CPT 00626 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 Spine and Spinal Cord |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • 22 - Increased Procedural Services • None • QX - Qualified nonphysician anesthetist service: With medical direction by a physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 00626 |
National average anesthesia conversion factor for CPT 00626 by major payers:
$59.77
$55.62
$57.72
$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 00626 | ||||||
United | 00626 | $70.00 | 1477811818 - ERIN CRAWFORD | 260089066 | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $84.66 | 1932140274 - CHRISTINE NIEMAN | 951965700 - (CA) ANESTHESIA SERVICE MEDICAL GROUP, INC. | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00626 | $70.00 | 1588705180 - VANILA SINGH | 260089066 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00626 | $99.00 | 1396235560 - SHIREEN NOURI | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $121.22 | 1154594562 - CRISTIANNA VALLERA | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $55.50 | 1679649156 - SCOTT MAYFIELD | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $113.00 | 1437179280 - SHARON LEANO | 680273974 - SUTTER VALLEY MEDICAL FOUNDATION | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00626 | $86.00 | 1316971278 - MARY KEYES | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $91.75 | 1790945509 - TONY CHIANG | 330292783 | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $117.22 | 1285687756 - ANIL TIWARI | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $128.69 | 1366424327 - HUNG NGUYEN | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $56.00 | 1639151996 - ADVENTIST HEALTH CLEARLAKE HOSPITAL, INC, REDBUD COMMUNITY HOSPITAL ANESTHESIA | 680395149 - (CA) ADVENTIST HEALTH CLEARLAKE HOSPITAL INC | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $81.44 | 1083266704 - ASTKHIK MANGASARIAN | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00626 | $80.00 | 1396139242 - DAMON YU | 871221902 - (CA) EL CAMINO ANESTHESIA | CA | Anesthesiology Physician (207L00000X) |
United | 00626 | $60.00 | 1548604960 - ZAIN HASAN | 232919472 - UPMC | 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 00626 vs. Other Anesthesia for Procedures on the Spine and Spinal Cord Codes
The CPT 00626 code is part of the Anesthesia services used for Anesthesia for Procedures on the Spine and Spinal Cord. 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 00626 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 |
|---|---|---|
| 00620-CPT | Moderate | Anes Thoracic Spine/Cord; Nos |
| 00625-CPT | Moderate | Anesthesia For Procedures On The Thoracic Spine And Cord, Via An Anterior Transthoracic Approach; Not Utilizing 1 Lung Ventilation |
| 00626-CPT | Moderate | Anesthesia For Procedures On The Thoracic Spine And Cord, Via An Anterior Transthoracic Approach; Utilizing 1 Lung Ventilation |
| 00632-CPT | Moderate | Anes Lumbar Region; Lumbar Sympathectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00626 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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