Anesthesia for Shoulder Replacement Surgery
CPT 01638
Reported by the anesthesiologist or CRNA when a patient undergoes total or reverse total shoulder arthroplasty, most often for advanced arthritis or an irreparable rotator cuff.
No national payment amount
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.
~$326.10 for a 90-minute example case in Dallas, TX
Where this example comes from
(base_units + time_units) × anesthesia_cf × locality_adjuster time_units = time_minutes / 15. locality_adjuster = 0.787 × work_gpci + 0.147 × pe_gpci + 0.066 × mp_gpci.
Source
Anesthesia has no single national rate — payment is (base units + time units) × the locality's anesthesia conversion factor, so the amount above is an example computed with Dallas, TX rates, before sequestration. Enter your ZIP for your own locality's number.
How much does Medicare pay for CPT 01638?
CPT 01638 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 $326.10 for a 90-minute case in Dallas, TX under the Q1 2026 release, before sequestration.
How often 01638 is billed
Across Original Medicare in CY2024, 01638 ranked #503 of the 7,879 CPT codes billed to Medicare that year, ranked by patients served or total allowed dollars.
2024 Medicare fee-for-service only, national totals — Medicare Advantage, Medicaid and commercial volume are excluded, 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 Q1 2026 fee schedule the rates above come from.
Common questions
Why is there no payment amount for 01638?
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. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.
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.
Saw this code on your bill?
What is a 01638 visit in patient-friendly terms?
In plain terms: Covers the anesthesia care given while a surgeon replaces the shoulder joint with an artificial one, whether a standard or reverse implant is used. Within the shoulder anesthesia family, this is the entry for joint replacement itself rather than for arthroscopy, rotator cuff repair, or fracture fixation, which have their own codes. Care usually combines general anesthesia with a nerve block placed near the neck and collarbone to numb the arm for hours after surgery. Think of an older adult having a worn-out shoulder joint replaced after years of arthritis pain. The surgeon's fee is billed separately from the anesthesia team's, so this line is the charge for keeping the patient asleep, monitored, and comfortable throughout the operation and for the nerve block that numbs the arm afterward. You'll typically see CPT 01638 on a bill or explanation of benefits (EOB) when a clinician performs or bills for this service.
How this amount is computed
amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000. To price an RVU figure of your own, use the RVU-to-dollars converter.
| Component | RVU |
|---|---|
| Work RVU | blank |
| Practice expense RVU (non-facility) | blank |
| Practice expense RVU (facility) | blank |
| Malpractice RVU | blank |
Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A blank means CMS publishes no national number for that part. Read it as unknown, and never as zero.
Rate history by release
National non-facility amount for 01638 across quarterly releases.
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q3 2026 Jun 30, 2026 – present | J | — | — |
| Q2 2026 Mar 10, 2026 – Jun 29, 2026 | J | — | — |
| Q1 2026 Dec 29, 2025 – Mar 9, 2026 | J | — | — |
| Q4 2025 Sep 11, 2025 – Dec 28, 2025 | J | — | — |
| Q3 2025 Jun 5, 2025 – Sep 10, 2025 | J | — | — |
| Q2 2025 Jun 5, 2025 – Jun 4, 2025 | J | — | — |
| Q1 2025 Dec 23, 2024 – Jun 4, 2025 | J | — | — |
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Source & method
This is computed from CMS's Medicare Physician Fee Schedule Q1 2026 release (schedule pfs, effective January 2026). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them.
Description written from primary sources: CMS Medicare Physician Fee Schedule Relative Value Files. Not derived from AMA CPT descriptor text.
Conversion factor $33.4009 read from the same file, row 11, column 26.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This link keeps pointing at the Q1 2026 figures, even after a newer release lands.
CPT 01638 Medicare Physician Fee Schedule rate (Q1 2026). Localis. https://localishealth.com/cpt/01638/2026/A