CPT 00561 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 for Intrathoracic Procedures Anesthesia |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | AA - Anesthesia by anesthesiologist P4 - A Patient with severe systemic disease None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 00561 |
National average anesthesia conversion factor for CPT 00561 by major payers:
$59.57
$56.17
$58.01
$57.75
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 00561 | $86.00 | 1154594562 - CRISTIANNA VALLERA | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $81.44 | 1154984706 - ANTONIO MORENO | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $36.00 | 1497875363 - PAUL E KIM MD INC, META SPORTS AND PAIN MEDICINE | 20696193 - (CA) PAUL E. KIM, MD, INC. | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00561 | $77.18 | 1396858783 - DEBRA LOTSTEIN | 953777340 - CHILDRENS HOSPITAL LOS ANGELES MEDICAL GROUP INC | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00561 | $117.22 | 1396701611 - JOHN REED | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $57.20 | 1316478415 - DANIEL CRAMER | 941502014 - SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $93.01 | 1932132974 - RICARDO RONQUILLO | 834708723 - (CA) G2 ANESTHESIA, PC | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $35.00 | 1902126634 - CHASE SMITH | 954457756 - (CA) CEDARS-SINAI MEDICAL CARE FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $128.69 | 1417976085 - JEFFREY SALL | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $61.00 | 1235636051 - HEMRA CIL | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $109.50 | 1750677167 - BENJAMIN RECORD | 133346908 - (NY) MEMORIAL PEDIATRIC GROUP | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00561 | $121.22 | 1093009169 - MATTHEW FISCHER | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $60.00 | 1760475198 - JUDI CAIN | 680334324 | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $58.58 | 1861843898 - KONSTANTIN INOZEMTSEV | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | CA | Anesthesiology Physician (207L00000X) |
United | 00561 | $121.22 | 1649209719 - GUNDAPPA NEELAKANTA | 954377219 | 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 00561 vs. Other Anesthesia Codes
The CPT 00561 code is part of the Anesthesia for Intrathoracic Procedures services used for Anesthesia. 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 00561 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 |
|---|---|---|
| 00561-CPT | Moderate | Anesthesia For Heart Surgery, Anesthesia Services For Heart Surgery Performed On A Newborn Or Infant. The Procedure Involves The Protective Sac Or The Large Blood Vessels (Aorta Vena Cava). Supplementary Ventilation May Be Provided. |
| 00562-CPT | Moderate | Anesth Hrt Surg W Pmp Age 1, Anesthesia For Procedures On Heart Pericardial Sac And Great Vessels Of Chest With Pump Oxygenator Age 1 Year Or Older For All Noncoronary Bypass Procedures Eg Valve Procedures Or For Re Operation For Coronary Bypass More Than 1 Month After Original Operation |
| 00563-CPT | Moderate | Anesthesia For Heart Surgery, Anesthesia Services For Heart Surgery Involving The Valves Or For A Repeat Bypass Surgery. The Procedure May Involve Supplementary Ventilation Or Induced Circulatory Arrest. |
| 00566-CPT | Moderate | Anesthe For Direct Corona Arter Bypass Grfting; W/O Pump Ox, Anesthesia For Direct Coronary Artery Bypass Grafting; Without Pump Ox |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00561 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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