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CPT 00926 Medicare payment status

Priced using anesthesia methodology

00926 · PFS Q2 2015 · Historical

See your local estimate for a sample 60-minute case.

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
00926
Release
Q2 2015, 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 RVU15BApril 1 – June 30, 2015

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

    PPRRVU15_V0213_Current.csv row 4,315 in rvu15b.zip

    In the CMS file

    Loading rows 4,313–4,317 of PPRRVU15_V0213_Current.csv…

    Download rvu15b.zip from CMS File fingerprint 61c24302bb17747bddd4aa44ef136d9628930f35dd595e299d9a5370bd394705

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CPT 00926 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 (Q2 2015 release).

Why is there no national PFS amount for 00926?

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 00926 are coming Join the waitlist →

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust 00926's amount.

CMS RVU15BApril 1 – June 30, 2015

Can you bill it with another code? Copy link

This code

00926

See every current NCCI pair for 00926 →

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.

  1. 01 PPRRVU15_V0213_Current.csv · Q2 2015 (RVU15B) · row 4,315—priced as anesthesia
    Effective
    April 1 – June 30, 2015
    Locator
    PPRRVU15_V0213_Current.csv in rvu15b.zip · row 4,315 of 16,085 · via CMS
    Fields read
    Status J (col 4)
    SHA-256 61c24302bb17747b…
  2. 02 Physician & Other Practitioners · CY2024—volume and who bills it limits
    Effective
    Calendar-year snapshot, on a different cycle from the Q2 2015 fee schedule
    Doesn’t establish
    Medicare Advantage, Medicaid or commercial volume.
    Note
    The dataset suppresses rows under 11 beneficiaries.

Cite this rate

CPT 00926 National PFS baseline: No national PFS rate (Q2 2015; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU15B, PPRRVU15_V0213_Current.csv row 4,315. Localis. https://localishealth.com/cpt/00926/2015/B

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.

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Usage and related codes Copy link

In CY2024, 00926 ranked #4,629 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Services
1,079
Allowed
$156,081
Beneficiaries
762

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.