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See a sample rate comparisonCPT 99135 Fee Schedule
Last Verified: September 2026
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.
Anesthesia Complicated By Util, Anesthesia Complicated By Utilization Of Controlledhypotension (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 | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99135 |
| Medicaid Fee Schedule | View Medicaid rates for 99135 |
National average reimbursement for CPT 99135 by major payers:
$190.47
$183.54
$252.35
$129.79
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CPT 99135
5 of 25 sample ratesHigher to lower in this preview
Michele Gatheridge
Poudre Valley Medical Group LLC
$350.00Published rateMiguel Chavez
Hawaii Hospital Physicians, Inc.
$314.35Published rateHumera Naqvi
Ipc Hospitalist Physicians Of New Jersey PC
$158.75Published rateDa Pediatric Rehabilitation
$55.00Published rateAll Ways Homecare Inc
$35.00Published rate
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See a sample payer proposalCPT 99135 vs. Other Qualifying Circumstances for Anesthesia Codes
The CPT 99135 code is part of the Medicine Services and Procedures services used for Qualifying Circumstances for Anesthesia. 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 99135 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 |
|---|---|---|
| 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 99135. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 99135 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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