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

Medicare expected-payment calculator

Enter a code, ZIP and date of service to get the allowed amount, what Medicare pays, and the CMS file and row 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 D

Place of service
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 01920

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 D · status J (Anesthesia)

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

View the CMS evidence
Code
01920
DOS
Not supplied
Locality
National (GPCI 1.000)
Service ZIP
Not supplied
Setting
Office (non-facility)
Participation
Participating provider
Modifiers
None
Units
1
Release
Q4 2026, revision 2
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)CMS RVU26DOctober 1 – December 31, 2026revision 2

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

    PPRRVU2026_Oct_nonQPP.csv row 284 in rvu26d-updated-08-26-2026.zip

    In the CMS file

    Loading rows 282–286 of PPRRVU2026_Oct_nonQPP.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

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