Priced using anesthesia methodology
01920 · PFS Q4 2014 · Historical
Illustrative example
~$248.49
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 01920’s RVUs, PFS status and conversion factor Physician relative value file (PPRRVU)CMS RVU14DOctober 1 – December 31, 2014
PPRRVU14_V0815_v5.csv
row 4,411
in rvu14d.zip
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File fingerprint The GPCIs Geographic practice cost indices (GPCI)CMS RVU14DOctober 1 – December 31, 2014
CY 2014 GPCI _12172013.csv
row 78
in rvu14d.zip
Loading rows 76–80 of CY 2014 GPCI _12172013.csv…
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File fingerprint Anesthesia conversion factors (ANES) CMS RVU14DOctober 1 – December 31, 2014
ANES 2014_V0103.csv
row 78
in rvu14d.zip
Loading rows 76–80 of ANES 2014_V0103.csv…
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File fingerprint
Source
In the CMS file
9ff6da39ad421c38c816089ae3bed4bd754a642336efa8e8901e9cc38cca8705
In the CMS file
544aec167a634687dc8b61f2eee8bfa75880a369328b9e79a6507bea595a58a2
In the CMS file
92dec4d2b34c359aed5901d306fc3e0ddff7d1ea620fda922ee253d6b868d3d2
60-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 7—set by CMS for this code and the same in every locality. One time unit is 15 minutes, rounded to one decimal, so a 60-minute case adds 4 time units.
CPT 01920 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 $248.49 for a 60-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
- 01920
- 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)CMS RVU14DOctober 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.
PPRRVU14_V0815_v5.csv row 4,411 in rvu14d.zip
In the CMS file
Loading rows 4,409–4,413 of PPRRVU14_V0815_v5.csv…
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9ff6da39ad421c38c816089ae3bed4bd754a642336efa8e8901e9cc38cca8705
Why is there no national PFS amount for 01920?
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 01920 is billed Copy link
Across Original Medicare in CY2024, 01920 ranked #2,244 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 Q4 2014 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 01920 National PFS baseline: No national PFS rate (Q4 2014; participating; whole service; GPCI 1.000; sequestration excluded). CMS RVU14D, PPRRVU14_V0815_v5.csv row 4,411. Localis. https://localishealth.com/cpt/01920/2014/D