CPT 00842 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 for Procedures on the Lower Abdomen Anesthesia |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None AA - Anesthesia by anesthesiologist P2 - A patient with mild systemic disease |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 00842 |
National average anesthesia conversion factor for CPT 00842 by major payers:
$57.23
$55.62
$57.01
$54.24
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 00842 | $25.00 | 1588292858 - KORINA SANDOVAL | 956130458 - EISENHOWER MEDICAL CENTER | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $42.00 | 1730267642 - DWAINE BOBO | 832718107 - (CA) SDA SERVICES OF CA | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $41.00 | 1255659181 - ARIEL HURTADO | 464150987 - (CA) VALLEY CHILDRENS MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $38.00 | 1114383080 - ADVANCE COMPREHENSIVE PAIN CARE INC | 475363224 - (CA) ADVANCE COMPREHENSIVE PAIN CARE, INC. | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00842 | $60.00 | 1871789354 - SCOTT AHLBRAND | 770460802 | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00842 | $68.00 | 1316915622 - JOHN LUBBEN | 272609487 - (CA) VENTANA ANESTHESIA ASSOCIATES INC | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $91.75 | 1972525608 - CARL COLLIER | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $61.00 | 1962720920 - ODINAKACHUKWU EHIE | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $58.00 | 1740501170 - ROBERT SCHUSTER | 464316329 | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $71.19 | 1598722381 - MICHAEL SULLIVAN | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $128.69 | 1831675065 - DENISE CHANG | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $65.00 | 1376531574 - ANDREA TRAYNOR | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $117.22 | 1508946690 - HO J CHOI | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $65.00 | 1356723761 - NICHOLAS GREGORY | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00842 | $69.62 | 1902973720 - PATRICIA HARRISON | 954540991 - USC CARE MEDICAL GROUP INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
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 00842 vs. Other Anesthesia Codes
The CPT 00842 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 00842 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 |
|---|---|---|
| 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. |
| 00842-CPT | Low | Anesthesia For Amniocentesis, Anesthesia Services For Amniocentesis A Procedure That Removes A Small Amount Of Amniotic Fluid For Testing During Pregnancy. |
| 00844-CPT | Moderate | Anes Iper Px Abdmnprnl Rescj, Anesthesia For Intraperitoneal Procedures In Lower Abdomen Including Laparoscopy; Abdominoperineal Resection |
| 00846-CPT | Moderate | Anesthesia For Uterus Removal, Anesthesia Services For Surgical Removal Of The Uterus (Hysterectomy) Through The Abdomen Including Removal Of The Ovaries And Fallopian Tubes (Radical Hysterectomy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00842. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00842 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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