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CPT 01991 Medicare anesthesia rate

Priced using anesthesia methodology

01991 · PFS Q2 2019 · Historical

Illustrative example

~$111.10

Source

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.

base_units
3
time_units
2
anesthesia_cf
22.22
amount
$111.10

time_units = time_minutes / 15, rounded to one decimal place.

The anesthesia conversion factor is CMS's published locality-adjusted value.

Citations

  • 01991’s RVUs, PFS status and conversion factor

    Physician relative value file (PPRRVU)CMS RVU19BApril 1 – June 30, 2019

    PPRRVU19_APR.csv row 5,086 in rvu19b.zip

    A HCPCS
    01991
    D Status code
    J
    Y Conversion factor
    36.0391
    In the CMS file

    Loading rows 5,084–5,088 of PPRRVU19_APR.csv…

    Download rvu19b.zip from CMS File fingerprint b427bbfdcb61b355ba034840681873d1bd6cdcf51752bdae1bab7c5449efc971

  • The GPCIs

    Geographic practice cost indices (GPCI)CMS RVU19BApril 1 – June 30, 2019

    GPCI2019.csv row 102 in rvu19b.zip

    D Work GPCI
    1.012
    E PE GPCI
    1.014
    F MP GPCI
    0.768
    In the CMS file

    Loading rows 100–104 of GPCI2019.csv…

    Download rvu19b.zip from CMS File fingerprint 89c03bb9abd9e67c1f2f0dbb14887720b1c5c01317514ca3c9fc70cd49a44fcf

  • Anesthesia conversion factors (ANES)

    CMS RVU19BApril 1 – June 30, 2019

    ANES2019.csv row 100 in rvu19b.zip

    D Anesthesia CF (non-QPP)
    22.2200
    In the CMS file

    Loading rows 98–102 of ANES2019.csv…

    Download rvu19b.zip from CMS File fingerprint 63d2d4cc52bcf8d64afb404979fc44f42a4d8065e2bd272438ae702d6eeb7232

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 3—set by CMS for this code and the same in every locality. One time unit is 15 minutes, rounded to one decimal, so a 30-minute case adds 2 time units.

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
01991
Release
Q2 2019, 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 RVU19BApril 1 – June 30, 2019

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    PPRRVU19_APR.csv row 5,086 in rvu19b.zip

    In the CMS file

    Loading rows 5,084–5,088 of PPRRVU19_APR.csv…

    Download rvu19b.zip from CMS File fingerprint b427bbfdcb61b355ba034840681873d1bd6cdcf51752bdae1bab7c5449efc971

Report a problem

CPT 01991 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 $111.10 for a 30-minute case in Dallas, TX under the Q2 2019 release, before sequestration.

Why is there no national PFS amount for 01991?

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.

Contract rate as % of Medicare Copy link

Arbitration outcomes for 01991 are coming Join the waitlist →

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust 01991's amount.

CMS RVU19BApril 1 – June 30, 2019

Can you bill it with another code? Copy link

This code

01991

See every current NCCI pair for 01991 →

Source & method Copy link

The PFS file shows this code is priced as anesthesia. The estimate uses the base units, case length, and locality conversion factor shown beside it.

  1. 01 PPRRVU19_APR.csv · Q2 2019 (RVU19B) · row 5,086—priced as anesthesia
    Effective
    April 1 – June 30, 2019
    Locator
    PPRRVU19_APR.csv in rvu19b.zip · row 5,086 of 16,971 · via CMS
    Fields read
    Status J (col 4)
    SHA-256 b427bbfdcb61b355…
  2. 02 Physician & Other Practitioners · CY2024—volume and who bills it limits
    Effective
    Calendar-year snapshot, on a different cycle from the Q2 2019 fee schedule
    Doesn’t establish
    Medicare Advantage, Medicaid or commercial volume.
    Note
    The dataset suppresses rows under 11 beneficiaries.

Cite this rate

CPT 01991 National PFS baseline: No national PFS rate (Q2 2019; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU19B, PPRRVU19_APR.csv row 5,086. Localis. https://localishealth.com/cpt/01991/2019/B

Past releases are never edited, so the citation stays checkable after CMS publishes a newer one. Methodology · Plain-text summary · JSON

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.

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Usage and related codes Copy link

In CY2024, 01991 ranked #2,245 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Services
17,953
Allowed
$1.4M
Beneficiaries
11,340

CY2024 Medicare fee-for-service, from the CMS Physician & Other Practitioners dataset (limits). Localis groups related codes for payment research; the grouping isn't the AMA's code families.