sample payer proposalCPT 00404 vs. Other Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle) Codes
The CPT 00404 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 00404 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. |
| 00410-CPT | Low | Anesth Correct Heart Rhythm, Anesthesia For Procedures On The Integumentary System On The Extremities Anterior Trunk And Perineum Electrical Conversion Of Arrhythmias |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00404. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00404 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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