CPT 01634 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 Shoulder and Axilla |
| 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 01634 by major payers:
$56.76
$54.09
$57.25
$55.57
| 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 01634 | ||||||
United | 01634 | $69.00 | 1679916431 - JAY SHEN | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $121.22 | 1376591644 - KOMAL PATEL | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $35.00 | 1649265794 - EVELYN NOREL | 954457756 - (CA) CEDARS-SINAI MEDICAL CARE FOUNDATION | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $44.00 | 1013987890 - FARZIN TAYEFEH | 460516802 - (CA) SHARP CORONADO HOSPITAL AND HEALTHCARE CENTER | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $69.62 | 1528562907 - PORUS MISTRY | 954540991 - USC CARE MEDICAL GROUP INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 01634 | $45.00 | 1326036260 - XIAOLIN WANG | 273083265 - (IL) MEMORIAL HEALTH SYSTEM | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $61.00 | 1356355499 - KEN ZUCKERMAN | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $121.22 | 1013959501 - LORRAINE LUBIN | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $65.00 | 1912011545 - REBECCA CLAURE | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $35.00 | 1659686111 - ASEEM HEMMAD | 203721204 - (CA) PAIN MANAGEMENT ASSOCIATES, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $53.00 | 1093799066 - CLAUDIA SANTOSA | 716046242 | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $91.75 | 1508884008 - ELIZABETH GHAZAL | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $84.66 | 1972571693 - WILLIAM LENNARD | 951965700 - (CA) ANESTHESIA SERVICE MEDICAL GROUP, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $65.00 | 1538300595 - GILLIAN ABIR | 770465765 | CA | Anesthesiology Physician (207L00000X) |
United | 01634 | $35.00 | 1609168939 - JACKLYN MA | 954457756 - (CA) CEDARS-SINAI MEDICAL CARE FOUNDATION | CA | Pediatric Anesthesiology Physician (207LP3000X) |
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 01634 vs. Other Anesthesia for Procedures on the Shoulder and Axilla Codes
The CPT 01634 code is part of the Anesthesia services used for Anesthesia for Procedures on the Shoulder and Axilla. 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 01634 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 |
|---|---|---|
| 01620-CPT | Low | Anesthesia For All Closed Procedures On Humeral Head And Neck, Sternoclavicular Joint, Acromioclavicular Joint, And Shoulder Joint |
| 01622-CPT | Low | Anes Shoulder Joint Arthroscopy |
| 01630-CPT | Moderate | Anesthesia For Open Or Surgical Arthroscopic Procedures On Humeral Head And Neck, Sternoclavicular Joint, Acromioclavicular Joint, And Shoulder Joint; Not Otherwise Specified |
| 01634-CPT | Moderate | Anesthesia For Open Or Surgical Arthroscopic Procedures On Humeral Head And Neck, Sternoclavicular Joint, Acromioclavicular Joint, And Shoulder Joint; Shoulder Disarticulation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 01634. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 01634 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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