CPT 00904 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 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 |
National average anesthesia conversion factor for CPT 00904 by major payers:
$57.91
$55.80
$56.93
$54.74
| 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 00904 | ||||||
United | 00904 | $106.55 | 1841233632 - GAREN SIMONYAN | 223376459 - HACKENSACK MERIDIAN HEALTH MEDICAL GROUP-SPECIALTY CARE PC | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $57.00 | 1073559191 - JAMES PAK | 941708041 - (CA) ANESTHESIOLOGISTS MEDICAL GROUP OF SAN FRANCISCO INC | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $121.22 | 1912111956 - VADIM GUDZENKO | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $65.00 | 1427251099 - MARYBETH BEWERSDORF | 472040579 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00904 | $61.00 | 1730370859 - CLAUDIA BENKWITZ | 943281663 | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00904 | $63.00 | 1831364322 - RAYMUNDO SALCEDO | 364418750 - (CA) SIMI VALLEY ANESTHESIA MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $65.00 | 1871780098 - JIANG-TI KONG | 770465765 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00904 | $128.69 | 1346282118 - ERROL LOBO | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $56.00 | 1992049480 - MAGDI A. SIDHOM, MD INC | 453937440 - (CA) MAGDI A SIDHOM MD INC | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $32.00 | 1639141005 - RAYMOND HSIEH | 1639141005 - (CA) RAYMOND HSIEH | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00904 | $86.00 | 1487921268 - JOHN MILLER | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $86.00 | 1407388622 - DANE SAKSA | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $65.00 | 1295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM | 752796815 - CHRISTUS HEALTH ARK-LA-TEX | TX | General Acute Care Hospital (282N00000X) |
United | 00904 | $75.00 | 1326579442 - SHRADHA KHADGE | 203395567 | CA | Anesthesiology Physician (207L00000X) |
United | 00904 | $117.22 | 1316409022 - DANH LE | 954401759 | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 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 |
|---|---|---|
| 00834-CPT | Moderate | Anesthesia For Hernia Repairs In The Lower Abdomen Not Otherwise Specified, Under 1 Year Of Age |
| 00902-CPT | Moderate | Anesthesia For Procedures On Perineal Integumentary System; Anorectal Procedure |
| 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 |
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 00904) and we'll show you how you compare in 15 minutes or less.