What is CPT code 00813?

CPT code 00813 refers to anesthesia for combined upper and lower gastrointestinal endoscopic procedures where the endoscope is introduced both proximal to and distal to the duodenum.

What types of services does CPT 00813 cover?

CPT 00813 covers anesthesia services for procedures on the lower abdomen, particularly combined upper and lower gastrointestinal endoscopic procedures.

What factors affect CPT 00813 fee schedules?

Factors affecting CPT 00813 fee schedules include Medicare & Medicaid rates, private insurance negotiated rates, geographic location, and the type of provider (e.g., hospital vs. private practice).

How does CPT 00813 compare to other anesthesia codes?

CPT 00813 is a moderate-complexity anesthesia code for lower abdomen procedures, involving more provider time and moderate medical decision-making compared to lower-level codes. It is one of several codes in the Anesthesia for Procedures on the Lower Abdomen category, such as 00820, 00840, and 00860.

CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare professionals to describe medical, surgical, and diagnostic services. They are essential for accurate billing and processing of claims by insurance companies, ensuring consistency in how services are reported and reimbursed.

How do I find out the cost of a medical procedure?

To find out the cost of a specific medical procedure, you can start by asking your healthcare provider for an estimate or contacting your insurance company to understand your out-of-pocket costs based on your plan. For a more direct way to look up fee schedules by CPT code and location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows you to search for pricing information specific to your situation.

Why do healthcare costs vary so much?

Healthcare costs can vary significantly due to several factors, including: the specific healthcare provider or facility (e.g., hospital vs. independent clinic), geographic location, your insurance plan and its negotiated rates with providers, the complexity of the service, and whether you are receiving in-network or out-of-network care. Market competition and regulatory environments also play a role.

Where can I find specific pricing for a medical service in my area?

To find specific pricing for a medical service in your area, you can use specialized tools designed for this purpose. We recommend using Payerprice's fee schedule lookup tool. It allows you to search for pricing information based on specific CPT codes and your location, providing insights into typical costs for various medical services.

CPT 00813 Fee Schedule

Last Verified: July 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 for Procedures on the Lower Abdomen Anesthesia
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

Preview provider-level rates for...

For billing codeCPT 00813

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	00813	$114.08	1750369609 - FRANK SCHWALBE	60646973 - YALE UNIVERSITY	NC	Anesthesiology Physician (207L00000X)
United	00813	$96.13	1881011138 - SHO TANAKA	223146927	CA	Critical Care Medicine (Anesthesiology) Physician (207LC0200X)
United	00813	$95.00	1891009247 - ZACHARY WALTON	61411029 - (CT) CONNECTICUT GI, P.C.	CA	Anesthesiology Physician (207L00000X)
United	00813	$40.00	1033297619 - SHUREA WILSON	232678055 - METHODIST ASSOCIATES IN HEALTHCARE INC	CA	Anesthesiology Physician (207L00000X)
United	00813	$40.00	1477895803 - RISHI KOTHARI	232809585 - JEFFERSON UNIVERSITY PHYSICIANS	CA	Anesthesiology Physician (207L00000X)
United	00813	$96.13	1376047837 - MOEZ MITHANI	223146927	WA	Anesthesiology Physician (207L00000X)
United	00813	$97.23	1013232842 - HENRY NGUYEN	61137531 - NUVANCE HEALTH MEDICAL PRACTICE CT INC	WA	Anesthesiology Physician (207L00000X)
United	00813	$147.14	1811122716 - ADITYA MARWAHA	461617561 - (NY) NORTH SHORE-LIJ ANESTHESIOLOGY PC	GA	Anesthesiology Physician (207L00000X)
United	00813	$147.14	1871630319 - CHRISTOPHER REEVES	461617561 - (NY) NORTH SHORE-LIJ ANESTHESIOLOGY PC	CA	Anesthesiology Physician (207L00000X)
United	00813	$95.00	1154391613 - SCOTT PENNINGTON	61411029 - (CT) CONNECTICUT GI, P.C.	GA	Anesthesiology Physician (207L00000X)
United	00813	$71.50	1568998409 - FEEL KANG	232743545	CA	Anesthesiology Physician (207L00000X)
United	00813	$264.72	1659528735 - PETER VON HOMEYER	131740114 - MONTEFIORE MEDICAL CENTER	WA	Anesthesiology Physician (207L00000X)
United	00813	$141.49	1871630319 - CHRISTOPHER REEVES	461617561 - (NY) NORTH SHORE-LIJ ANESTHESIOLOGY PC	CA	Anesthesiology Physician (207L00000X)
United	00813	$147.14	1831175504 - KATHERINE POOLE	461617561 - (NY) NORTH SHORE-LIJ ANESTHESIOLOGY PC	WA	Certified Registered Nurse Anesthetist (367500000X)
United	00813	$95.00	1154391613 - SCOTT PENNINGTON	61411029 - (CT) CONNECTICUT GI, P.C.	GA	Anesthesiology Physician (207L00000X)
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 Codes

The CPT 00813 code is part of the Anesthesia for Procedures on the Lower Abdomen services used for Anesthesia. 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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