localis

Describe a service in plain words, or type a CPT/HCPCS code.

CPT 01215

Priced using anesthesia methodology

01215 · PFS Q1 2013 · Historical

See your local estimate for a sample 120-minute case.

CPT 01215 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 (Q1 2013 release).

Amount evidence: base units, time units, and locality conversion factor in the estimate. The PFS row establishes the anesthesia pricing pathway.

Inspect PFS status evidence
Code
01215
Release
Q1 2013, revision 2
Result
Priced using anesthesia methodology

Citations

  • Establishes the PFS status (J) and the resulting pathway for this code: priced using anesthesia methodology.

    Physician relative value file (PPRRVU)

    Q1 2013 · revision 2

    Latest revision of this release

    Release period: January 1 – March 31, 2013

    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 PPRRVU13_V1226_UP0.csv in rvu13ar.zip (row 4,121)
    hcpcs (col 1)
    01215
    modifier (col 2)
    blank
    status_code (col 4)
    J

    SHA-256: 79b1988bb9cbab6a61634b6463d26ce88cca431c3e36fa3b73792f29882d95b4

    Original source file

Compact facts

Why is there no national PFS amount for 01215?

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. 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.

Payment considerations Copy link

Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.

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.

Payment rules

Can you bill it with another code? 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 between it and 01215.

See every current NCCI pair for 01215 →

History
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 & related

How often 01215 is billed Copy link

Across Original Medicare in CY2024, 01215 ranked #1,265 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 1.7 times on average that year.

Beneficiaries
14,788
Office + facility patients combined
Services
24,477
Times it was billed
Allowed
$7.6M
Total Medicare 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 Q1 2013 fee schedule above.

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Source & method

Show sources

The anesthesia estimate uses the base units, case length, and locality conversion factor identified beside that estimate. The PFS file establishes the pricing pathway. Releases are immutable: historical evidence remains tied to the specified release. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Physician relative value file (Q1 2013) · rvu13ar.zip (PPRRVU13_V1226_UP0.csv row 4,121)

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

This citation identifies the source release, so its evidence remains reproducible after a newer release lands.

CPT 01215 National PFS baseline: No national PFS rate (Q1 2013; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/01215/2013/A