CPT 01656
Priced using anesthesia methodology
01656 · PFS Q2 2016 · Historical
Illustrative example
~$352.32
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 Every input comes from a published CMS file. Open the same file at the row shown and the values match. 01656’s RVUs, PFS status and conversion factor Physician relative value file (PPRRVU)CMS RVU16BApril 1 – June 30, 2016
PPRRVU16_April_V0202.csv
row 4,574
in rvu16b.zip
Loading rows 4,572–4,576 of PPRRVU16_April_V0202.csv…
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File fingerprint The GPCIs Geographic practice cost indices (GPCI)CMS RVU16BApril 1 – June 30, 2016
CY2016_GPCIs.csv
row 78
in rvu16b.zip
Loading rows 76–80 of CY2016_GPCIs.csv…
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File fingerprint Anesthesia conversion factors (ANES) CMS RVU16BApril 1 – June 30, 2016
ANES_V0105.csv
row 78
in rvu16b.zip
Loading rows 76–80 of ANES_V0105.csv…
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File fingerprint
Source
In the CMS file
a6f009bac8359a1f7d870e6b668dd2e69d1658423373dbb0ca0c267cdae773b9
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 10—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 01656 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 $352.32 for a 90-minute case in Dallas, TX under the Q2 2016 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
- 01656
- Release
- Q2 2016, revision 1
- Result
- Priced using anesthesia methodology
Citations
Every input comes from a published CMS file. Open the same file at the row shown and the values match.
-
Shows this code’s PFS status (J). Result: Priced using anesthesia methodology.
Physician relative value file (PPRRVU)CMS RVU16BApril 1 – June 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_April_V0202.csv row 4,574 in rvu16b.zip
- A HCPCS
- 01656
- B Modifier
- blank
- D Status code
- J
In the CMS file
Loading rows 4,572–4,576 of PPRRVU16_April_V0202.csv…
Download rvu16b.zip from CMS File fingerprint
a6f009bac8359a1f7d870e6b668dd2e69d1658423373dbb0ca0c267cdae773b9
Why is there no national PFS amount for 01656?
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.
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 01656 is billed Copy link
Across Original Medicare in CY2024, 01656 ranked #4,049 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 Q2 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 01656 National PFS baseline: No national PFS rate (Q2 2016; participating; whole service; GPCI 1.000; sequestration excluded). CMS RVU16B, PPRRVU16_April_V0202.csv row 4,574. Localis. https://localishealth.com/cpt/01656/2016/B