CPT 01234 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 Upper Leg (Except Knee) |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • P3 - A patient with severe systemic disease • QX - Qualified nonphysician anesthetist service: With medical direction by a physician |
| Complexity Level | Moderate |
National average anesthesia conversion factor for CPT 01234 by major payers:
$55.61
$54.09
$57.12
$55.48
| 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 01234 | ||||||
United | 01234 | $99.00 | 1740786805 - CECILIA CANALES | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $63.00 | 1134141286 - RONALD ROTHSTEIN | 330359522 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $63.00 | 1386663540 - JOSEPH FARLO | 330359522 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $57.50 | 1710129325 - GOLDIE WINGE | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $121.22 | 1750812319 - HAYLEY OSEN | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $99.00 | 1437541828 - BENJAMIN CHU | 954395492 | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 01234 | $38.00 | 1649483884 - JONATHAN KELLING | 814038573 - (CA) SOUTHERN CALIFORNIA SPINE & JOINT INSTITUTE | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $121.22 | 1407388622 - DANE SAKSA | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $56.00 | 1427289776 - RYAN JAMISON | 800927296 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $69.00 | 1255520789 - MATTHEW LE DUC | 330440096 - (CA) NEWPORT HARBOR ANESTHESIA CONSULTANTS MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $117.22 | 1215462825 - JESSE SNIDER | 954401759 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $99.00 | 1669414140 - KEREN ZIV | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $91.75 | 1114459542 - PHILLIP PEARSON | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 01234 | $117.22 | 1932341690 - SANG LE | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 01234 | $76.80 | 1508211012 - SUSANA RODRIGUES VACAS | 42697983 - MASS GENERAL BRIGHAM INCORPORATED | 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 01234 vs. Other Anesthesia for Procedures on the Upper Leg (Except Knee) Codes
The CPT 01234 code is part of the Anesthesia services used for Anesthesia for Procedures on the Upper Leg (Except Knee). 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 01234 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 01234. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 01234 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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