{
    "code": "00813",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/00813/2020/A",
    "release_specific_url": "https://localishealth.com/cpt/00813/2020/A",
    "description": "Anesthesia care when a patient has both an upper endoscopy and a lower endoscopy under the same anesthetic, in one session. It exists so that a back-to-back scope of the esophagus, stomach and duodenum plus a colonoscopy is reported once rather than as two separate anesthesia services. The anesthesia professional keeps the patient sedated across both parts, including the change in position and the shared airway during the upper portion.",
    "answer": {
        "question": "How much does Medicare pay for CPT 00813?",
        "text": "CPT 00813 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 $153.91 for a 30-minute case in Dallas, TX under the Q1 2020 release, before sequestration."
    },
    "release": {
        "schedule": "pfs",
        "year": 2020,
        "quarter": "A",
        "label": "Q1 2020",
        "effective": "January 1 – March 31, 2020",
        "revision": 1
    },
    "status": {
        "code": "J",
        "non_facility_payable": false,
        "facility_payable": false
    },
    "national_rates_usd": {
        "office_non_facility": null,
        "facility": null,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": null,
        "practice_expense_non_facility": null,
        "practice_expense_facility": null,
        "malpractice": null
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0896,
    "source": {
        "label": "Physician relative value file (Q1 2020)",
        "cms_url": "https://www.cms.gov/files/zip/rvu20a-updated-01312020.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2020/A",
        "file": "PPRRVU20_Jan.csv",
        "row": 5067,
        "sha256": "28d2c1e57daa957d1eef39cb96dc0e0f55fd4e6ab886473e117d9b4f43a9875d"
    },
    "modified_at": "2026-08-04T03:09:22+00:00"
}