CPT 00172
Priced using anesthesia methodology
00172 · PFS Q1 2013 · Historical
See your local estimate for a sample 60-minute case.
CPT 00172 is an anesthesia code, so Medicare has no single national rate: payment is (base units + time units) × the locality's anesthesia conversion factor, so the amount varies by locality and case length (Q1 2013 release).
Amount evidence: base units, time units, and locality conversion factor in the estimate. The PFS row establishes the anesthesia pricing pathway.
Inspect PFS status evidence
- Code
- 00172
- Release
- Q1 2013, revision 1
- Result
- Priced using anesthesia methodology
Citations
-
Establishes the PFS status (J) and the resulting pathway for this code: priced using anesthesia methodology.
Physician relative value file (PPRRVU)Q1 2013 · revision 1
Latest revision of this release
Release period: January 1 – March 31, 2013
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
Record details
PPRRVU13.csv in rvu13a.zip (row 3,937)- hcpcs (col 1)
- 00172
- modifier (col 2)
- blank
- status_code (col 4)
- J
SHA-256: a84cdae37ebaadbaf680d8ea6051f442d6e61fb44436ca61dc94a43051d877e8
Why is there no national PFS amount for 00172?
Its status indicator is 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. 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.
Payment considerations Copy link
Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.
Other payment indicators (10)
Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
Can you bill it with another code? Copy link
Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit between it and 00172.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
How often 00172 is billed Copy link
Across Original Medicare in CY2024, 00172 ranked #7,190 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.
2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q1 2013 fee schedule above.
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Source & method
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The anesthesia estimate uses the base units, case length, and locality conversion factor identified beside that estimate. The PFS file establishes the pricing pathway. Releases are immutable: historical evidence remains tied to the specified release. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This citation identifies the source release, so its evidence remains reproducible after a newer release lands.
CPT 00172 National PFS baseline: No national PFS rate (Q1 2013; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/00172/2013/A