Priced using anesthesia methodology
01392 · PFS Q3 2016 · Historical
Illustrative example
~$220.20
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. time_units = time_minutes / 15, rounded to one decimal place. The anesthesia conversion factor is CMS's published locality-adjusted value. Citations 01392’s RVUs, PFS status and conversion factor Physician relative value file (PPRRVU)CMS RVU16CJuly 1 – September 30, 2016
PPRRVU16_V0517.csv
row 4,538
in rvu16c.zip
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File fingerprint The GPCIs Geographic practice cost indices (GPCI)CMS RVU16CJuly 1 – September 30, 2016
CY2016_GPCIs.csv
row 78
in rvu16c.zip
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File fingerprint Anesthesia conversion factors (ANES) CMS RVU16CJuly 1 – September 30, 2016
ANES_V0105.csv
row 78
in rvu16c.zip
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File fingerprint
Source
In the CMS file
81464316ee60bdd4aa33b47a636b521a77a73481c795300cbab67f48dbe432d9
In the CMS file
ce389037033017a10b7796f84dc6b74289b96eaff624513d7e97db9a2688a7a3
In the CMS file
a8f782f84278459791ea62c7fad8731a70ec2b791c2935309b4b3df5fbc10e06
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 4—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.
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
- 01392
- Release
- Q3 2016, 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)CMS RVU16CJuly 1 – September 30, 2016
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
PPRRVU16_V0517.csv row 4,538 in rvu16c.zip
In the CMS file
Loading rows 4,536–4,540 of PPRRVU16_V0517.csv…
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81464316ee60bdd4aa33b47a636b521a77a73481c795300cbab67f48dbe432d9
CPT 01392 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 $220.20 for a 90-minute case in Dallas, TX under the Q3 2016 release, before sequestration.
Why is there no national PFS amount for 01392?
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)
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.
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.
What it means outside Medicare Copy link
Usage and related codes Copy link
How often 01392 is billed Copy link
Across Original Medicare in CY2024, 01392 ranked #1,754 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 Q3 2016 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 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.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
CPT 01392 National PFS baseline: No national PFS rate (Q3 2016; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU16C, PPRRVU16_V0517.csv row 4,538. Localis. https://localishealth.com/cpt/01392/2016/C