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See a sample rate comparisonCPT 00731 Fee Schedule
CPT 00731 is classified under Anesthesia, in the Anesthesia for Procedures on the Upper Abdomen subgroup.
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 |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 00731 |
National average anesthesia conversion factor for CPT 00731 by major payers:
$59.60
BCBS / Anthem
$123.56
UnitedHealthcare
$63.99
Aetna
$275.84
Cigna
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CPT 00731
5 of 25 sample ratesHigher to lower in this preview
Bhupendra Dodhiawala
North Shore-Lij Anesthesiology PC
$147.14Published rateSho Tanaka
$96.13Published rateChad Miller
$60.00Published rateAlaa Kalloub
$52.00Published rateRishi Kothari
Jefferson University Physicians
$40.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 00731 vs. Other Anesthesia for Procedures on the Upper Abdomen Codes
The table lists codes related to 00731. Select one to see its fee schedule.
| 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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Frequently Asked Questions
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.
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.
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.
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.
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.