CPT 00811 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 Lower Abdomen |
| Common Place of Service | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • QZ - CRNA service; without medical direction by a physician • QS - Monitored anesthesia care service • None |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 00811 |
National average anesthesia conversion factor for CPT 00811 by major payers:
$44.57
$61.64
$55.41
$147.86
| 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 00811 | ||||||
United | 00811 | $121.79 | 1356784524 - STEPHEN RIVOLI | 800886397 | FL | Anesthesiology Physician (207L00000X) |
United | 00811 | $90.00 | 1811263296 - ALEXANDER BOWEN | 275281875 - (NY) MIDTOWN MEDICAL PLLC | LA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00811 | $105.00 | 1952017113 - SYNERGY ANESTHESIA CT PLLC | 921303042 - (CA) SYNERGY ANESTHESIA CT PLLC | CA | Anesthesiology Physician (207L00000X) |
United | 00811 | $114.08 | 1750369609 - FRANK SCHWALBE | 60646973 - YALE UNIVERSITY | NC | Anesthesiology Physician (207L00000X) |
United | 00811 | $136.05 | 1093169237 - DARION PEARSON | 461617561 - (NY) NORTH SHORE-LIJ ANESTHESIOLOGY PC | CA | Anesthesiology Physician (207L00000X) |
United | 00811 | $71.50 | 1083176143 - CAROLYN WRIGHT | 232743545 | CA | Anesthesiology Physician (207L00000X) |
United | 00811 | $71.50 | 1760579643 - KRZYSZTOF LAUDANSKI | 232743545 | PA | Anesthesiology Physician (207L00000X) |
United | 00811 | $90.00 | 1639159833 - SANJAI ISAAC | 463915494 - (NJ) ALLIED DIGESTIVE HEALTH, LLC | TX | Anesthesiology Physician (207L00000X) |
United | 00811 | $385.51 | 1124016589 - MICHAEL PESCE | 390816848 - MERCY HEALTH SYSTEM CORPORATION | CA | Anesthesiology Physician (207L00000X) |
United | 00811 | $115.04 | 1467408302 - EDWARD EISLER | 133544120 - CAREMOUNT MEDICAL, P.C. | CA | Anesthesiology Physician (207L00000X) |
United | 00811 | $98.83 | 1790016772 - NEHA PATEL | 133884168 - WESTCHESTER MEDICAL GROUP, P.C. D/B/A WESTMED MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00811 | $95.00 | 1780059030 - MALLORY FOSSA | 61446900 - (CT) CONNECTICUT CHILDRENS SPECIALTY GROUP INC | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00811 | $40.00 | 1033297619 - SHUREA WILSON | 232678055 - METHODIST ASSOCIATES IN HEALTHCARE INC | CA | Anesthesiology Physician (207L00000X) |
United | 00811 | $132.61 | 1528045507 - CARROLL CHAMBERS | 232592835 - (PA) CHILDRENS ANESTHESIOLOGY ASSOCIATES LTD | NC | Anesthesiology Physician (207L00000X) |
United | 00811 | $96.13 | 1881011138 - SHO TANAKA | 223146927 | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
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 00811 vs. Other Anesthesia for Procedures on the Lower Abdomen Codes
The CPT 00811 code is part of the Anesthesia services used for Anesthesia for Procedures on the Lower 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 00811 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 |
|---|---|---|
| 00731-CPT | Moderate | Anesthesia For Upper Gastrointestinal Endoscopic Procedures, Endoscope Introduced Proximal To Duodenum; Not Otherwise Specified |
| 00732-CPT | Moderate | Anesthesia For Upper Gastrointestinal Endoscopic Procedures, Endoscope Introduced Proximal To Duodenum; Endoscopic Retrograde Cholangiopancreatography (Ercp) |
| 00800-CPT | Low | Anes Low Anterior Abdominal Wall; Nos |
| 00811-CPT | Low | Anesthesia For Lower Intestinal Endoscopic Procedures, Endoscope Introduced Distal To Duodenum; Not Otherwise Specified |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00811. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00811 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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