CPT 01958
Priced using anesthesia methodology
01958 · PFS Q4 2018 · Historical
Illustrative example
~$243.43
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 Supplies the RVUs and PFS status for this code and component. Q4 2018 · revision 1 Latest revision of this release Release period: October 1 – December 31, 2018 SHA-256: c6312c12acd1b8ed78b409e8508357929aa7e764e333ec568ebb9c0774b7dc4d Supplies the geographic adjustment factors for this locality. Q4 2018 · revision 1 Latest revision of this release Release period: October 1 – December 31, 2018 SHA-256: 21ed101a0289138276ab9d441fb44c691a40d34de8f7bd58c7b57b0d0f28d3d2 Supplies the dollar conversion factor used in the formula. Q4 2018 · revision 1 Latest revision of this release Release period: October 1 – December 31, 2018 SHA-256: c6312c12acd1b8ed78b409e8508357929aa7e764e333ec568ebb9c0774b7dc4d Q4 2018 · revision 1 Latest revision of this release Release period: October 1 – December 31, 2018 SHA-256: dba50a279321bc58d93e608c4d1f8e18b3a674f12b2a91e2bedeba0b8e33c6c1
Source
Record details
PPRRVU18_OCT.csv
in
rvu18d.zip
(row 4,911)
Record details
GPCI2018.csv
in
rvu18d.zip
(row 102)
Record details
PPRRVU18_OCT.csv
in
rvu18d.zip
(row 11)
Record details
ANES2018.csv
in
rvu18d.zip
(row 100)
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 5—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 01958 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 $243.43 for a 90-minute case in Dallas, TX under the Q4 2018 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
- 01958
- Release
- Q4 2018, 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)Q4 2018 · revision 1
Latest revision of this release
Release period: October 1 – December 31, 2018
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
PPRRVU18_OCT.csv in rvu18d.zip (row 4,911)- hcpcs (col 1)
- 01958
- modifier (col 2)
- blank
- status_code (col 4)
- J
SHA-256: c6312c12acd1b8ed78b409e8508357929aa7e764e333ec568ebb9c0774b7dc4d
Why is there no national PFS amount for 01958?
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
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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.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
CPT 01958 National PFS baseline: No national PFS rate (Q4 2018; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/01958/2018/D