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

CPT 01380

Priced using anesthesia methodology

01380 · PFS Q4 2014 · Historical

Illustrative example

~$203.31

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
22.59
amount
$203.31

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

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

Citations

  • Supplies the RVUs and PFS status for this code and component.

    Physician relative value file (PPRRVU)

    Q4 2014 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2014

    Record details PPRRVU14_V0815_v5.csv in rvu14d.zip (row 4,319)
    hcpcs (col 1)
    01380
    status_code (col 4)
    J

    SHA-256: 9ff6da39ad421c38c816089ae3bed4bd754a642336efa8e8901e9cc38cca8705

    Original source file

  • Supplies the geographic adjustment factors for this locality.

    Geographic practice cost indices (GPCI)

    Q4 2014 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2014

    Record details CY 2014 GPCI _12172013.csv in rvu14d.zip (row 78)
    work_gpci (col 4)
    1.014
    pe_gpci (col 5)
    1.013
    mp_gpci (col 6)
    0.803

    SHA-256: 544aec167a634687dc8b61f2eee8bfa75880a369328b9e79a6507bea595a58a2

    Original source file

  • Supplies the dollar conversion factor used in the formula.

    Physician relative value file (PPRRVU)

    Q4 2014 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2014

    Record details PPRRVU14_V0815_v5.csv in rvu14d.zip (row 11)
    conversion_factor (col 25)
    35.8228

    SHA-256: 9ff6da39ad421c38c816089ae3bed4bd754a642336efa8e8901e9cc38cca8705

    Original source file

  • Anesthesia conversion factors (ANES)

    Q4 2014 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2014

    Record details ANES 2014_V0103.csv in rvu14d.zip (row 78)
    non_qpp_conversion_factor (col 4)
    22.59

    SHA-256: 92dec4d2b34c359aed5901d306fc3e0ddff7d1ea620fda922ee253d6b868d3d2

    Original source file

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.

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 $203.31 for a 90-minute case in Dallas, TX under the Q4 2014 release, before sequestration.

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
Q4 2014, 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)

    Q4 2014 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2014

    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 PPRRVU14_V0815_v5.csv in rvu14d.zip (row 4,319)
    hcpcs (col 1)
    01380
    modifier (col 2)
    blank
    status_code (col 4)
    J

    SHA-256: 9ff6da39ad421c38c816089ae3bed4bd754a642336efa8e8901e9cc38cca8705

    Original source file

Plain-text summary

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.

Payment considerations Copy link

Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.

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

Check a pair of codes 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 for the pair.

See every current NCCI pair for 01380 →

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.

Usage and related codes Copy link

How often 01380 is billed Copy link

Across Original Medicare in CY2024, 01380 ranked #2,369 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Beneficiaries
9,517
Office + facility beneficiaries combined
Services
13,570
Times it was billed
Allowed
$920,275
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 Q4 2014 fee schedule above.

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Source & method

Show sources

The anesthesia estimate uses the base units, case length, and locality conversion factor shown beside it. The PFS file shows this code is priced as anesthesia. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.

Physician relative value file (Q4 2014) · rvu14d.zip (PPRRVU14_V0815_v5.csv row 4,319)

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

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

CPT 01380 National PFS baseline: No national PFS rate (Q4 2014; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/01380/2014/D