CPT 00952 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 • 11 - Office |
| 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 00952 by major payers:
$45.87
$54.11
$55.82
$55.39
| 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 00952 | ||||||
United | 00952 | $113.00 | 1194878439 - JOSEPH ANDRESEN | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $128.69 | 1205003159 - DANIEL LEUNG | 943281663 | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $83.00 | 1417299595 - KIUMARS GHADJAR | 932316816 | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $121.22 | 1487921268 - JOHN MILLER | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $135.50 | 1396766671 - JOHN LENART | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $117.22 | 1326533597 - DUSTIN SINGER | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $61.00 | 1164678512 - RAMANA NAIDU | 943281663 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 00952 | $54.00 | 1508940578 - GARY LEE | 680304987 - (CA) NORTHERN CALIFORNIA ANESTHESIA PHYSICIANS, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $55.50 | 1356640718 - LISA COLOSIMO | 954401759 | CA | Critical Care Medicine (Anesthesiology) Physician (207LC0200X) |
United | 00952 | $71.19 | 1518328400 - SARAH YIP | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $66.00 | 1043519606 - CHRISTOPHER NGUYEN | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $117.22 | 1679916431 - JAY SHEN | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $65.00 | 1841331923 - STEVEN LIPMAN | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $121.22 | 1982638839 - NOEL CHUN | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 00952 | $45.00 | 1023450947 - INTERVENTIONAL ANESTHESIA & PAIN MANAGEMENT CLINIC INC. | 454787068 - (CA) INTERVENTIONAL ANESTHESIA PAIN MANAGEMENT CLINIC INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
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 00952 vs. Other Anesthesia for Procedures on the Perineum Codes
The CPT 00952 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 00952 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 |
|---|---|---|
| 00840-CPT | Moderate | Anes Intraperitoneal Low Abd; Nos |
| 00942-CPT | Low | Anesthesia For Vaginal Procedures (Including Biopsy Of Labia, Vagina, Cervix Or Endometrium); Colpotomy, Vaginectomy, Colporrhaphy, And Open Urethral Procedures |
| 00944-CPT | Moderate | Anes Vaginal; Vaginal Hysterectomy |
| 00952-CPT | Low | Anesthesia For Vaginal Procedures (Including Biopsy Of Labia, Vagina, Cervix Or Endometrium); Hysteroscopy And/Or Hysterosalpingography |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00952. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00952 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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