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Describe a service in plain words, or type a CPT/HCPCS code.

CPT 00540

Priced using anesthesia methodology

00540 · PFS Q4 2022 · Historical

Illustrative example

~$514.08

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
12
time_units
12
anesthesia_cf
21.42
amount
$514.08

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

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

Citations

  • Supplies the RVUs and PFS status for this code and component.

    Physician relative value file (PPRRVU)

    Q4 2022 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2022

    Record details PPRRVU22_OCT.csv in rvu22d.zip (row 5,237)
    hcpcs (col 1)
    00540
    status_code (col 4)
    J

    SHA-256: f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab

    Original source file

  • Supplies the geographic adjustment factors for this locality.

    Geographic practice cost indices (GPCI)

    Q4 2022 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2022

    Record details GPCI2022.csv in rvu22d.zip (row 102)
    work_gpci (col 5)
    1.023
    pe_gpci (col 6)
    1.026
    mp_gpci (col 7)
    0.546

    SHA-256: 4038a5882c9297287e9540f2a2096064540c2ed8beab7a4e79aa803f186647ea

    Original source file

  • Supplies the dollar conversion factor used in the formula.

    Physician relative value file (PPRRVU)

    Q4 2022 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2022

    Record details PPRRVU22_OCT.csv in rvu22d.zip (row 11)
    conversion_factor (col 25)
    34.6062

    SHA-256: f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab

    Original source file

  • Anesthesia conversion factors (ANES)

    Q4 2022 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2022

    Record details ANES2022.csv in rvu22d.zip (row 100)
    non_qpp_conversion_factor (col 4)
    21.42

    SHA-256: 37158fcca205ea96063a5103347f02a5cc903d24ec42173ac3e1398236cfa202

    Original source file

  • Anesthesia base units by CPT code

    Q1 2022 · revision 1

    Latest revision of this release

    Release period: January 1 – March 31, 2022

    Record details Section 508 compliant version of CY_2022_Anesthesia_Base_Units_110921.txt in 2022-anesthesia-base-units-cpt-code.zip (row 62)
    base_units (col 2)
    12

    SHA-256: ebbf7d42ecaf759c280f0b9fced5ea71dd16505a0563bb7c942cee068c797fde

    Original source file

180-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 12—set by CMS for this code and the same in every locality. One time unit is 15 minutes, rounded to one decimal, so a 180-minute case adds 12 time units.

CPT 00540 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 $514.08 for a 180-minute case in Dallas, TX under the Q4 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
00540
Release
Q4 2022, 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)

    Q4 2022 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2022

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

    Record details PPRRVU22_OCT.csv in rvu22d.zip (row 5,237)
    hcpcs (col 1)
    00540
    modifier (col 2)
    blank
    status_code (col 4)
    J

    SHA-256: f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab

    Original source file

Plain-text summary

Why is there no national PFS amount for 00540?

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.

See every current NCCI pair for 00540 →

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 00540 is billed Copy link

Across Original Medicare in CY2024, 00540 ranked #2,164 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Beneficiaries
5,032
Office + facility beneficiaries combined
Services
6,827
Times it was billed
Allowed
$2.5M
Total Medicare allowed dollars

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 Q4 2022 fee schedule above.

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Source & method

Show sources

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.

Physician relative value file (Q4 2022) · rvu22d.zip (PPRRVU22_OCT.csv row 5,237)

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

CPT 00540 National PFS baseline: No national PFS rate (Q4 2022; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/00540/2022/D