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CPT 00215 Medicare anesthesia rate

Priced using anesthesia methodology

00215 · PFS Q2 2017 · Historical

Illustrative example

~$550.75

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
22.03
amount
$550.75

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 RVU17BApril 1 – June 30, 2017

    PPRRVU17_V0209.csv row 4,501 in rvu17b.zip

    A HCPCS
    00215
    D Status code
    J
    Y Conversion factor
    35.8887
    In the CMS file

    Loading rows 4,499–4,503 of PPRRVU17_V0209.csv…

    Download rvu17b.zip from CMS File fingerprint 98ce34eaa1f673ddaba572e4aa6186f4d0b1d8dc452577f68ea672cb487e34b9

  • The GPCIs

    Geographic practice cost indices (GPCI)CMS RVU17BApril 1 – June 30, 2017

    CY2017_GPCIs.csv row 102 in rvu17b.zip

    D Work GPCI
    1.015
    E PE GPCI
    1.012
    F MP GPCI
    0.770
    In the CMS file

    Loading rows 100–104 of CY2017_GPCIs.csv…

    Download rvu17b.zip from CMS File fingerprint 2b5a24240d7dacfa826bfdd1d7d91b8fd0932774fb42edd11a697dc5103716a9

  • Anesthesia conversion factors (ANES)

    CMS RVU17BApril 1 – June 30, 2017

    ANES_V0101.csv row 100 in rvu17b.zip

    D Anesthesia CF (non-QPP)
    22.0300
    In the CMS file

    Loading rows 98–102 of ANES_V0101.csv…

    Download rvu17b.zip from CMS File fingerprint fdcfcbe49c94d56713b007c27840a8462316aae4dc9629f4ac3c2165ebbc3a98

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
Q2 2017, 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 RVU17BApril 1 – June 30, 2017

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

    PPRRVU17_V0209.csv row 4,501 in rvu17b.zip

    In the CMS file

    Loading rows 4,499–4,503 of PPRRVU17_V0209.csv…

    Download rvu17b.zip from CMS File fingerprint 98ce34eaa1f673ddaba572e4aa6186f4d0b1d8dc452577f68ea672cb487e34b9

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 $550.75 for a 240-minute case in Dallas, TX under the Q2 2017 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 RVU17BApril 1 – June 30, 2017

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 PPRRVU17_V0209.csv · Q2 2017 (RVU17B) · row 4,501—priced as anesthesia
    Effective
    April 1 – June 30, 2017
    Locator
    PPRRVU17_V0209.csv in rvu17b.zip · row 4,501 of 16,478 · via CMS
    Fields read
    Status J (col 4)
    SHA-256 98ce34eaa1f673dd…
  2. 02 Physician & Other Practitioners · CY2024—volume and who bills it limits
    Effective
    Calendar-year snapshot, on a different cycle from the Q2 2017 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 (Q2 2017; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU17B, PPRRVU17_V0209.csv row 4,501. Localis. https://localishealth.com/cpt/00215/2017/B

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.