localis

Type a CPT/HCPCS code, a place, a service in plain words, or a whole claim line like 90837 LCSW 94110.

Try

CPT 00218 Medicare anesthesia rate

Priced using anesthesia methodology

00218 · PFS Q1 2023 · Historical

Illustrative example

~$611.32

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
13
time_units
16
anesthesia_cf
21.08
amount
$611.32

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

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

Citations

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 13—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.

View CMS source and method

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
00218
Release
Q1 2023, 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 RVU23AJanuary 1 – March 31, 2023

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

    PPRRVU23_JAN.csv row 5,426 in rvu23a-updated-01-31-2023.zip

    In the CMS file

    Loading rows 5,424–5,428 of PPRRVU23_JAN.csv…

    Download rvu23a-updated-01-31-2023.zip from CMS File fingerprint 6f53a5e460a624cc096065c1eb974e0cc48861d51a30afa919d817c0593af2c9

Report a problem

CPT 00218 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 $611.32 for a 240-minute case in Dallas, TX under the Q1 2023 release, before sequestration.

Why is there no national PFS amount for 00218?

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 00218 are coming Join the waitlist →

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust 00218's amount.

CMS RVU23AJanuary 1 – March 31, 2023

Can you bill it with another code? Copy link

This code

00218

See every current NCCI pair for 00218 →

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 PPRRVU23_JAN.csv · Q1 2023 (RVU23A) · row 5,426—priced as anesthesia
    Source
    Physician relative value file (PPRRVU), Q1 2023 release
    Effective
    January 1 – March 31, 2023
    Locator
    PPRRVU23_JAN.csv in rvu23a-updated-01-31-2023.zip · row 5,426 of 18,010 · via CMS
    Fields read
    Status J (col 4)
    SHA-256 6f53a5e460a624cc…
  2. 02 Physician & Other Practitioners · CY2024—volume and who bills it limits
    Source
    CMS Physician & Other Practitioners dataset
    Effective
    Calendar-year snapshot, on a different cycle from the Q1 2023 fee schedule
    Doesn’t establish
    Medicare Advantage, Medicaid or commercial volume.
    Note
    The dataset suppresses rows under 11 beneficiaries.

Cite this rate

CPT 00218 National PFS baseline: No national PFS rate (Q1 2023; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU23A, PPRRVU23_JAN.csv row 5,426. Localis. https://localishealth.com/cpt/00218/2023/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.

Did this answer your question about CPT 00218?

Tell us what you were trying to work out and we'll answer you or build the page that does.

Did this page answer your question?

Usage and related codes Copy link

In CY2024, 00218 ranked #5,994 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Services
159
Allowed
$75,168
Beneficiaries
119

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.