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See a sample rate comparisonCPT 99135 Fee Schedule
CPT 99135 is classified under Medicine Services and Procedures, in the Qualifying Circumstances for Anesthesia subgroup.
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 | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 99135 |
| Medicaid Fee Schedule | $35.00 median of the 7 states in the free preview · View Medicaid rates for 99135 |
National average reimbursement for CPT 99135 by major payers:
$190.47
BCBS / Anthem
$183.54
UnitedHealthcare
$252.35
Aetna
$129.79
Cigna
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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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Payer Contract Negotiation
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See a sample payer proposalCPT 99135 vs. Other Qualifying Circumstances for Anesthesia Codes
The table lists codes related to 99135. 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 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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Frequently Asked Questions
To find out the cost of a medical procedure, you should contact your healthcare provider's billing department directly and also check with your health insurance company for your specific benefits and out-of-pocket costs. For a general estimate based on CPT code and location, you can use tools like Payerprice.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare professionals to describe medical, surgical, and diagnostic services. They are crucial for understanding medical costs because they provide a universal language for billing and processing insurance claims, allowing you to look up specific service prices.
For a fee schedule lookup based on CPT code and specific location, you can utilize tools such as Payerprice. This can help you understand the potential costs of various medical services before you receive them.
No, healthcare providers can charge different amounts for the same medical service. Factors like the provider's location, facility type (e.g., hospital vs. independent clinic), their negotiated rates with insurance companies, and their individual fee schedules can all influence the final cost.
Several factors influence the cost of a medical procedure, including the complexity of the procedure, the healthcare provider's fees, the facility where the service is performed (e.g., outpatient clinic vs. hospital inpatient), your geographic location, your insurance coverage, and any negotiated rates between your insurer and the provider.
Your health insurance significantly impacts the price you pay by covering a portion of the cost. The amount you owe depends on your deductible, co-payment, co-insurance, and whether the provider is in-network or out-of-network. Your plan's benefits determine what services are covered and at what percentage.