Priced using anesthesia methodology
00790 · PFS Q3 2023 · Historical
Illustrative example
~$484.84
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 00790’s RVUs, PFS status and conversion factor Physician relative value file (PPRRVU)CMS RVU23CJuly 1 – September 30, 2023
PPRRVU23_JUL.csv
row 5,605
in rvu23c.zip
Loading rows 5,603–5,607 of PPRRVU23_JUL.csv…
Download rvu23c.zip from CMS
File fingerprint The GPCIs Geographic practice cost indices (GPCI)CMS RVU23CJuly 1 – September 30, 2023
GPCI2023.csv
row 102
in rvu23c.zip
Loading rows 100–104 of GPCI2023.csv…
Download rvu23c.zip from CMS
File fingerprint Anesthesia conversion factors (ANES) CMS RVU23CJuly 1 – September 30, 2023
ANES2023.csv
row 100
in rvu23c.zip
Loading rows 98–102 of ANES2023.csv…
Download rvu23c.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 95
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
64251eae48773025b05c6e45a77e1909e7151c421fe8f346124ba9623c491e37
In the CMS file
137b8d9e8f68fd447b4021fe845ad875c082237bc752c7aabeb2731a57b4e75c
In the CMS file
68f9e8284fa2134e8d348abca9271a694a7f32b67541b80d2982ef4fd37679f3
ebbf7d42ecaf759c280f0b9fced5ea71dd16505a0563bb7c942cee068c797fde
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 7—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
- 00790
- Release
- Q3 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 RVU23CJuly 1 – September 30, 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_JUL.csv row 5,605 in rvu23c.zip
In the CMS file
Loading rows 5,603–5,607 of PPRRVU23_JUL.csv…
Download rvu23c.zip from CMS File fingerprint
64251eae48773025b05c6e45a77e1909e7151c421fe8f346124ba9623c491e37
CPT 00790 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 $484.84 for a 240-minute case in Dallas, TX under the Q3 2023 release, before sequestration.
Why is there no national PFS amount for 00790?
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 00790 are coming Join the waitlist →
Which billing rules and modifiers apply? Copy link
CMS's surgical and split-billing indicators don't adjust 00790's amount.
CMS RVU23CJuly 1 – September 30, 2023
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.
-
01 PPRRVU23_JUL.csv · Q3 2023 (RVU23C) · row 5,605—priced as anesthesia
- Effective
- July 1 – September 30, 2023
- Locator
- PPRRVU23_JUL.csv in rvu23c.zip · row 5,605 of 18,132 · via CMS
- Fields read
-
Status J (col 4)SHA-256 64251eae48773025…
-
02 Physician & Other Practitioners · CY2024—volume and who bills it limits
- Effective
- Calendar-year snapshot, on a different cycle from the Q3 2023 fee schedule
- Doesn’t establish
- Medicare Advantage, Medicaid or commercial volume, or the exact place of service: CMS publishes only the facility vs non-facility split, so the Office (non-facility) share does not identify urgent care or any other specific setting.
- Note
- The dataset suppresses rows under 11 beneficiaries. Specialty groups with fewer than 30 observed clinicians are omitted, so the shares can fall short of 100%.
Cite this rate
CPT 00790 National PFS baseline: No national PFS rate (Q3 2023; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU23C, PPRRVU23_JUL.csv row 5,605. Localis. https://localishealth.com/cpt/00790/2023/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.
Did this answer your question about CPT 00790?
Tell us what you were trying to work out and we'll answer you or build the page that does.
Usage and related codes Copy link
In CY2024, 00790 ranked #242 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.
- Services
- 368,547
- Allowed
- $88.0M
- Beneficiaries
- 243,416
Who bills 00790 to Medicare
0% Office (non-facility) · 100% facility- Anesthesiology 99%
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.