CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit alphanumeric codes used by medical professionals to describe medical, surgical, and diagnostic services to payers for billing purposes. They are crucial for accurately communicating what services were provided.

How can I find the cost of a medical procedure?

To find the cost of a specific medical procedure, especially based on CPT codes and your specific location, you can utilize price transparency tools. We recommend using a service like Payerprice. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get an estimate of costs. It's always a good idea to also contact your healthcare provider's billing department and your insurance company for the most accurate out-of-pocket estimates.

What factors influence the cost of healthcare services?

Several factors influence the cost of healthcare services, including the type and complexity of the service, the provider's location and reputation, facility fees (hospital vs. outpatient clinic), the insurance plan you have, whether the provider is in-network or out-of-network, and negotiated rates between providers and insurers. The specific CPT code for a service can also play a role in its base pricing.

Why do prices vary so much between providers?

Healthcare prices vary significantly between providers due to a multitude of factors. These include differences in operating costs, negotiated rates with various insurance companies, the provider's specialty and experience, the technology and equipment used, the geographic location, and whether the facility is a hospital or a standalone clinic. Price transparency tools, like Payerprice, can help you compare costs for the same CPT code across different providers and locations.

Can I get an estimate for a medical service before receiving it?

Yes, you can and should request an estimate for medical services in advance. Under the No Surprises Act, healthcare providers and facilities are generally required to give you a "Good Faith Estimate" of expected charges if you are uninsured or choose not to use your insurance. For insured individuals, it's best to contact your provider's billing department and your insurance company directly for a personalized estimate. Additionally, you can use tools like Payerprice to research general fee schedules based on CPT codes and location, which can help you understand potential costs beforehand.

CPT 00731 Fee Schedule

Last Verified: September 2026

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.

Anesthesia For Upper Gastroint, Anesthesia For Upper Gastrointestinal Endoscopic Procedures Endoscope Introduced Proximal To Duodenum Not Otherwise Specified Nterpretation And Report Tery Disease Data Preparation And Transmission A

Key Fact	Detail
Service Type	Anesthesia Anesthesia for Procedures on the Upper Abdomen
Common Place of Service	24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital
Common Modifiers	QS - Monitored anesthesia care service QZ - CRNA service; without medical direction by a physician None
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 00731
Medicaid Fee Schedule	View Medicaid rates for 00731

National average anesthesia conversion factor for CPT 00731 by major payers:

$56.32

$123.56

$55.79

$97.95

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 00731.

CPT 00731

5 of 25 sample ratesHigher to lower in this preview

Bhupendra Dodhiawala
North Shore-Lij Anesthesiology PC
CAAnesthesiology PhysicianNPI 1609810886Tax ID 46-1617561
$147.14Published rate
Sho Tanaka
CACritical Care Medicine (Anesthesiology) PhysicianNPI 1881011138Tax ID 22-3146927
$96.13Published rate
Chad Miller
OHVascular Neurology PhysicianNPI 1467477901Tax ID 20-701782
$60.00Published rate
Alaa Kalloub
INOrthopaedic Surgery PhysicianNPI 1497196554Tax ID 58-2501863
$52.00Published rate
Rishi Kothari
Jefferson University Physicians
CAAnesthesiology PhysicianNPI 1477895803Tax ID 23-2809585
$40.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

This code appears in 1 published specialty market.

Explore state-level rates by specialty

CPT 00731 vs. Other Anesthesia for Procedures on the Upper Abdomen Codes

The CPT 00731 code is part of the Anesthesia services used for Anesthesia for Procedures on the Upper Abdomen. 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 00731 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
00702-CPT	Low	Anesthesia For Liver Surgery, Anesthesia Services For Liver Surgery. Procedures Can Include Removing A Sample Of Tissue For Testing (Biopsy) Management Of Bleeding Or Partial Removal Of The Organ.
00731-CPT	Moderate	Anesthesia For Upper Gastroint, Anesthesia For Upper Gastrointestinal Endoscopic Procedures Endoscope Introduced Proximal To Duodenum Not Otherwise Specified Nterpretation And Report Tery Disease Data Preparation And Transmission A
00732-CPT	Moderate	Anesthesia For Upper Gastroint, Anesthesia For Upper Gastrointestinal Endoscopic Procedures Endoscope Introduced Proximal To Duodenum Endoscopic Retrograde Cholangiopancreatography(Ercp) Nterpretation And Report Tery Disease Data Preparation And Transmission A
00750-CPT	Low	Anesthesia For Hernia Repair, Anesthesia Services For Surgery To Repair A Hernia. Hernias Occur When Organs Or Other Structures Bulge Through Containing Tissue Into Other Areas. Common Types Include Incisional Hernias (Through A Surgical Scar) And Stomach Hernias (Into Upper Abdomen).

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00731. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 00731 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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CPT 00731 Fee Schedule

Compare published rates across providers.

Bhupendra Dodhiawala

Sho Tanaka

Chad Miller

Alaa Kalloub

Rishi Kothari