The formula Copy link
Payment = (base units + time units) × the locality's anesthesia conversion factor. Base units are a fixed per-code value CMS publishes to reflect the complexity of the anesthesia service. Unlike PFS RVUs, they are not split into work, practice expense, and malpractice. Time units come from the anesthesia minutes reported on the claim: the contractor divides the minutes by 15 and rounds to one decimal place.
Why it is priced separately Copy link
Status J codes don’t use the standard PFS formula at all. Because the RVU file shows no amount for them, they are easy to mistake for bundled or excluded codes; status indicators explains the difference. An actual anesthesia amount needs a locality and the reported anesthesia time, not just the code.
Its own conversion factor, and its own QP/non-QP split Copy link
CMS publishes the anesthesia conversion factor per locality, while the PFS conversion factors are national. The CY2026 QP/non-QP split described in the 2026 conversion factor guide applies here too: each locality has a QP and a non-QP anesthesia conversion factor.
Anesthesia payment calculator Copy link
Enter the code's base units, the reported anesthesia time, and your locality's anesthesia conversion factor. For example, 5 base units plus 45 minutes (45 ÷ 15 = 3 time units) is 8 total units—at a $21.00 anesthesia conversion factor that is 8 × $21.00 = $168.00.
Time units are minutes ÷ 15, rounded to one decimal place. The anesthesia conversion factor is published per locality—find yours on its locality page. Sequestration is not applied here.
Frequently asked Copy link
Do anesthesia codes have work, PE, and MP RVUs?
No. Anesthesia (status J) codes are priced from base units and time units under their own formula.
What do I need to compute an anesthesia amount?
A locality, to look up its anesthesia conversion factor, and the anesthesia time in minutes, to compute time units. The code alone is not enough.
Sources Copy link
- CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field)
- CMS Physician Fee Schedule overview (cms.gov)
- CMS Medicare Claims Processing Manual (Pub. 100-04)
Written from primary CMS sources—see how we source, compute, and verify everything on this site.
- The Medicare contractor computes anesthesia time units by dividing the reported anesthesia time by 15 minutes and rounding the result to one decimal place. —CMS Medicare Claims Processing Manual (Pub. 100-04)
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