CPT 00406 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 | • 24 - Ambulatory Surgical Center • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • AA - Anesthesia by anesthesiologist • P2 - A patient with mild systemic disease • P3 - A patient with severe systemic disease |
| Complexity Level | Moderate |
National average anesthesia conversion factor for CPT 00406 by major payers:
$58.38
$55.94
$57.53
$55.74
| 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 00406 | ||||||
United | 00406 | $121.22 | 1013448653 - JASON COHEN | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $86.00 | 1164928917 - RICHA PARDIKAR | 954373072 | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $38.00 | 1295775237 - WILLIAM HALSEY | 932807351 - (CA) BROOKWOOD ANESTHESIA INC | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $38.00 | 1942632542 - ERIC LEE | 475167236 - (CA) REGIONAL ANESTHESIA ASSOCIATES INC | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $78.08 | 1184700932 - ARTHUR LAM | 912073120 | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $121.22 | 1124447115 - CHRISTINA NGUYEN | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $69.00 | 1629410519 - ELI LUONG | 391824445 - UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $55.00 | 1225471048 - YUICHIRO HAYASHI | 910858192 - (NV) DESERT ORTHOPAEDIC CENTER LTD | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00406 | $35.00 | 1437217767 - JAMIE TAYLOR | 954457756 - (CA) CEDARS-SINAI MEDICAL CARE FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $34.00 | 1780077230 - CPMS MEDICAL GROUP, COMPREHENSIVE PAIN MANAGEMENT SPECIALISTS | 260422850 - (CA) CPMS MEDICAL GROUP INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00406 | $53.00 | 1467438036 - ANDREW HESSELTINE | 272767291 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00406 | $34.00 | 1730255258 - CHIA LEE | 330273569 | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $40.00 | 1366411217 - ANGELINE BARNES | 330941787 - (CA) DIOGENES ANESTHESIA MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $55.50 | 1033522032 - STACI BECKER | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Anesthesiology Physician (207L00000X) |
United | 00406 | $70.00 | 1740608595 - JAMES XIE | 260089066 | 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 00406 vs. Other Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle) Codes
The CPT 00406 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 00406 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 |
| 00406-CPT | Moderate | Anesthesia For Procedures On The Integumentary System On The Extremities, Anterior Trunk And Perineum; Radical Or Modified Radical Procedures On Breast With Internal Mammary Node Dissection |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00406 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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