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CPT 00215 Medicare anesthesia rate

Priced using anesthesia methodology

00215 · PFS Q3 2014 · Historical

Illustrative example

~$564.75

Source

Formula

(base_units + time_units) × anesthesia_cf

Localis calculated this from CMS’s published inputs. Select an underlined value to see where it comes from.

base_units
9
time_units
16
anesthesia_cf
22.59
amount
$564.75

time_units = time_minutes / 15, rounded to one decimal place.

The anesthesia conversion factor is CMS's published locality-adjusted value.

Citations

  • 00215’s RVUs, PFS status and conversion factor

    Physician relative value file (PPRRVU)CMS RVU14CJuly 1 – September 30, 2014

    PPRRVU14_V0515.csv row 4,128 in rvu14c.zip

    A HCPCS
    00215
    D Status code
    J
    Y Conversion factor
    35.8228
    In the CMS file

    Loading rows 4,126–4,130 of PPRRVU14_V0515.csv…

    Download rvu14c.zip from CMS File fingerprint c77da0d012ff73dec8680d5f6f50582fc7e72005bc55edb2f131a02f0b1c293c

  • The GPCIs

    Geographic practice cost indices (GPCI)CMS RVU14CJuly 1 – September 30, 2014

    CY 2014 GPCI _12172013.csv row 78 in rvu14c.zip

    D Work GPCI
    1.014
    E PE GPCI
    1.013
    F MP GPCI
    0.803
    In the CMS file

    Loading rows 76–80 of CY 2014 GPCI _12172013.csv…

    Download rvu14c.zip from CMS File fingerprint 544aec167a634687dc8b61f2eee8bfa75880a369328b9e79a6507bea595a58a2

  • Anesthesia conversion factors (ANES)

    CMS RVU14CJuly 1 – September 30, 2014

    ANES 2014_V0103.csv row 78 in rvu14c.zip

    D Anesthesia CF (non-QPP)
    22.5900
    In the CMS file

    Loading rows 76–80 of ANES 2014_V0103.csv…

    Download rvu14c.zip from CMS File fingerprint 92dec4d2b34c359aed5901d306fc3e0ddff7d1ea620fda922ee253d6b868d3d2

240-minute example case in Dallas, TX

Anesthesia has no single national rate—payment is (base units + time units) × the locality's anesthesia conversion factor. This example is before sequestration. Enter the service-location ZIP and case length for a local estimate.

Base units 9—set by CMS for this code and the same in every locality. One time unit is 15 minutes, rounded to one decimal, so a 240-minute case adds 16 time units.

Amount evidence: base units, time units, and the locality conversion factor, shown in the estimate. The PFS row shows this code is priced as anesthesia.

Inspect PFS status evidence
Code
00215
Release
Q3 2014, revision 1
Result
Priced using anesthesia methodology

Citations

  • Shows this code’s PFS status (J). Result: Priced using anesthesia methodology.

    Physician relative value file (PPRRVU)CMS RVU14CJuly 1 – September 30, 2014

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    PPRRVU14_V0515.csv row 4,128 in rvu14c.zip

    In the CMS file

    Loading rows 4,126–4,130 of PPRRVU14_V0515.csv…

    Download rvu14c.zip from CMS File fingerprint c77da0d012ff73dec8680d5f6f50582fc7e72005bc55edb2f131a02f0b1c293c

Report a problem

CPT 00215 is an anesthesia code, so Medicare has no single national rate: payment is (base units + time units) × the locality's anesthesia conversion factor—for example, about $564.75 for a 240-minute case in Dallas, TX under the Q3 2014 release, before sequestration.

Why is there no national PFS amount for 00215?

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. Choose a locality to see that factor.

Contract rate as % of Medicare Copy link

Arbitration outcomes for 00215 are coming Join the waitlist →

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust 00215's amount.

CMS RVU14CJuly 1 – September 30, 2014

Can you bill it with another code? Copy link

This code

00215

See every current NCCI pair for 00215 →

Source & method Copy link

The PFS file shows this code is priced as anesthesia. The estimate uses the base units, case length, and locality conversion factor shown beside it.

  1. 01 PPRRVU14_V0515.csv · Q3 2014 (RVU14C) · row 4,128—priced as anesthesia
    Effective
    July 1 – September 30, 2014
    Locator
    PPRRVU14_V0515.csv in rvu14c.zip · row 4,128 of 15,901 · via CMS
    Fields read
    Status J (col 4)
    SHA-256 c77da0d012ff73de…
  2. 02 Physician & Other Practitioners · CY2024—volume and who bills it limits
    Effective
    Calendar-year snapshot, on a different cycle from the Q3 2014 fee schedule
    Doesn’t establish
    Medicare Advantage, Medicaid or commercial volume.
    Note
    The dataset suppresses rows under 11 beneficiaries.

Cite this rate

CPT 00215 National PFS baseline: No national PFS rate (Q3 2014; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU14C, PPRRVU14_V0515.csv row 4,128. Localis. https://localishealth.com/cpt/00215/2014/C

Past releases are never edited, so the citation stays checkable after CMS publishes a newer one. Methodology · Plain-text summary · JSON

How has it changed? Copy link

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.

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Usage and related codes Copy link

In CY2024, 00215 ranked #3,689 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Services
1,914
Allowed
$576,332
Beneficiaries
1,244

CY2024 Medicare fee-for-service, from the CMS Physician & Other Practitioners dataset (limits). Localis groups related codes for payment research; the grouping isn't the AMA's code families.