CPT 00864 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 Bladder Surgery, Anesthesia Services For A Surgery On The Bladder. Examples Of These Procedures Include Removal Of A Tumor Bladder Stones Or The Bladder Itself.

Key Fact	Detail
Service Type	Anesthesia for Procedures on the Lower Abdomen Anesthesia
Common Place of Service	21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital
Common Modifiers	None P3 - A patient with severe systemic disease QX - Qualified nonphysician anesthetist service: With medical direction by a physician
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 00864

National average anesthesia conversion factor for CPT 00864 by major payers:

$54.51

$55.79

$57.05

$54.91

Preview provider-level rates for...

For billing codeCPT 00864

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	00864	$34.00	1497080436 - MONIQUE TU	471510173 - (CA) ALVARADO PHYSICIANS MEDICAL GROUP	CA	Anesthesiology Physician (207L00000X)
United	00864	$55.50	1336282474 - BRIAN MACK	952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE	CA	Anesthesiology Physician (207L00000X)
United	00864	$61.00	1982991915 - LINDSEY HUDDLESTON	943281663	CA	Anesthesiology Physician (207L00000X)
United	00864	$81.44	1407963747 - RODNEY MCKEEVER	330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM	CA	Anesthesiology Physician (207L00000X)
United	00864	$99.00	1376746834 - ANITA GUPTA	954395492	CA	Pain Medicine (Anesthesiology) Physician (207LP2900X)
United	00864	$121.22	1609009935 - LISA LEE	954395492	CA	Pediatric Anesthesiology Physician (207LP3000X)
United	00864	$128.69	1437511920 - NICHOLAS MENDEZ	943281660	CA	Anesthesiology Physician (207L00000X)
United	00864	$99.00	1649346164 - JENNIFER LUCERO	954395492	CA	Anesthesiology Physician (207L00000X)
United	00864	$86.00	1023456118 - MICHAEL WOLFE	954377219	CA	Anesthesiology Physician (207L00000X)
United	00864	$35.00	1447246277 - STEVEN SUN	954457756 - (CA) CEDARS-SINAI MEDICAL CARE FOUNDATION	CA	Anesthesiology Physician (207L00000X)
United	00864	$71.19	1518910355 - MINDAUGAS VIELA	274803222 - CITY OF HOPE MEDICAL FOUNDATION	CA	Anesthesiology Physician (207L00000X)
United	00864	$117.22	1750539342 - SUZANNE STROM	954401759	CA	Anesthesiology Physician (207L00000X)
United	00864	$65.00	1508156407 - HEATHER WERTH	880310956 - ROBERT B. MCBEATH, M.D., P.C.	CA	Anesthesiology Physician (207L00000X)
United	00864	$61.00	1972358620 - DEAHNNE LEVAS	943281663	CA	Anesthesiology Physician (207L00000X)
United	00864	$67.09	1437511920 - NICHOLAS MENDEZ	943281660	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 00864 vs. Other Anesthesia Codes

The CPT 00864 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 00864 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
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.
00862-CPT	Moderate	Anesthesia For Kidney Surgery, Anesthesia Services Provided For All Types Of Surgery On The Kidneys Including Procedures Involving The Upper Part Of The Urinary Tract Between The Bladder And The Kidneys.
00864-CPT	Moderate	Anesthesia Bladder Surgery, Anesthesia Services For A Surgery On The Bladder. Examples Of These Procedures Include Removal Of A Tumor Bladder Stones Or The Bladder Itself.
00866-CPT	Moderate	Anes Xtrprt Lw Abd Adrnlctmy, Anesthesia For Extraperitoneal Procedures In Lower Abdomen Including Urinary Tract; Adrenalectomy

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00864. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 00864 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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