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

Calculator
Effective Jan 1, 2024 through Mar 8, 2024. This is revision 1—CMS published revision 2 with rates effective Mar 9, 2024 (posted Apr 1, 2024).

CPT 01938

Priced using anesthesia methodology

01938 · PFS Q1 2024 · Historical

Illustrative example

~$124.86

Source

Formula

(base_units + time_units) × anesthesia_cf

Localis-derived calculation from published inputs. Select an underlined input to inspect its source field.

base_units
4
time_units
2
anesthesia_cf
20.81
amount
$124.86

time_units = time_minutes / 15.

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)

    Q1 2024 · revision 2

    Latest revision of this release

    Release period: March 9 – March 31, 2024

    Record details PPRRVU24_JAN.csv in rvu24ar-posted-04-01-2024.zip (row 6,063)
    hcpcs (col 1)
    01938
    status_code (col 4)
    J

    SHA-256: b6c71c98c3e26e2b217817da7000cc3516dc360a1c74d5ffd8f46bfa835f9741

    Original source file

  • Supplies the geographic adjustment factors for this locality.

    Geographic practice cost indices (GPCI)

    Q1 2024 · revision 2

    Latest revision of this release

    Release period: March 9 – March 31, 2024

    Record details GPCI2024.csv in rvu24ar-posted-04-01-2024.zip (row 99)
    work_gpci (col 5)
    1.011
    pe_gpci (col 6)
    1.007
    mp_gpci (col 7)
    0.877

    SHA-256: 4b92cf5fa9921e29a8149d07473a63e3b62e172742b2969d1dce9502162405c4

    Original source file

  • Supplies the dollar conversion factor used in the formula.

    Physician relative value file (PPRRVU)

    Q1 2024 · revision 2

    Latest revision of this release

    Release period: March 9 – March 31, 2024

    Record details PPRRVU24_JAN.csv in rvu24ar-posted-04-01-2024.zip (row 11)
    conversion_factor (col 25)
    33.2875

    SHA-256: b6c71c98c3e26e2b217817da7000cc3516dc360a1c74d5ffd8f46bfa835f9741

    Original source file

  • Anesthesia conversion factors (ANES)

    Q1 2024 · revision 2

    Latest revision of this release

    Release period: March 9 – March 31, 2024

    Record details ANES2024.csv in rvu24ar-posted-04-01-2024.zip (row 97)
    non_qpp_conversion_factor (col 4)
    20.81

    SHA-256: c3b5156943ad766b2ea329aed645743dc68d526171ebad31c4a36e74a60c9e05

    Original source file

  • Anesthesia base units by CPT code

    Q1 2022 · revision 1

    Latest revision of this release

    Release period: January 1 – March 31, 2022

    Record details Section 508 compliant version of CY_2022_Anesthesia_Base_Units_110921.txt in 2022-anesthesia-base-units-cpt-code.zip (row 257)
    base_units (col 2)
    4

    SHA-256: ebbf7d42ecaf759c280f0b9fced5ea71dd16505a0563bb7c942cee068c797fde

    Original source file

30-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, so a 30-minute case adds 2 time units.

View CMS source and method

CPT 01938 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 $124.86 for a 30-minute case in Dallas, TX under the Q1 2024 release, before sequestration.

Amount evidence: base units, time units, and locality conversion factor in the estimate. The PFS row establishes the anesthesia pricing pathway.

Inspect PFS status evidence
Code
01938
Release
Q1 2024, revision 1
Result
Priced using anesthesia methodology

Citations

  • Establishes the PFS status (J) and the resulting pathway for this code: priced using anesthesia methodology.

    Physician relative value file (PPRRVU)

    Q1 2024 · revision 1

    Superseded revision

    Release period: January 1 – March 8, 2024

    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 PPRRVU24_JAN.csv in rvu24a-updated-04-01-2024.zip (row 6,063)
    hcpcs (col 1)
    01938
    modifier (col 2)
    blank
    status_code (col 4)
    J

    SHA-256: 034f3aa88a63e6f7ca3859c09b3945dce139171a6fc5a710300fc7b815e9b65b

    Original source file

Compact facts

Why is there no national PFS amount for 01938?

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. 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.

Payment considerations Copy link

Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.

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.

Payment rules

Can you bill it with another code? 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 between it and 01938.

See every current NCCI pair for 01938 →

History
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 & related

How often 01938 is billed Copy link

Across Original Medicare in CY2024, 01938 ranked #1,138 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 1.8 times on average that year.

Beneficiaries
56,169
Office + facility patients combined
Services
99,228
Times it was billed
Allowed
$8.6M
Total Medicare allowed dollars
Compare: ↑ #1,137 more popular · 50543 ↓ #1,140 less popular · 67039

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 Q1 2024 fee schedule above.

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Source & method

Show sources

The anesthesia estimate uses the base units, case length, and locality conversion factor identified beside that estimate. The PFS file establishes the pricing pathway. Releases are immutable: historical evidence remains tied to the specified release. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Physician relative value file (Q1 2024) · rvu24a-updated-04-01-2024.zip (PPRRVU24_JAN.csv row 6,063)

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

Cite this rate

This citation identifies the source release, so its evidence remains reproducible after a newer release lands.

CPT 01938 National PFS baseline: No national PFS rate (Q1 2024; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/01938/2024/A/1