CPT 00404 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 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 |
National average anesthesia conversion factor for CPT 00404 by major payers:
$57.64
$55.74
$56.85
$54.41
| 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 00404 | ||||||
United | 00404 | $67.09 | 1184183212 - JONATHAN VILLANUEVA | 943281660 | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $60.00 | 1619014503 - AMEER MOUSSA | 811684142 | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $60.00 | 1326036260 - XIAOLIN WANG | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $69.00 | 1568418309 - TAMARA JURSON | 680304987 - (CA) NORTHERN CALIFORNIA ANESTHESIA PHYSICIANS, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $67.09 | 1265810055 - SARA ABU-TABIKH | 943281657 | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00404 | $84.66 | 1689037632 - THU NGUYEN | 951965700 - (CA) ANESTHESIA SERVICE MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $117.22 | 1609038793 - KATHERINE MCCARTNEY | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $65.00 | 1407991631 - VLADIMIR NEKHENDZY | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $38.00 | 1609006592 - THOMAS JACQUES | 871222471 - (CA) PAIN CLINICS OF CENTRAL CALIFORNIA INC | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $49.50 | 1740267343 - WAFIK ABDOU | 770411079 - (CA) WAFIK A ABDOU MD INC | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $65.00 | 1841619244 - MARK BOYAJIAN | 474880567 - (CA) WEST HILLS ANESTHESIA AND PERIOPERATIVE PHYSICIANS | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $57.50 | 1922487545 - HOWARD ZEE | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $128.69 | 1366755209 - KAREN FLEMING | 943281660 | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00404 | $72.00 | 1679832422 - GISELA LOPEZ PAYARES | 812171811 - (TX) AUSTIN GASTROENTEROLOGY ANESTHESIA ASSOCIATES PLLC | CA | Anesthesiology Physician (207L00000X) |
United | 00404 | $61.00 | 1679584791 - MICHAEL MOELLENHOFF | 943281663 | 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 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 | Anesthesia For Procedures On The Integumentary System On The Extremities, Anterior Trunk And Perineum; Not Otherwise Specified |
| 00402-CPT | Moderate | 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 Procedures On The Integumentary System On The Extremities, Anterior Trunk And Perineum; Radical Or Modified Radical Procedures On Breast |
| 00410-CPT | Low | 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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