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See a sample rate comparisonCPT 00812 Fee Schedule
CPT 00812 is classified under Anesthesia, in the Anesthesia for Procedures on the Lower Abdomen subgroup.
Anesthesia For Lower Intestina, Anesthesia For Lower Intestinal Endoscopic Procedures Endoscope Introduced Distal To Duodenum Screening Colonoscopy Nterpretation And Report Tery Disease Data Preparation And Transmission A
| 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 |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 00812 |
National average anesthesia conversion factor for CPT 00812 by major payers:
$56.17
BCBS / Anthem
$69.45
UnitedHealthcare
$70.71
Aetna
$208.80
Cigna
Compare published rates across providers.
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CPT 00812
5 of 25 sample ratesHigher to lower in this preview
Gamal Mostafa
North Shore-Lij Medical PC
$141.49Published rateRandal Zhou
Yale University
$111.30Published rateRohan Patel
Allied Digestive Health, LLC
$90.00Published rateJoseph Yampaglia
Dream Partners LLC
$80.00Published rateHeather Del Valle
Ivi America, LLC
$55.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 00812 vs. Other Anesthesia for Procedures on the Lower Abdomen Codes
The table lists codes related to 00812. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 00800-CPT | Low | Anesthe For Procs On Lower Anterio Abdomi Wall; Not Otherw, Anesthesia For Procedures On Lower Anterior Abdominal Wall; Not Otherw |
| 00802-CPT | Moderate | Anesthesia Abdomen Shaping, Anesthesia Services For Surgery To Remove Excess Skin And Reconstruct The Lower Portion Of The Abdominal Wall (Abdominal Apron). |
| 00811-CPT | Low | Anesthesia For Lower Intestina, Anesthesia For Lower Intestinal Endoscopic Procedures Endoscope Introduced Distal To Duodenum Not Otherwise Specified Nterpretation And Report Tery Disease Data Preparation And Transmission A |
| 00812-CPT | Low | Anesthesia For Lower Intestina, Anesthesia For Lower Intestinal Endoscopic Procedures Endoscope Introduced Distal To Duodenum Screening Colonoscopy Nterpretation And Report Tery Disease Data Preparation And Transmission A |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00812. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00812 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 00812 reports anesthesia for a screening colonoscopy, a lower intestinal endoscopic procedure with the scope introduced beyond the duodenum. It is billed by the anesthesia provider.
When a polyp is removed or a biopsy is taken during a screening colonoscopy, anesthesia is usually reported with 00811 instead, with modifier PT for Medicare or modifier 33 for many commercial plans, so the screening benefit and its cost-sharing waiver still apply.
Anesthesia codes such as CPT 00812 are paid as base units for the procedure plus time units for the minutes of anesthesia, multiplied by a conversion factor. Medicare's conversion factor varies by locality, and commercial contracts negotiate their own. Modifiers for medical direction (for example AA, QK and QX) change how the payment is split between the anesthesiologist and the CRNA.
This page lists the rates commercial payers have published for CPT 00812 in their Transparency in Coverage files, so you can compare payers and see where a contract falls. For government benchmarks, PayerPrice also has the Medicare fee schedule lookup and Medicaid fee schedules by state.