CPT 00942 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 00942 by major payers:
$57.13
$55.71
$56.38
$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 00942 | ||||||
United | 00942 | $65.00 | 1003013442 - JACK KAN | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $72.00 | 1982135323 - DAVID JANICZEK | 850106941 - (NM) ST VINCENT HOSPITAL | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $60.00 | 1447726997 - CONCIERGE ANESTHESIA | 832033781 - (CA) CONCIERGE ANESTHESIA | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $75.00 | 1003856097 - DAVID IRWIN | 943158784 - (CA) ANESTHESIA CARE ASSOCIATES MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $52.00 | 1265929582 - ROBERT LANDON | 941502014 - SOUTHERN MONTEREY COUNTY MEMORIAL HOSPITAL | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $121.22 | 1730683541 - ASHIE KAPOOR | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $86.00 | 1154985901 - ELENA MADAN | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $60.00 | 1487828802 - ERIN JAMES | 680334324 | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $80.00 | 1952357238 - LAWRENCE YEE | 871221902 - (CA) EL CAMINO ANESTHESIA | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $31.00 | 1538155668 - BRETT BUTZ | 460535361 - (CA) INTERVENTIONAL PAIN PHYSICIANS INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00942 | $63.00 | 1528450624 - SANAZ GHAFFARI | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $57.00 | 1255352654 - THOMAS YEH | 770366626 - (CA) PREMIER ANESTHESIA MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $99.00 | 1912111956 - VADIM GUDZENKO | 953812774 | CA | Anesthesiology Physician (207L00000X) |
United | 00942 | $38.00 | 1700176971 - BRIAN LAI | 870994202 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00942 | $69.00 | 1912119629 - JASON GREENBERG | 680304987 - (CA) NORTHERN CALIFORNIA ANESTHESIA PHYSICIANS, INC. | 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 00942 vs. Other Anesthesia for Procedures on the Perineum Codes
The CPT 00942 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 00942 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 |
|---|---|---|
| 00882-CPT | Moderate | Anes Major Low Abd Vessels; Inferior Ven |
| 00938-CPT | Low | Anesthesia For Procedures On Male Genitalia (Including Open Urethral Procedures); Insertion Of Penile Prosthesis (Perineal Approach) |
| 00940-CPT | Low | Anes Vaginal Inc Bx Labia Vagin Cervix N |
| 00942-CPT | Low | Anesthesia For Vaginal Procedures (Including Biopsy Of Labia, Vagina, Cervix Or Endometrium); Colpotomy, Vaginectomy, Colporrhaphy, And Open Urethral Procedures |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00942. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00942 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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