CPT 00472 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 19 - Off Campus Outpatient 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 00472 by major payers:
$56.56
$55.83
$57.33
$55.25
| 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 00472 | ||||||
United | 00472 | $99.00 | 1306880976 - MARC IRAVANI | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $91.75 | 1205279940 - KRISTEL JAN MAGSINO | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $128.69 | 1487072195 - ALBERT YEN | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $65.00 | 1235102880 - MICHAEL DO | 472040579 | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $63.00 | 1528450624 - SANAZ GHAFFARI | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $96.66 | 1730270489 - MATTHEW HAIGHT | 390806261 - THE MEDICAL COLLEGE OF WISCONSIN INC | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00472 | $128.69 | 1174719017 - NICHOLAS RIEGELS | 943281663 | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00472 | $113.00 | 1669697892 - HENRY LIU | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $84.00 | 1629061361 - JAMES JABER | 941458282 - NORTHBAY HEALTHCARE GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $66.13 | 1396704672 - RICHARD DUONG | 953942828 - (CA) PIH HEALTH PHYSICIANS | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $60.00 | 1154732451 - SUSAN TRINH | 842910266 - (CA) PROFESSIONAL ANESTHESIA ASSOCIATES PC | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $69.62 | 1851583793 - CHUCK NGUYEN | 954540991 - USC CARE MEDICAL GROUP INC | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $55.00 | 1295743516 - RITA KAR | 953942828 - (CA) PIH HEALTH PHYSICIANS | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $60.00 | 1114395605 - KELLIE MORRIS | 330406164 | CA | Anesthesiology Physician (207L00000X) |
United | 00472 | $55.50 | 1235257999 - DAVINDER RAMSINGH | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | 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 00472 vs. Other Anesthesia for Procedures on the Thorax (Chest Wall and Shoulder Girdle) Codes
The CPT 00472 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 00472 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 |
|---|---|---|
| 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) |
| 00410-CPT | Low | Anesthesia For Procedures On The Integumentary System On The Extremities, Anterior Trunk And Perineum; Electrical Conversion Of Arrhythmias |
| 00470-CPT | Moderate | Anes Rib Resection; Nos |
| 00472-CPT | Moderate | Anes Rib Resection; Thorocoplasty |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00472. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00472 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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