Anesthesia for Combined Upper and Lower Endoscopy
CPT 00813
Reported when a patient undergoes upper and lower GI endoscopy during the same anesthesia session.
No national payment amount
Anesthesia code: paid via base + time units × a separate anesthesia conversion factor, not the standard PFS RVU formula. Supply a locality (and time_minutes for a specific amount) to compute it.
~$150.08 for a 30-minute example case in Dallas, TX
Where this example comes from
(base_units + time_units) × anesthesia_cf time_units = time_minutes / 15. The anesthesia conversion factor is CMS's published locality-adjusted value.
Source
Anesthesia has no single national rate — payment is (base units + time units) × the locality's anesthesia conversion factor, so the amount above is an example computed with Dallas, TX rates, before sequestration. Enter your ZIP and your own case length for your locality's number.
Base units 5 — set by CMS for this code and the same in every locality. One time unit is 15 minutes, so a 30-minute case adds 2 time units.
How much does Medicare pay for CPT 00813? Copy link
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 $150.08 for a 30-minute case in Dallas, TX under the Q2 2021 release, before sequestration.
Source: Physician relative value file (Q2 2021) · effective April 2021 · materially updated Aug 4, 2026 · compact facts
Can you bill it with another code? Copy link
Enter a second CPT or HCPCS code billed the same date of service to check the current NCCI procedure-to-procedure edit between it and 00813.
How often 00813 is billed Copy link
Across Original Medicare in CY2024, 00813 ranked #264 of the 7,879 CPT codes billed to Medicare that year, ranked by patients served or total allowed dollars.
2024 Medicare fee-for-service only, national totals — Medicare Advantage, Medicaid and commercial volume are excluded, 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 2021 fee schedule the rates above come from.
Common questions Copy link
Why is there no payment amount for 00813?
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. Ask for a locality to see that factor. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.
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.
Saw this code on your bill? Copy link
For patientsWhat does CPT code 00813 mean?
CPT code 00813: Anesthesia for Combined Upper and Lower Endoscopy. A common example is someone with unexplained iron-deficiency anemia or weight loss, where the source of bleeding could be anywhere in the digestive tract. Rather than sedate them twice on two different days, the gastroenterologist does the upper scope and the colonoscopy in one sitting. The anesthesia clinician covers the whole combined session under this single code.
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Source & method
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This is computed from CMS's Medicare Physician Fee Schedule Q2 2021 release (schedule pfs, effective April 2021). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them. Our methodology covers all of this in depth — sourcing, parsing, versioning, and how claims are cross-checked before they ship.
Description written from primary sources: CMS Medicare Physician Fee Schedule Relative Value Files. Not derived from AMA CPT descriptor text.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This link keeps pointing at the Q2 2021 figures, even after a newer release lands.
CPT 00813 Medicare Physician Fee Schedule rate (Q2 2021). Localis. https://localishealth.com/cpt/00813/2021/B