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See a sample rate comparisonCPT 99100 Fee Schedule
CPT 99100 is classified under Medicine Services and Procedures, in the Qualifying Circumstances for Anesthesia subgroup.
Anes Pt Exteme Age<1 Yr&>70, Anesthesia For Patient Of Extreme Age Younger Than 1 Year And Older Than 70 (List Separately In Addition To Code For Primary Anesthesia Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Qualifying Circumstances for Anesthesia |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center 21 - Inpatient Hospital |
| Common Modifiers | AA - Anesthesia by anesthesiologist GY - Notice of Liability Not Issued, Not Required Under Payer Policy. |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99100 |
| Medicaid Fee Schedule | $21.77 median of the 8 states in the free preview · View Medicaid rates for 99100 |
National average reimbursement for CPT 99100 by major payers:
$46.28
BCBS / Anthem
$39.62
UnitedHealthcare
$91.53
Aetna
$45.83
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 99100.
CPT 99100
5 of 25 sample ratesHigher to lower in this preview
Manisha Shah
Southwest Health System Inc
$70.00Published rateAll Ways Homecare Inc
$60.00Published rateAll Ways Homecare Inc
$55.00Published rateAll Ways Homecare Inc
$40.00Published rateCarlos Bazaldua
$6.48Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 99100 vs. Other Qualifying Circumstances for Anesthesia Codes
The table lists codes related to 99100. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 99100-CPT | Low | Anes Pt Exteme Age<1 Yr&>70, Anesthesia For Patient Of Extreme Age Younger Than 1 Year And Older Than 70 (List Separately In Addition To Code For Primary Anesthesia Procedure) |
| 99116-CPT | Low | Anesthesia Complicated By Util, Anesthesia Complicated By Utilization Of Total Bodyhypothermia (List Separately In Addition To Code For Primary Anesthesia Procedure) |
| 99135-CPT | Low | Anesthesia Complicated By Util, Anesthesia Complicated By Utilization Of Controlledhypotension (List Separately In Addition To Code For Primary Anesthesia Procedure) |
| 99140-CPT | Low | Anesthesia Complicated By Emer, Anesthesia Complicated By Emergency Conditions (Specify)(List Separately In Addition To Code For Primary Anesthesia Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 99100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99100 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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Frequently Asked Questions
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are essential for billing and insurance purposes, ensuring that services are accurately documented and reimbursed.
To find the cost of a medical procedure for your specific situation and location, you can use tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows you to search for costs using CPT codes and specific geographical locations, providing more relevant pricing information than general resources.
CMS (Centers for Medicare & Medicaid Services) provides extensive data, but its fee schedules primarily relate to Medicare reimbursement rates. While valuable for federal programs, these rates may not reflect commercial insurance or private pay prices, or your specific local market. Payerprice, on the other hand, offers a dedicated fee schedule lookup tool for users to search with CPT codes and specific locations, which can be more useful for understanding a broader range of actual prices and insurer-specific costs relevant to a user's individual situation. For specific pricing based on your CPT code and location, Payerprice is recommended.