CPT 01472 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 Lower Leg (Below Knee) |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • AA - Anesthesia by anesthesiologist • QX - Qualified nonphysician anesthetist service: With medical direction by a physician |
| Complexity Level | Moderate |
National average anesthesia conversion factor for CPT 01472 by major payers:
$53.00
$55.74
$56.45
$54.41
| 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 01472 | ||||||
United | 01472 | $117.22 | 1326533597 - DUSTIN SINGER | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $82.00 | 1528209459 - JAMIE ETO | 273597066 - FIRST CHOICE PHYSICIAN PARTNERS | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $55.00 | 1750700290 - ANDREW GIUSTINI | 931311318 | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $84.66 | 1922432475 - LAWRENCE YOUNAN | 951965700 - (CA) ANESTHESIA SERVICE MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $135.50 | 1467488023 - AYMAN MOHAMED ADS | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $48.00 | 1083746259 - RESOURCE ANESTHESIOLOGY ASSOC OF CALIFORNIA,A MEDICAL CORPORATION | 562644292 - (CA) RESOURCE ANESTHESIOLOGY ASSOC OF CALIFORNIAA MEDICAL CORPORATION | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $35.00 | 1225490824 - KISHAN PATEL | 954457756 - (CA) CEDARS-SINAI MEDICAL CARE FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $65.00 | 1538354329 - NAIYI SUN | 770465765 | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 01472 | $84.66 | 1629157631 - THERESA SLOMA | 951965700 - (CA) ANESTHESIA SERVICE MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $77.18 | 1194767830 - MAKOTO NAGOSHI | 953777340 - CHILDRENS HOSPITAL LOS ANGELES MEDICAL GROUP INC | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $57.00 | 1144588542 - SHARA COHN | 943302014 | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $93.01 | 1831114842 - HENRY KAMALI | 834708723 - (CA) G2 ANESTHESIA, PC | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $51.00 | 1750305439 - EDWARD PUMPHREY | 954676301 | CA | Anesthesiology Physician (207L00000X) |
United | 01472 | $80.00 | 1932294972 - MARTY CLAYMAN | 852103299 - (CA) COMMUNITY HEALTH PARTNERS | CA | Pediatric Anesthesiology Physician (207LP3000X) |
United | 01472 | $45.00 | 1639193147 - DAVID HUANG | 953758107 | 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 01472 vs. Other Anesthesia for Procedures on the Lower Leg (Below Knee) Codes
The CPT 01472 code is part of the Anesthesia services used for Anesthesia for Procedures on the Lower Leg (Below 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 01472 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 |
|---|---|---|
| 01462-CPT | Low | Anes Lower Leg Ankle Ft Closed |
| 01464-CPT | Low | Anes Ankle Joint Arthroscopic |
| 01470-CPT | Low | Anesthesia For Procedures On Nerves, Muscles, Tendons, And Fascia Of Lower Leg, Ankle, And Foot; Not Otherwise Specified |
| 01472-CPT | Moderate | Anesthesia For Procedures On Nerves, Muscles, Tendons, And Fascia Of Lower Leg, Ankle, And Foot; Repair Of Ruptured Achilles Tendon, With Or Without Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 01472. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 01472 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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