CPT 00813 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 • 21 - Inpatient Hospital |
| Common Modifiers | • QZ - CRNA service; without medical direction by a physician • QS - Monitored anesthesia care service • None |
| Complexity Level | Moderate |
National average anesthesia conversion factor for CPT 00813 by major payers:
$56.88
$122.06
$55.87
$93.15
| 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 00813 | ||||||
United | 00813 | $71.50 | 1932137072 - JONATHAN GAVRIN | 232743545 | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $115.04 | 1467408302 - EDWARD EISLER | 133544120 - CAREMOUNT MEDICAL, P.C. | CA | Anesthesiology Physician (207L00000X) |
United | 00813 | $71.50 | 1932137072 - JONATHAN GAVRIN | 232743545 | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $71.50 | 1104320597 - RAMI SOUFAN | 232743545 | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $264.72 | 1659528735 - PETER VON HOMEYER | 131740114 - MONTEFIORE MEDICAL CENTER | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $264.72 | 1295278463 - SERGII GORBACHOV | 131740114 - MONTEFIORE MEDICAL CENTER | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $147.14 | 1194161497 - JOHN-PAUL SARA | 453023019 - NORTH SHORE-LIJ MEDICAL PC | LA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00813 | $264.72 | 1174029854 - JOHN LIPIZ | 131740114 - MONTEFIORE MEDICAL CENTER | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $71.50 | 1104320597 - RAMI SOUFAN | 232743545 | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $97.23 | 1013232842 - HENRY NGUYEN | 61137531 - NUVANCE HEALTH MEDICAL PRACTICE CT INC | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $85.00 | 1811122716 - ADITYA MARWAHA | 472449054 | GA | Anesthesiology Physician (207L00000X) |
United | 00813 | $95.00 | 1154391613 - SCOTT PENNINGTON | 61411029 - (CT) CONNECTICUT GI, P.C. | GA | Anesthesiology Physician (207L00000X) |
United | 00813 | $114.08 | 1205024924 - JODI SHERMAN | 60646973 - YALE UNIVERSITY | CA | Anesthesiology Physician (207L00000X) |
United | 00813 | $264.72 | 1659528735 - PETER VON HOMEYER | 131740114 - MONTEFIORE MEDICAL CENTER | WA | Anesthesiology Physician (207L00000X) |
United | 00813 | $147.14 | 1831175504 - KATHERINE POOLE | 461617561 - (NY) NORTH SHORE-LIJ ANESTHESIOLOGY PC | WA | Certified Registered Nurse Anesthetist (367500000X) |
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 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 And Lower Gastrointestinal Endoscopic Procedures, Endoscope Introduced Both Proximal To And Distal To The Duodenum |
| 00820-CPT | Moderate | Anes Lower Posterior Abdominal Wall |
| 00840-CPT | Moderate | Anes Intraperitoneal Low Abd; Nos |
| 00860-CPT | Moderate | Anes Extraperitoneal Low Abd Inc Urinary |
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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