Priced using anesthesia methodology
00952 · PFS Q4 2022 · Historical
Illustrative example
~$171.36
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 00952’s RVUs, PFS status and conversion factor Physician relative value file (PPRRVU)CMS RVU22DOctober 1 – December 31, 2022
PPRRVU22_OCT.csv
row 5,347
in rvu22d.zip
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File fingerprint The GPCIs Geographic practice cost indices (GPCI)CMS RVU22DOctober 1 – December 31, 2022
GPCI2022.csv
row 102
in rvu22d.zip
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File fingerprint Anesthesia conversion factors (ANES) CMS RVU22DOctober 1 – December 31, 2022
ANES2022.csv
row 100
in rvu22d.zip
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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 152
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
f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab
In the CMS file
4038a5882c9297287e9540f2a2096064540c2ed8beab7a4e79aa803f186647ea
In the CMS file
37158fcca205ea96063a5103347f02a5cc903d24ec42173ac3e1398236cfa202
ebbf7d42ecaf759c280f0b9fced5ea71dd16505a0563bb7c942cee068c797fde
60-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 4—set by CMS for this code and the same in every locality. One time unit is 15 minutes, rounded to one decimal, so a 60-minute case adds 4 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
- 00952
- Release
- Q4 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)CMS RVU22DOctober 1 – December 31, 2022
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
PPRRVU22_OCT.csv row 5,347 in rvu22d.zip
In the CMS file
Loading rows 5,345–5,349 of PPRRVU22_OCT.csv…
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f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab
CPT 00952 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 $171.36 for a 60-minute case in Dallas, TX under the Q4 2022 release, before sequestration.
Why is there no national PFS amount for 00952?
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 00952 are coming Join the waitlist →
Which billing rules and modifiers apply? Copy link
CMS's surgical and split-billing indicators don't adjust 00952's amount.
CMS RVU22DOctober 1 – December 31, 2022
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 PPRRVU22_OCT.csv · Q4 2022 (RVU22D) · row 5,347—priced as anesthesia
- Effective
- October 1 – December 31, 2022
- Locator
- PPRRVU22_OCT.csv in rvu22d.zip · row 5,347 of 17,726 · via CMS
- Fields read
-
Status J (col 4)SHA-256 f8774a019545e1fd…
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02 Physician & Other Practitioners · CY2024—volume and who bills it limits
- Effective
- Calendar-year snapshot, on a different cycle from the Q4 2022 fee schedule
- Doesn’t establish
- Medicare Advantage, Medicaid or commercial volume.
- Note
- The dataset suppresses rows under 11 beneficiaries.
Cite this rate
CPT 00952 National PFS baseline: No national PFS rate (Q4 2022; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU22D, PPRRVU22_OCT.csv row 5,347. Localis. https://localishealth.com/cpt/00952/2022/D
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, 00952 ranked #1,359 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.
- Services
- 57,535
- Allowed
- $6.3M
- Beneficiaries
- 40,101
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.