CPT 00920 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center • 21 - Inpatient Hospital |
| Common Modifiers | • None • AA - Anesthesia by anesthesiologist • QX - Qualified nonphysician anesthetist service: With medical direction by a physician |
| Complexity Level | Low |
National average anesthesia conversion factor for CPT 00920 by major payers:
$56.88
$55.68
$54.60
$18.17
| 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 00920 | ||||||
United | 00920 | $55.50 | 1609338029 - KEVIN TAN | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $70.00 | 1992949515 - MARIANNE CHEN | 260089066 | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $50.00 | 1245265487 - DAVID GOFF | 830339515 - (CA) YVONNE GOFF, MD | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $57.50 | 1831120070 - PEREGRINA ARCIAGA | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $65.00 | 1447662689 - EVAN SLEIPNESS | 330636378 - (CA) ANESTHESIA CONSULTANTS OF CALIFORNIA MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $128.69 | 1215399589 - DYLAN MASTERS | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $60.00 | 1932294972 - MARTY CLAYMAN | 923191040 | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00920 | $128.69 | 1326133042 - EDWARD TANG | 943281660 | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $83.00 | 1609042308 - PIA ANETTE HOF | 471884235 - CEP AMERICA | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $63.00 | 1588611826 - FAYEZ TAKLA | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $60.00 | 1740241710 - MARK LANDON | 330406164 | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $55.27 | 1497487185 - KATHERINE EGAN | 823162244 | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $35.00 | 1427048545 - NIRMALA THEJOMURTHY | 954457756 - (CA) CEDARS-SINAI MEDICAL CARE FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00920 | $117.22 | 1083932255 - ARIANA NELSON | 954401759 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00920 | $91.75 | 1114151719 - ALI MEHDIZADEH | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
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 00920 vs. Other Anesthesia for Procedures on the Perineum Codes
The CPT 00920 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 00920 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 |
|---|---|---|
| 00872-CPT | Moderate | Anes Lithotripsy Shock Wave; W Water Bat |
| 00918-CPT | Moderate | Anesthesia For Transurethral Procedures (Including Urethrocystoscopy); With Fragmentation, Manipulation And/Or Removal Of Ureteral Calculus |
| 00920-CPT | Low | Anes Male External Genitalia; Nos |
| 00926-CPT | Low | Anes Male Ext Genit; Rad Orchiectomy Ing |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00920 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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