CPT 01996 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 Other Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • AA - Anesthesia by anesthesiologist • GC - Service performed by resident under supervision |
| Complexity Level | Low |
National average reimbursement for CPT 01996 by major payers:
$106.58
$167.03
$172.08
$116.39
| 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 01996 | ||||||
United | 01996 | $247.41 | 1346322559 - MARY RISVOLD | 421411630 - IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION | AZ | Anesthesiology Physician (207L00000X) |
United | 01996 | $261.05 | 1528028537 - JOHN MOORE | 474291438 | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 01996 | $114.00 | 1255449500 - EDWARD CAMPBELL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 01996 | $216.00 | 1700156528 - SHEA MAGILL | 273822866 - (AZ) NORTHEASTERN ANESTHESIA PLLC | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 01996 | $216.00 | 1760679385 - JOSE ORTIZ | 273822866 - (AZ) NORTHEASTERN ANESTHESIA PLLC | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 01996 | $165.38 | 1386662393 - JANET ISAACS | 300392876 | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 01996 | $114.00 | 1851644405 - BRAD PETERSON | 270431100 - (AZ) REDDY GI | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 01996 | $270.00 | 1659371102 - ALINA GRIGORE | 351728855 - I U ANESTHESIOLOGY ASSOCIATES, LLC | AZ | Anesthesiology Physician (207L00000X) |
United | 01996 | $120.00 | 1215226287 - DAVID DELATTE | 621691808 - (TN) CHARLES T WOLOHON MD | AZ | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 01996 | $114.00 | 1346444148 - CATHERYNNE MORGAN | 1346444148 - (AZ) CATHERYNNE MORGAN | AZ | Anesthesiology Physician (207L00000X) |
United | 01996 | $114.00 | 1912960865 - PAUL WAYNE | 1912960865 - (AZ) PAUL WAYNE | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 01996 | $174.00 | 1295316420 - WILLIAM BOLAND | 753186720 | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 01996 | $332.45 | 1649742990 - MARINA NOVACK | 942958258 - BANNER-UNIVERSITY MEDICAL GROUP | AZ | Anesthesiology Physician (207L00000X) |
United | 01996 | $132.00 | 1194987545 - STACIE MICHAELIS | 260904640 - ARIZONA PAIN SPECIALISTS PLLC | AZ | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 01996 | $129.00 | 1538300215 - GREEN LEAF ANESTHESIA CONSULTANTS INC | 262197698 - (AZ) GREEN LEAF ANESTHESIA CONSULTANTS INC | AZ | Certified Registered Nurse Anesthetist (367500000X) |
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 01996 vs. Other Anesthesia for Other Procedures Codes
The CPT 01996 code is part of the Anesthesia services used for Anesthesia for Other 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 01996 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 |
|---|---|---|
| 01932-CPT | Moderate | Anesthesia For Therapeutic Interventional Radiological Procedures Involving The Venous/Lymphatic System (Not To Include Access To The Central Circulation); Intrathoracic Or Jugular |
| 01990-CPT | Moderate | Physiological Support Organ Harvest Brai |
| 01991-CPT | Low | Anesthesia For Diagnostic Or Therapeutic Nerve Blocks And Injections (When Block Or Injection Is Performed By A Different Physician Or Other Qualified Health Care Professional); Other Than The Prone Position |
| 01996-CPT | Low | Daily Management Epidural Subarachnoid D |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 01996. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 01996 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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