Priced using anesthesia methodology
00215 · PFS Q3 2021 · Historical
Illustrative example
~$536.00
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 RVU21CJuly 1 – September 30, 2021
PPRRVU21_JUL.csv
row 5,021
in rvu21c-updated-6302021.zip
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File fingerprint The GPCIs Geographic practice cost indices (GPCI)CMS RVU21CJuly 1 – September 30, 2021
GPCI2021.csv
row 102
in rvu21c-updated-6302021.zip
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File fingerprint Anesthesia conversion factors (ANES) CMS RVU21CJuly 1 – September 30, 2021
ANES2021.csv
row 100
in rvu21c-updated-6302021.zip
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File fingerprint
Source
In the CMS file
ee14b5306942acfe4554d2d7cf3fe95d7b1a0f41fc7a0445bc2d06df857dd7b6
In the CMS file
28f1a06af5324ac2feaeab21e65a4a74eaf793af8939abc64782776ff6e4128e
In the CMS file
42cf809d2405377a43a1227b10fe996e24f2fd0afe451b30f94a726a02950fb5
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 2021, 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 RVU21CJuly 1 – September 30, 2021
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
PPRRVU21_JUL.csv row 5,021 in rvu21c-updated-6302021.zip
In the CMS file
Loading rows 5,019–5,023 of PPRRVU21_JUL.csv…
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ee14b5306942acfe4554d2d7cf3fe95d7b1a0f41fc7a0445bc2d06df857dd7b6
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 $536.00 for a 240-minute case in Dallas, TX under the Q3 2021 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 RVU21CJuly 1 – September 30, 2021
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 PPRRVU21_JUL.csv · Q3 2021 (RVU21C) · row 5,021—priced as anesthesia
- Effective
- July 1 – September 30, 2021
- Locator
- PPRRVU21_JUL.csv in rvu21c-updated-6302021.zip · row 5,021 of 17,403 · via CMS
- Fields read
-
Status J (col 4)SHA-256 ee14b5306942acfe…
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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 Q3 2021 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 2021; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU21C, PPRRVU21_JUL.csv row 5,021. Localis. https://localishealth.com/cpt/00215/2021/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.