Priced using anesthesia methodology
00215 · PFS Q1 2020 · Historical
Illustrative example
~$552.75
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. 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 RVU20AJanuary 1 – March 31, 2020
PPRRVU20_Jan.csv
row 4,981
in rvu20a-updated-01312020.zip
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File fingerprint The GPCIs Geographic practice cost indices (GPCI)CMS RVU20AJanuary 1 – March 31, 2020
GPCI2020.csv
row 101
in rvu20a-updated-01312020.zip
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File fingerprint Anesthesia conversion factors (ANES) CMS RVU20AJanuary 1 – March 31, 2020
ANES2020.csv
row 100
in rvu20a-updated-01312020.zip
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File fingerprint
Source
In the CMS file
28d2c1e57daa957d1eef39cb96dc0e0f55fd4e6ab886473e117d9b4f43a9875d
In the CMS file
80d084eb7324488cbcc8b47c56c7955afab25f33ae807c4fe6d9305010c97162
In the CMS file
a348d4533a1fa0af28ccbcbd1b9ddebaebaebcc601fbd96d3aaa6a2861cb0631
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
- Q1 2020, 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 RVU20AJanuary 1 – March 31, 2020
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
PPRRVU20_Jan.csv row 4,981 in rvu20a-updated-01312020.zip
In the CMS file
Loading rows 4,979–4,983 of PPRRVU20_Jan.csv…
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28d2c1e57daa957d1eef39cb96dc0e0f55fd4e6ab886473e117d9b4f43a9875d
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 $552.75 for a 240-minute case in Dallas, TX under the Q1 2020 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 RVU20AJanuary 1 – March 31, 2020
Can you bill it with another code? Copy link
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.
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01 PPRRVU20_Jan.csv · Q1 2020 (RVU20A) · row 4,981—priced as anesthesia
- Effective
- January 1 – March 31, 2020
- Locator
- PPRRVU20_Jan.csv in rvu20a-updated-01312020.zip · row 4,981 of 17,236 · via CMS
- Fields read
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Status J (col 4)SHA-256 28d2c1e57daa957d…
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02 Physician & Other Practitioners · CY2024—volume and who bills it limits
- Effective
- Calendar-year snapshot, on a different cycle from the Q1 2020 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 (Q1 2020; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU20A, PPRRVU20_Jan.csv row 4,981. Localis. https://localishealth.com/cpt/00215/2020/A
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.