CPT 00542 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 Intrathoracic Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 23 - Emergency Room |
| Common Modifiers | • None • AA - Anesthesia by anesthesiologist • P3 - A patient with severe systemic disease |
| Complexity Level | Moderate |
National average anesthesia conversion factor for CPT 00542 by major payers:
$55.26
$56.02
$57.60
$56.08
| 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 00542 | ||||||
United | 00542 | $86.00 | 1255759254 - KENNETH HIGGINS | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $55.50 | 1700059615 - ROBERT FIELD | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $70.00 | 1740691237 - SARA STROWD | 260089066 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $86.00 | 1083000822 - MYROSLAV FIGURA | 954373071 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $70.00 | 1407008097 - CHRISTINE JETTE | 260089066 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $61.00 | 1235187345 - CHANHUNG LEE | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $83.00 | 1427545201 - MAURICIO HERNANDEZ | 471884235 - CEP AMERICA | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $55.00 | 1659356368 - ANDY LE | 364999438 - (CA) CA MEDICAL CONSULTANTS | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $61.00 | 1396500823 - CRAIG BEAMAN | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $99.00 | 1548436462 - HARKIRAT CHAHAL | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $86.00 | 1619408960 - LINDSAY BROWN | 954377219 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00542 | $38.00 | 1164458733 - CHRISTINE CHOW | 330674406 | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $64.00 | 1700044815 - JEFFREY LOH | 880820406 - (HI) QUEENS UNIVERSITY MEDICAL GROUP | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00542 | $31.00 | 1619131935 - MEG OHARE | 1619131935 - (CA) MEG OHARE | CA | Anesthesiology Physician (207L00000X) |
United | 00542 | $60.00 | 1316053044 - SAN DIEGUITO ANESTHESIOLOGY MEDICAL GROUP, INC. | 330406164 | 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 00542 vs. Other Anesthesia for Intrathoracic Procedures Codes
The CPT 00542 code is part of the Anesthesia services used for Anesthesia for Intrathoracic Procedures. 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 00542 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 |
|---|---|---|
| 00540-CPT | Moderate | Anesthesia For Thoracotomy Procedures Involving Lungs, Pleura, Diaphragm, And Mediastinum (Including Surgical Thoracoscopy); Not Otherwise Specified |
| 00541-CPT | Moderate | Anesthesia For Thoracotomy Procedures Involving Lungs, Pleura, Diaphragm, And Mediastinum (Including Surgical Thoracoscopy); Utilizing 1 Lung Ventilation |
| 00542-CPT | Moderate | Anes Thoracotomy Proc; Decortication |
| 00546-CPT | Moderate | Anesthesia For Thoracotomy Procedures Involving Lungs, Pleura, Diaphragm, And Mediastinum (Including Surgical Thoracoscopy); Pulmonary Resection With Thoracoplasty |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00542. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00542 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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