CPT 00921 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • AA - Anesthesia by anesthesiologist • QS - Monitored anesthesia care service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 00921 |
National average anesthesia conversion factor for CPT 00921 by major payers:
$45.84
$54.10
$55.28
$22.12
| 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 00921 | ||||||
United | 00921 | $65.00 | 1356723761 - NICHOLAS GREGORY | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $52.50 | 1023338696 - REBECCA MARGOLIS | 953777340 - CHILDRENS HOSPITAL LOS ANGELES MEDICAL GROUP INC | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 00921 | $42.00 | 1679559637 - CORRY KUCIK | 910843135 | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00921 | $63.15 | 1295984078 - MAHFUZUL MAJUMDAR | 850105601 - PRESBYTERIAN HEALTHCARE SERVICES | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $62.00 | 1306038476 - SUSIE CHO | 824555570 - (CA) AXIOM ANESTHESIA GROUP INC | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $65.00 | 1407140080 - DANH DO | 351904143 - (IN) NORTHSIDE ANESTHESIA SERVICES, LLC | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $52.00 | 1407103906 - SHABNAM MOSS | 271876899 | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $135.50 | 1295723708 - MARK WITTMAN | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00921 | $60.00 | 1548791577 - JASON HUNG | 742932237 - (TX) COMMUNITY MEDICINE ASSOCIATES | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $61.00 | 1700842119 - JACQUELINE LEUNG | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $78.00 | 1982921862 - SEKSAN SREPHICHIT | 954656412 - (CA) PACIFIC VALLEY MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $99.00 | 1437541828 - BENJAMIN CHU | 954377219 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00921 | $65.69 | 1366459679 - STEVEN THORUP | 911939739 - FRANCISCAN MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $58.00 | 1366636862 - HUONG LE | 464316329 | CA | Anesthesiology Physician (207L00000X) |
United | 00921 | $128.49 | 1659726404 - SUJANA DONTUKURTHY | 571004971 - PRISMA HEALTH-UNIVERSITY MEDICAL GROUP | CA | Pediatric Anesthesiology Physician (207LP3000X) |
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 00921 vs. Other Anesthesia for Procedures on the Perineum Codes
The CPT 00921 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 00921 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 |
|---|---|---|
| 00920-CPT | Low | Anes Male External Genitalia; Nos |
| 00921-CPT | Low | Anesthesia For Procedures On Male Genitalia (Including Open Urethral Procedures); Vasectomy, Unilateral/Bilateral |
| 00922-CPT | Low | Anes Male Ext Genit; Seminal Vessels |
| 00924-CPT | Low | Anesthesia For Procedures On Male Genitalia (Including Open Urethral Procedures); Undescended Testis, Unilateral Or Bilateral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00921 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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