CPT 00916 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 Perineum Anesthesia |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None P3 - A patient with severe systemic disease AA - Anesthesia by anesthesiologist |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 00916 |
National average anesthesia conversion factor for CPT 00916 by major payers:
$57.70
$55.62
$57.00
$54.41
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 00916 | $38.00 | 1144238429 - JOHN BRAZILL | 208703660 - (CA) BAKERSFIELD PAIN MANAGEMENT, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $37.00 | 1467649657 - UNIVERSITY PAIN CONSULTANTS, INC. | 261162041 - (CA) UNIVERSITY PAIN CONSULTANTS INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00916 | $55.00 | 1467080341 - AN BUI | 237064656 - HEALING THE SOUL | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $45.00 | 1730100330 - UDAYA DESILVA | 952082686 - RIDGECREST REGIONAL HOSPITAL | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00916 | $61.00 | 1841751385 - MARYTE GYLYS | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $84.66 | 1528209103 - MATTHEW NUCKOLS | 951965700 - (CA) ANESTHESIA SERVICE MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $83.00 | 1700110087 - RIA DASGUPTA | 471884235 - CEP AMERICA | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $60.00 | 1972062883 - GLORIA BELONWU | 680334324 | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $94.00 | 1417253386 - MELISSA HAEHN | 410949198 - (MN) ANESTHESIOLOGY, P.A. | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $38.00 | 1730100330 - UDAYA DESILVA | 43807824 - (CA) US DESILVA MD A MEDICAL | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00916 | $89.00 | 1932631256 - ANNA FRACKMAN | 391824445 - UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $83.00 | 1457304099 - HAZEM ZEKRY | 471884235 - CEP AMERICA | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $57.50 | 1730943366 - ALEXANDRE JOOSTEN | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $121.22 | 1861429060 - ROBERT POUSMAN | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00916 | $61.00 | 1457552390 - MATTHIAS BRAEHLER | 943281663 | 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 00916 vs. Other Anesthesia Codes
The CPT 00916 code is part of the Anesthesia for Procedures on the Perineum 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 00916 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 |
|---|---|---|
| 00836-CPT | Moderate | Anesthesia For Hernia Repair, Anesthesia Services For An Infant Related To Surgery To Repair A Hernia. Hernias Occur When Organs Or Other Structures Bulge Through Containing Tissue Into Other Areas. Stomach Hernias (Into Upper Abdomen) Are Common In Babies. |
| 00910-CPT | Low | Anesthesia Bladder Procedure, Anesthesia Services For A Bladder Or Urinary Tract Procedure. Examples Include A Scope-Assisted Bladder Exam (Urethrocystoscopy) And Treatment Of Bleeding In The Urinary Tract. |
| 00912-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. |
| 00916-CPT | Moderate | Anesthesia Bladder Procedure, Anesthesia Services For A Bladder Or Urinary Tract Procedure. Examples Include A Scope-Assisted Bladder Exam (Urethrocystoscopy) And Treatment Of Bleeding In The Urinary Tract. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00916. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00916 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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