CPT 00402
Priced using anesthesia methodology
00402 · PFS Q2 2022 · Historical
Illustrative example
~$235.62
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 Every input comes from a published CMS file. Open the same file at the row shown and the values match. 00402’s RVUs, PFS status and conversion factor Physician relative value file (PPRRVU)CMS RVU22BApril 1 – June 30, 2022
PPRRVU22_APR.csv
row 5,170
in rvu22b.zip
Loading rows 5,168–5,172 of PPRRVU22_APR.csv…
Download rvu22b.zip from CMS
File fingerprint The GPCIs Geographic practice cost indices (GPCI)CMS RVU22BApril 1 – June 30, 2022
GPCI2022.csv
row 102
in rvu22b.zip
Loading rows 100–104 of GPCI2022.csv…
Download rvu22b.zip from CMS
File fingerprint Anesthesia conversion factors (ANES) CMS RVU22BApril 1 – June 30, 2022
ANES2022.csv
row 100
in rvu22b.zip
Loading rows 98–102 of ANES2022.csv…
Download rvu22b.zip from CMS
File fingerprint Anesthesia base units by CPT code Q1 2022January 1 – March 31, 2022
Section 508 compliant version of CY_2022_Anesthesia_Base_Units_110921.txt
row 42
in 2022-anesthesia-base-units-cpt-code.zip
Download 2022-anesthesia-base-units-cpt-code.zip from CMS
File fingerprint
Source
In the CMS file
7a64189403d440641280d5e90c1ebf39bbdc950a292e6d6f2a8bf8dc144ae305
In the CMS file
4038a5882c9297287e9540f2a2096064540c2ed8beab7a4e79aa803f186647ea
In the CMS file
37158fcca205ea96063a5103347f02a5cc903d24ec42173ac3e1398236cfa202
ebbf7d42ecaf759c280f0b9fced5ea71dd16505a0563bb7c942cee068c797fde
90-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 5—set by CMS for this code and the same in every locality. One time unit is 15 minutes, rounded to one decimal, so a 90-minute case adds 6 time units.
CPT 00402 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 $235.62 for a 90-minute case in Dallas, TX under the Q2 2022 release, before sequestration.
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
- 00402
- Release
- Q2 2022, revision 1
- Result
- Priced using anesthesia methodology
Citations
Every input comes from a published CMS file. Open the same file at the row shown and the values match.
-
Shows this code’s PFS status (J). Result: Priced using anesthesia methodology.
Physician relative value file (PPRRVU)CMS RVU22BApril 1 – June 30, 2022
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
PPRRVU22_APR.csv row 5,170 in rvu22b.zip
- A HCPCS
- 00402
- B Modifier
- blank
- D Status code
- J
In the CMS file
Loading rows 5,168–5,172 of PPRRVU22_APR.csv…
Download rvu22b.zip from CMS File fingerprint
7a64189403d440641280d5e90c1ebf39bbdc950a292e6d6f2a8bf8dc144ae305
Why is there no national PFS amount for 00402?
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.
Payment considerations Copy link
Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.
Other payment indicators (10)
Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
Can you bill it with another code? Copy link
Check a pair of codes Copy link
Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.
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.
Usage and related codes Copy link
How often 00402 is billed Copy link
Across Original Medicare in CY2024, 00402 ranked #1,332 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 1.6 times on average that year.
2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q2 2022 fee schedule above.
Did this answer your question about CPT 00402?
We're building this out in the open. Tell us what you were actually trying to work out and we'll either answer you directly or build the page that does.
Source & method
Show sources
Hide
The anesthesia estimate uses the base units, case length, and locality conversion factor shown beside it. The PFS file shows this code is priced as anesthesia. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
CPT 00402 National PFS baseline: No national PFS rate (Q2 2022; participating; whole service; GPCI 1.000; sequestration excluded). CMS RVU22B, PPRRVU22_APR.csv row 5,170. Localis. https://localishealth.com/cpt/00402/2022/B