CPT 01320
Priced using anesthesia methodology
01320 · PFS Q3 2026
See your local estimate for a sample 90-minute case.
CPT 01320 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 (Q3 2026 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
- 01320
- Release
- Q3 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)Q3 2026 · revision 1
Latest revision of this release
Release period: July 1 – September 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_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 208)- hcpcs (col 1)
- 01320
- modifier (col 2)
- blank
- status_code (col 4)
- J
SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21
Why is there no national PFS amount for 01320?
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 (9)
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, 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 01320.
Billing together (NCCI edits) Copy link
NCCI Q3 2026Based on CMS's National Correct Coding Initiative (NCCI). A few examples appear here; use the complete edit page to check a specific pair.
Not separately payable with 01320 on the same date of service—no modifier bypasses the edit (modifier indicator 0)
Showing 3 of 369.
Separately payable with 01320 only when an NCCI-associated modifier is appropriate and documented (modifier indicator 1)
Showing 3 of 162.
Modifier 59 and the X modifiers are not a universal bypass—CMS expects the most specific applicable modifier, and which one that is depends on the pair and the documented circumstances.
Common payment questions Copy link
Why would a Medicare claim for 01320 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- 369 codes form NCCI pairs with 01320 carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
- 162 codes pair with 01320 under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
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 01320 is billed Copy link
Across Original Medicare in CY2024, 01320 ranked #2,505 of the 7,879 CPT codes billed to Medicare that year, by patients served or total 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 Q3 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 01320 National PFS baseline: No national PFS rate (Q3 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/01320/2026/C