CPT 01636 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 • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • P3 - A patient with severe systemic disease • QK - Medical direction of two, three or four concurrent anesthesia procedures • QX - Qualified nonphysician anesthetist service: With medical direction by a physician |
| Complexity Level | Moderate |
National average anesthesia conversion factor for CPT 01636 by major payers:
$57.53
$55.62
$57.70
$56.08
| 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 01636 | ||||||
United | 01636 | $78.00 | 1780710145 - AAKASH AGARWALA | 954656412 - (CA) PACIFIC VALLEY MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $55.00 | 1396970463 - ERIN MARTIN | 237064656 - HEALING THE SOUL | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $55.00 | 1194014274 - AALAP SHAH | 813848579 - (CA) AALAP C SHAH MD INC | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $38.00 | 1629032891 - BRIAN LEVINE | 932003418 - (CA) LP HEALTH | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $55.00 | 1093970766 - LARISSA GREBENCHTCHIKOVA | 251891482 - (PA) NORTH PITTSBURGH ANESTHESIA ASSOCIATES, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $46.34 | 1700073178 - ERIKA HUBBARD | 824591168 - (CA) TRIAS GLOBAL LLC | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $81.44 | 1558552471 - DANIELA KARAGYOZYAN | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $62.00 | 1639190820 - NICHOLAS SAKELLARIOU | 954444226 - (CA) BUENA VISTA ANESTHESIA MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $121.22 | 1114488806 - BRITTANY BURTON | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $128.69 | 1255534129 - SARAH VANKOVA | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $50.00 | 1437100427 - VAPRNET ANESTHESIOLOGY NETWORK | 203556568 | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $74.00 | 1598226789 - JOHN KLEINMAN | 952655301 - (CA) ANESTHESIA MEDICAL GROUP OF SANTA BARBARA, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $56.00 | 1629680665 - ANDY LE MD INC | 270168936 - (CA) ANDY LE MD INC | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $128.69 | 1710483201 - TENZING LAMA | 943281660 | CA | Anesthesiology Physician (207L00000X) |
United | 01636 | $91.75 | 1760709166 - VICTORIA VO | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | 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 01636 vs. Other Anesthesia for Procedures on the Shoulder and Axilla Codes
The CPT 01636 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 01636 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 |
| 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 |
| 01636-CPT | Moderate | Anesthesia For Open Or Surgical Arthroscopic Procedures On Humeral Head And Neck, Sternoclavicular Joint, Acromioclavicular Joint, And Shoulder Joint; Interthoracoscapular (Forequarter) Amputation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 01636. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 01636 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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