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See a sample rate comparisonCPT 00904 Fee Schedule
Last Verified: October 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.
Anes For Proc On Perineal Integumentary System (Including Biopsy Of Male Genital System); Radical Perineal Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Anesthesia Anesthesia for Procedures on the Perineum |
| 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 |
| Medicare Fee Schedule | View Medicare rates for 00904 |
National average anesthesia conversion factor for CPT 00904 by major payers:
$57.91
$55.80
$56.93
$54.74
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CPT 00904
5 of 25 sample ratesHigher to lower in this preview
Jacqueline Leung
$128.69Published rateChristopher Clave
Anesthesia Medical Group Of Santa Barbara, Inc.
$74.00Published rateThomas Schares
Resource Anesthesiology Associates Of Nm Inc
$62.00Published rateJames Pak
Anesthesiologists Medical Group Of San Francisco Inc
$57.00Published rateMark Schlesinger, M.D., A Professional Corporation, Schlesinger Pain Centers
Mark Schlesinger, M.D. A Professional Corporation
$32.00Published rate
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See a sample payer proposalCPT 00904 vs. Other Anesthesia for Procedures on the Perineum Codes
The CPT 00904 code is part of the Anesthesia services used for Anesthesia for Procedures on the Perineum. 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 00904 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 |
|---|---|---|
| 00902-CPT | Moderate | Anesthesia Rectal Procedure, Anesthesia Services For A Procedure On The Anus Or Rectum. |
| 00904-CPT | Moderate | Anes For Proc On Perineal Integumentary System (Including Biopsy Of Male Genital System); Radical Perineal Procedure |
| 00906-CPT | Low | Anes Perineal Integ; Vulvectomy |
| 00908-CPT | Moderate | Anesthesia Prostate Surgery, Anesthesia Services For Surgery To Remove The Prostate Gland. The Procedure May Include Removal Of Related Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00904. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00904 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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