CPT 01250
Priced using anesthesia methodology
01250 · PFS Q2 2026 · Historical
Illustrative example
~$245.28
Formula (base_units + time_units) × anesthesia_cf Localis-derived calculation from published inputs. Select an underlined input to inspect its source field. time_units = time_minutes / 15. The anesthesia conversion factor is CMS's published locality-adjusted value. Citations Supplies the RVUs and PFS status for this code and component. Q2 2026 · revision 1 Latest revision of this release Release period: April 1 – June 30, 2026 SHA-256: afc9cf9fe60742518cf6aaccd507edc035052ab9ab1be48644be39f38fceec48 Supplies the geographic adjustment factors for this locality. Q2 2026 · revision 1 Latest revision of this release Release period: April 1 – June 30, 2026 SHA-256: 7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264 Supplies the dollar conversion factor used in the formula. Q2 2026 · revision 1 Latest revision of this release Release period: April 1 – June 30, 2026 SHA-256: afc9cf9fe60742518cf6aaccd507edc035052ab9ab1be48644be39f38fceec48 Q2 2026 · revision 1 Latest revision of this release Release period: April 1 – June 30, 2026 SHA-256: c4d61aa42106998615db595414cebb13f48d68484edf5fa339de9cb0f8abf8a8 Q1 2022 · revision 1 Latest revision of this release Release period: January 1 – March 31, 2022 SHA-256: ebbf7d42ecaf759c280f0b9fced5ea71dd16505a0563bb7c942cee068c797fde
Source
Record details
PPRRVU2026_Apr_nonQPP.csv
in
rvu26b-updated-05-01-2026.zip
(row 203)
Record details
GPCI2026.csv
in
rvu26b-updated-05-01-2026.zip
(row 99)
Record details
PPRRVU2026_Apr_nonQPP.csv
in
rvu26b-updated-05-01-2026.zip
(row 11)
Record details
ANES2026.csv
in
rvu26b-updated-05-01-2026.zip
(row 97)
Record details
Section 508 compliant version of CY_2022_Anesthesia_Base_Units_110921.txt
in
2022-anesthesia-base-units-cpt-code.zip
(row 171)
120-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, so a 120-minute case adds 8 time units.
CPT 01250 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 $245.28 for a 120-minute case in Dallas, TX under the Q2 2026 release, before sequestration.
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
- 01250
- Release
- Q2 2026, revision 1
- 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)Q2 2026 · revision 1
Latest revision of this release
Release period: April 1 – June 30, 2026
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
PPRRVU2026_Apr_nonQPP.csv in rvu26b-updated-05-01-2026.zip (row 203)- hcpcs (col 1)
- 01250
- modifier (col 2)
- blank
- status_code (col 4)
- J
SHA-256: afc9cf9fe60742518cf6aaccd507edc035052ab9ab1be48644be39f38fceec48
Why is there no national PFS amount for 01250?
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.
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 01250.
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.
How often 01250 is billed Copy link
Across Original Medicare in CY2024, 01250 ranked #2,013 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 1.5 times on average that year.
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 Q2 2026 fee schedule above.
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Source & method
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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.
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 01250 National PFS baseline: No national PFS rate (Q2 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/01250/2026/B