CPT 00812
Anesthesia for Lower Gastrointestinal Screening Endoscopy
Priced using anesthesia methodology
00812 · PFS Q3 2022 · Historical
See your local estimate for a sample 30-minute case.
CPT 00812 is an anesthesia code, so Medicare has no single national rate: payment is (base units + time units) × the locality's anesthesia conversion factor, so the amount varies by locality and case length (Q3 2022 release).
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
- 00812
- Release
- Q3 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)Q3 2022 · revision 1
Latest revision of this release
Release period: July 1 – September 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.
Record details
PPRRVU22_JUL.csv in rvu22c-updated-06172022.zip (row 5,271)- hcpcs (col 1)
- 00812
- modifier (col 2)
- blank
- status_code (col 4)
- J
SHA-256: f0a493a192a21b1faa980aa71d22c8ae064e87b564f51a67e1229fcee376df41
Why is there no national PFS amount for 00812?
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 00812 is billed Copy link
Across Original Medicare in CY2024, 00812 ranked #269 of the 7,879 CPT codes billed to Medicare that year, by patients served or total 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 Q3 2022 fee schedule above.
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Source & method
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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.
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 00812 National PFS baseline: No national PFS rate (Q3 2022; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/00812/2022/C