CPT 01380 Medicare anesthesia rate in Q1 2013: ~$196.38 example

Priced using anesthesia methodology

01380 · PFS Q1 2013 · Historical

Illustrative example

~$196.38

Source

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.

base_units: 3
time_units: 6
anesthesia_cf: 21.82
amount: $196.38

time_units = time_minutes / 15, rounded to one decimal place.

The anesthesia conversion factor is CMS's published locality-adjusted value.

Citations

01380’s RVUs, PFS status and conversion factor

Physician relative value file (PPRRVU)CMS RVU13AJanuary 1 – March 31, 2013revision 2

PPRRVU13_V1226_UP0.csv row 4,137 in rvu13ar.zip

A HCPCS

01380

D Status code

J

Y Conversion factor

34.0230

In the CMS file

Loading rows 4,135–4,139 of PPRRVU13_V1226_UP0.csv…

Download rvu13ar.zip from CMS File fingerprint 79b1988bb9cbab6a61634b6463d26ce88cca431c3e36fa3b73792f29882d95b4
The GPCIs

Geographic practice cost indices (GPCI)CMS RVU13AJanuary 1 – March 31, 2013revision 2

GPCI2013.csv row 77 in rvu13ar.zip

D Work GPCI

1.009

E PE GPCI

1.017

F MP GPCI

0.834

In the CMS file

Loading rows 75–79 of GPCI2013.csv…

Download rvu13ar.zip from CMS File fingerprint 445bfe306db4fa6abc834ff7015d2afb42353e7c8f369486671c173818e5b680
Anesthesia conversion factors (ANES)

CMS RVU13AJanuary 1 – March 31, 2013revision 2

ANES2013.csv row 78 in rvu13ar.zip

D Anesthesia CF (non-QPP)

21.8200

In the CMS file

Loading rows 76–80 of ANES2013.csv…

Download rvu13ar.zip from CMS File fingerprint ec437ff66b1b880ffc38cad2e3b716fe3ce28489148bddc7aa17b50fec2533bc

90-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 3—set by CMS for this code and the same in every locality. One time unit is 15 minutes, rounded to one decimal, so a 90-minute case adds 6 time units.

View CMS source and method

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: 01380
Release: Q1 2013, revision 2
Result: Priced using anesthesia methodology

Citations

Shows this code’s PFS status (J). Result: Priced using anesthesia methodology.

Physician relative value file (PPRRVU)CMS RVU13AJanuary 1 – March 31, 2013revision 2

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

PPRRVU13_V1226_UP0.csv row 4,137 in rvu13ar.zip

In the CMS file

Loading rows 4,135–4,139 of PPRRVU13_V1226_UP0.csv…

Download rvu13ar.zip from CMS File fingerprint 79b1988bb9cbab6a61634b6463d26ce88cca431c3e36fa3b73792f29882d95b4

Report a problem

CPT 01380 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 $196.38 for a 90-minute case in Dallas, TX under the Q1 2013 release, before sequestration.

Why is there no national PFS amount for 01380?

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 01380 are coming Join the waitlist →

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust 01380's amount.

CMS RVU13AJanuary 1 – March 31, 2013revision 2

Can you bill it with another code? Copy link

See every current NCCI pair for 01380 →

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 PPRRVU13_V1226_UP0.csv · Q1 2013 (RVU13A) · row 4,137—priced as anesthesia

Source

Physician relative value file (PPRRVU), Q1 2013 release

Effective

January 1 – March 31, 2013

Locator

PPRRVU13_V1226_UP0.csv in rvu13ar.zip · row 4,137 of 15,619 · via CMS

Fields read

Status J (col 4)

SHA-256 79b1988bb9cbab6a…
02 Physician & Other Practitioners · CY2024—volume and who bills it limits

Source

CMS Physician & Other Practitioners dataset

Effective

Calendar-year snapshot, on a different cycle from the Q1 2013 fee schedule

Doesn’t establish

Medicare Advantage, Medicaid or commercial volume.

Note

The dataset suppresses rows under 11 beneficiaries.

Cite this rate

CPT 01380 National PFS baseline: No national PFS rate (Q1 2013; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU13A, PPRRVU13_V1226_UP0.csv row 4,137. Localis. https://localishealth.com/cpt/01380/2013/A

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, 01380 ranked #2,369 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Services: 13,570
Allowed: $920,275
Beneficiaries: 9,517

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.