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See a sample rate comparisonCPT 00938 Fee Schedule
Last Verified: October 2026
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.
Anes Insj Penile Prosthesis, Anesthesia For Procedures On Male Genitalia (Including Open Urethral Procedures); Insertion Of Penile Prosthesis (Perineal Approach)
| 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 P3 - A patient with severe systemic disease QX - Qualified nonphysician anesthetist service: With medical direction by a physician |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 00938 |
National average anesthesia conversion factor for CPT 00938 by major payers:
$57.17
$55.62
$56.75
$54.24
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CPT 00938
5 of 25 sample ratesHigher to lower in this preview
Celina Crisman
Montefiore Medical Center
$249.14Published rateEric Woodard
Eric J Woodard Md PC
$88.25Published rateMarc Christensen
Mass General Brigham Incorporated
$76.80Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$60.00Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$10.00Published rate
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See a sample payer proposalCPT 00938 vs. Other Anesthesia for Procedures on the Perineum Codes
The CPT 00938 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 00938 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 |
|---|---|---|
| 00936-CPT | Moderate | Anesthesia For Penis Surgery, Anesthesia Services For A Surgery To Remove The Penis. The Procedure May Include Removing Lymph Glands In The Groin And Pelvis And Reconstruction Of The Urinary Tract (Urethra). |
| 00938-CPT | Low | Anes Insj Penile Prosthesis, Anesthesia For Procedures On Male Genitalia (Including Open Urethral Procedures); Insertion Of Penile Prosthesis (Perineal Approach) |
| 00940-CPT | Low | Anesthesia Of Female Genitals, Anesthesia Services For A Procedure Involving A Womans Genitals: Labia Vulva Vagina Cervix Or Uterus. Examples Include Scope-Assisted Exams Taking A Tissue Sample For Testing (Biopsy) Microscopic Imaging And Minor Surgery. |
| 00942-CPT | Low | Anesthesia Of Female Genitals, Anesthesia Services For A Procedure Involving A Womans Genitals: Labia Vulva Vagina Cervix Or Uterus. Examples Include Scope-Assisted Exams Taking A Tissue Sample For Testing (Biopsy) Microscopic Imaging And Minor Surgery. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00938. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00938 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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