CPT 00820 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • QX - Qualified nonphysician anesthetist service: With medical direction by a physician • AA - Anesthesia by anesthesiologist |
| Complexity Level | Moderate |
National average anesthesia conversion factor for CPT 00820 by major payers:
$57.71
$55.72
$57.02
$54.41
| 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 00820 | ||||||
United | 00820 | $91.75 | 1932735966 - ALEXANDER NEMIROV | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $61.00 | 1417985334 - JAMES BRANDES | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $50.00 | 1770548521 - MATTHEW VO | 273068347 | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $63.00 | 1326084294 - JEFF GE | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $52.50 | 1528160447 - GARY SCOTT | 953777340 - CHILDRENS HOSPITAL LOS ANGELES MEDICAL GROUP INC | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $35.00 | 1356632392 - JENNIFER GERBER | 954457756 - (CA) CEDARS-SINAI MEDICAL CARE FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $55.00 | 1255448726 - KATHERINE QUINTANA | 364999438 - (CA) CA MEDICAL CONSULTANTS | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $65.00 | 1578531430 - ANTHONY DOUFAS | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $56.00 | 1467549683 - SHUNMUGARAJA SUBBIAH MD A PROFESSIONAL MEDICAL CORPORATION | 870699380 - (CA) SHUNMUGARAJA SUBBIAH MD A PROFESSIONAL MEDICAL CORPORATION | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $57.50 | 1336128669 - AVRAHAM WEISSMAN | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $86.00 | 1053369397 - JONATHAN HO | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $66.00 | 1194822338 - DUSTIN MORRIS | 272563652 - (CA) ORION ANESTHESIA CONSULTANTS INC | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $69.00 | 1255520789 - MATTHEW LE DUC | 330440096 - (CA) NEWPORT HARBOR ANESTHESIA CONSULTANTS MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $91.75 | 1104872118 - LOMA LINDA UNIV ANESTHESIOLOGY MEDICAL GROUP INC | 330292783 | CA | Anesthesiology Physician (207L00000X) |
United | 00820 | $60.00 | 1336316355 - JESSICA BRODT | 770460802 | CA | 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 00820 vs. Other Anesthesia for Procedures on the Lower Abdomen Codes
The CPT 00820 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 00820 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 |
|---|---|---|
| 00820-CPT | Moderate | Anes Lower Posterior Abdominal Wall |
| 00830-CPT | Low | Anes Hernia Rep Low Abd; Nos |
| 00834-CPT | Moderate | Anesthesia For Hernia Repairs In The Lower Abdomen Not Otherwise Specified, Under 1 Year Of Age |
| 00862-CPT | Moderate | Anesthesia For Extraperitoneal Procedures In Lower Abdomen, Including Urinary Tract; Renal Procedures, Including Upper One-Third Of Ureter, Or Donor Nephrectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00820 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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