CPT 00926 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 00926 by major payers:
$57.33
$55.71
$56.60
$54.24
| 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 00926 | ||||||
United | 00926 | $128.69 | 1851307631 - LUDWIG LIN | 943281660 | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $86.00 | 1922487545 - HOWARD ZEE | 300802553 | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $81.44 | 1376746834 - ANITA GUPTA | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00926 | $113.00 | 1912119413 - BRIAN DULA | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $78.00 | 1598793119 - KURT NEUBAUER | 954656412 - (CA) PACIFIC VALLEY MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $48.00 | 1669407839 - ANESTHESIA MEDICAL GROUP OF RIVERSIDE, INC | 952630277 - (CA) ANESTHESIA MEDICAL GROUP OF RIVERSIDE, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $65.00 | 1508859398 - JOHN CHAN | 770414846 - (CA) MODESTO ANESTHESIA MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $86.00 | 1275196305 - MAZIAR NOURIAN | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $69.62 | 1760837306 - ASHLEY BALENTINE | 954540991 - USC CARE MEDICAL GROUP INC | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $60.00 | 1144205063 - GAGAN MAHAJAN | 680344702 | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $55.50 | 1891157269 - GABRIEL REYES | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $78.00 | 1306882493 - WILLIAM LO | 364573347 | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $99.52 | 1215254552 - KATHERINE CHIU | 954540991 - USC CARE MEDICAL GROUP INC | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $65.00 | 1730215229 - STEPHEN FISCHER | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00926 | $99.00 | 1548436462 - HARKIRAT CHAHAL | 954395492 | 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 00926 vs. Other Anesthesia for Procedures on the Perineum Codes
The CPT 00926 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 00926 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00926. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00926 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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