CPT 00868 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • P3 - A patient with severe systemic disease • AA - Anesthesia by anesthesiologist |
| Complexity Level | Moderate |
National average anesthesia conversion factor for CPT 00868 by major payers:
$58.12
$55.88
$57.24
$55.23
| 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 00868 | ||||||
United | 00868 | $81.44 | 1134559776 - JOSE CESAR | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00868 | $50.00 | 1649204942 - HTOO AUNG | 943342387 | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $61.00 | 1174250161 - BERNADETTE WILKS | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $57.50 | 1255563714 - SUMIT SINGH | 954395492 | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00868 | $81.44 | 1760709166 - VICTORIA VO | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00868 | $40.00 | 1043303878 - STANISLAUS ANESTHESIA MEDICAL GROUP | 200184970 - (CA) STANISLAUS ANESTHESIA MEDICAL GROUP INC | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $77.18 | 1437576634 - JOCELYN WONG | 953777340 - CHILDRENS HOSPITAL LOS ANGELES MEDICAL GROUP INC | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $55.00 | 1467466193 - ROWELL LOYOLA | 953942828 - (CA) PIH HEALTH PHYSICIANS | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $61.00 | 1275571788 - VERONICA SEGREDO | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $70.00 | 1326036260 - XIAOLIN WANG | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $67.09 | 1396701017 - RICHARD ROWE | 943281660 | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $128.69 | 1821450594 - MICHAEL CURTIS | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $63.00 | 1851488779 - BASSAM KADRY | 474852990 - (MI) INSIGHT ANESTHESIA PLLC | CA | Anesthesiology Physician (207L00000X) |
United | 00868 | $84.66 | 1801820261 - GLORIA HWANG | 951965700 - (CA) ANESTHESIA SERVICE MEDICAL GROUP, INC. | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00868 | $75.00 | 1538151543 - PAUL CATTAFI | 850889913 - (TX) SOUND PHYSICIANS ANESTHESIOLOGY OF TEXAS PLLC | 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 00868 vs. Other Anesthesia for Procedures on the Lower Abdomen Codes
The CPT 00868 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 00868 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 |
|---|---|---|
| 00862-CPT | Moderate | Anesthesia For Extraperitoneal Procedures In Lower Abdomen, Including Urinary Tract; Renal Procedures, Including Upper One-Third Of Ureter, Or Donor Nephrectomy |
| 00866-CPT | Moderate | Anes Extraperitoneal Low Abd; Adrenalect |
| 00868-CPT | Moderate | Anes Extraperitoneal Low Abd; Renal Tran |
| 00870-CPT | Moderate | Anes Extraperitoneal Low Abd; Cystolitho |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00868. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00868 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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