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See a sample rate comparisonCPT 00813 Fee Schedule
Last Verified: October 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 Combined Upper, Anesthesia For Combined Upper And Lower Gastrointestinal Endoscopic Procedures Endoscope Introducedboth Proximal To And Distal To The Duodenum 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 21 - Inpatient Hospital |
| Common Modifiers | QZ - CRNA service; without medical direction by a physician QS - Monitored anesthesia care service None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 00813 |
National average anesthesia conversion factor for CPT 00813 by major payers:
$56.88
$122.06
$55.87
$93.15
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CPT 00813
5 of 25 sample ratesHigher to lower in this preview
Michael Pesce
Mercy Health System Corporation
$481.89Published rateBhupendra Dodhiawala
North Shore-Lij Anesthesiology PC
$147.14Published rateNeha Patel
Westchester Medical Group, P.C. D/B/A Westmed Medical Group
$98.83Published rateScott Pennington
Connecticut Gi, P.C.
$95.00Published rateRishi Kothari
Jefferson University Physicians
$40.00Published rate
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See a sample payer proposalCPT 00813 vs. Other Anesthesia for Procedures on the Lower Abdomen Codes
The CPT 00813 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 00813 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 |
|---|---|---|
| 00813-CPT | Moderate | Anesthesia For Combined Upper, Anesthesia For Combined Upper And Lower Gastrointestinal Endoscopic Procedures Endoscope Introducedboth Proximal To And Distal To The Duodenum Nterpretation And Report Tery Disease Data Preparation And Transmission A |
| 00820-CPT | Moderate | Anes Lower Posterior Abdominal Wall |
| 00840-CPT | Moderate | Anesthesia Abdomen Procedure, Anesthesia Services For A Procedure Involving Any Structure On The Interior Of The Abdomen. This Includes Scope-Assisted (Laparoscope) Procedures. |
| 00860-CPT | Moderate | Anesthesia Abdominal Surgery, Anesthesia Services For A Procedure Involving A Structure Accessible Through The Lower Abdomen Such As The Bladder Urinary Tract And Adrenal Glands. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00813. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00813 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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