CPT 01916 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 Radiological Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • QS - Monitored anesthesia care service • AA - Anesthesia by anesthesiologist • None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 01916 |
National average anesthesia conversion factor for CPT 01916 by major payers:
$48.61
$54.10
$56.61
$55.33
| 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 01916 | ||||||
United | 01916 | $142.17 | 1619268893 - CARLYLE HAMSHER | 223849199 - WAKE FOREST UNIVERSITY HEALTH SCIENCES | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 01916 | $70.00 | 1992238992 - BRETT ATHANS | 260089066 | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $83.00 | 1639123581 - ROGER FENNELL | 471884235 - CEP AMERICA | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $99.00 | 1275028854 - NIGEL WILKINSON-MAITLAND | 954377219 | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $99.00 | 1649406778 - REZA BORNA | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $121.54 | 1427438670 - KHA LAI | 760482007 - U.S. ANESTHESIA PARTNERS OF TEXAS, P.A. | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $128.69 | 1275571788 - VERONICA SEGREDO | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $38.00 | 1831306414 - MARIA PRIETO | 823167421 - (CA) NORTH VALLEY ANESTHESIA ASSOCIATES | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $69.00 | 1659312908 - JEFFREY SWISHER | 680304987 - (CA) NORTHERN CALIFORNIA ANESTHESIA PHYSICIANS, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $69.62 | 1396784088 - JACK BERGER | 954540991 - USC CARE MEDICAL GROUP INC | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 01916 | $90.00 | 1396847893 - JEFFREY SHAPIRO | 208584688 - (CA) ANESTHESIA CARE CONSULTANTS, INC. | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $54.00 | 1326146705 - NATALIA BALYTSKY | 680477806 - (CA) INTEGRATED PAIN MANAGEMENT MEDICAL GROUP | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $99.00 | 1972130771 - NICHOLAS BACHER | 954395492 | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $65.00 | 1144626714 - TALBERT ANESTHESIA GROUP INCORPORATED | 472040579 | CA | Anesthesiology Physician (207L00000X) |
United | 01916 | $40.00 | 1609805209 - YAOHUI LI | 203806624 | 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 01916 vs. Other Anesthesia for Radiological Procedures Codes
The CPT 01916 code is part of the Anesthesia services used for Anesthesia for Radiological Procedures. 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 01916 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 |
|---|---|---|
| 01916-CPT | Moderate | Anes Arteriorgram Needle Carotid Vertebr |
| 01920-CPT | Moderate | Anesthesia For Cardiac Catheterization Including Coronary Angiography And Ventriculography (Not To Include Swan-Ganz Catheter) |
| 01922-CPT | Moderate | Anesa.4 Computerized Axial Tomography Scan/Magnetic R.Imaging |
| 01924-CPT | Moderate | Anesthesia For Therapeutic Interventional Radiological Procedures Involving The Arterial System; Not Otherwise Specified |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 01916. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 01916 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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