localis

Describe a service in plain words, or type a CPT/HCPCS code.

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Medicare expected-payment calculator

Enter a billing code, the service-location ZIP and the date of service. Get the Medicare allowed amount, how it splits between Medicare and coinsurance, and the CMS evidence behind each figure.

Claim details

CPT / HCPCS code
Service location
ZIP
Locality

Leave blank for the national baseline.

Date of service
Date of service
CMS release

CMS release: 2026 C

Place of service Office (non-facility) Facility
Modifiers: None
Supplied modifier

Select a supplied modifier. Click it again to remove it.

Professional/technical component concept concept does not apply to this code.
Professional/technical component concept concept does not apply to this code.
Bilateral adjustment concept does not apply to this code.
Assistant-at-surgery concept does not apply to this code.
Assistant-at-surgery concept does not apply to this code.
Assistant-at-surgery concept does not apply to this code.
Assistant-at-surgery concept does not apply to this code.
Co-surgeon concept does not apply to this code.
Team surgery concept does not apply to this code.

Single-line modifiers only. Pricing -51? Use the MPPR calculator.

Payment answer

No amount determinable for 01820

Anesthesia code: paid via base + time units × a separate anesthesia conversion factor, not the standard PFS RVU formula. Supply a locality (and time_minutes for a specific amount) to compute it.

The available evidence does not establish a $0 allowance. Release 2026 C · status J (Anesthesia)

Medicare prices this under the anesthesia formula—(base units + time units) × the locality anesthesia conversion factor—not the standard RVU formula. Ask for a locality to see that factor.

View the CMS evidence
Code
01820
DOS
Not supplied
Locality
National (GPCI 1.000)
Service ZIP
Not supplied
Setting
Office (non-facility)
Participation
Participating provider
Modifiers
None
Units
1
Release
Q3 2026, revision 1
Sequestration
Shown separately from the allowed amount

Anesthesia code: paid via base + time units × a separate anesthesia conversion factor, not the standard PFS RVU formula. Supply a locality (and time_minutes for a specific amount) to compute it.

Citations

  • Establishes the PFS status of the base code.

    Physician relative value file (PPRRVU)

    Q3 2026 · revision 1

    Latest revision of this release

    Release period: July 1 – September 30, 2026

    This status record alone does not establish an allowed amount or a coverage determination.

    Record details PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 272)
    hcpcs (col 1)
    01820
    modifier (col 2)
    blank
    status_code (col 4)
    J

    SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

    Original source file

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