2026 data Public-data reference. official source

Anesthesia

262 procedures in Anesthesia. Medicare reimbursement averages $188.65 per service; billed charges average N/A. Source: CMS Medicare Physician & Other Practitioners 2023.

Anesthesia services for surgical procedures

262 procedures · Avg Medicare payment: $188.65

Code Procedure Medicare Billed
00142 Anesthesia For Lens Surgery $76.73 $866.53
00811 Anesthesia For Other Procedure On Large Bowel Using An... $80.96 $1,009.00
00731 Anesthesia For Other Procedure On Esophagus, Stomach,... $82.98 $1,106.39
00812 Anesthesia For Exam Of Colon Using An Endoscope $82.47 $951.03
00813 Anesthesia For Procedure On Small And Large Bowel... $97.62 $1,287.04
01402 Anesthesia For Procedure For Total Knee Joint... $182.62 $2,353.47
00790 Anesthesia For Other Procedure On Upper Abdomen $193.30 $2,453.57
00910 Anesthesia For Other Procedure On Urinary System... $72.90 $1,012.86
01922 Anesthesia For X-Ray Or Radiation Therapy $116.61 $1,624.47
00400 Anesthesia For Other Procedure On Skin Of Arms, Legs,... $91.09 $1,241.47
00840 Anesthesia For Other Procedure On Lower Abdomen $174.43 $2,308.36
01480 Anesthesia For Other Procedure On Lower Leg, Ankle,... $105.90 $1,424.73
01214 Anesthesia For Total Hip Replacement $194.99 $2,509.95
01810 Anesthesia For Procedure On Nerves, Muscles, Tendons,... $73.30 $985.74
00670 Anesthesia For Extensive Surgery On Spine $324.63 $4,179.02
00300 Anesthesia For Other Procedure On Skin, Muscles, Or... $125.11 $1,645.49
00140 Anesthesia For Other Procedure On Eye $100.09 $1,151.57
00537 Anesthesia For Procedure To Assess Heart Electrical... $248.25 $3,152.81
00520 Anesthesia For Other Closed Procedure On Chest $123.06 $1,648.21
00918 Anesthesia For Fragmenting, Manipulation And/or... $113.66 $1,503.92
01230 Anesthesia For Procedure On Upper 2/3rd Of Thigh Bone $159.46 $2,077.25
00732 Anesthesia For Procedure On Gallbladder, Pancreas, Or... $119.49 $1,602.07
00320 Anesthesia For Other Procedure On Neck Area (1 Year Or... $150.95 $1,915.47
01992 Anesthesia For Nerve Block And Injection Procedure,... $90.88 $1,636.24
00902 Anesthesia For Procedure On Anus And Rectum $98.04 $1,295.33
01630 Anesthesia For Other Procedure On Top Of Arm Bone And... $147.06 $1,877.80
00410 Anesthesia For Procedure To Correct Abnormal Heart... $60.24 $819.51
00145 Anesthesia For Retinal Surgery $124.87 $1,501.78
01638 Anesthesia For Open Or Endoscopic Total Shoulder Joint... $224.83 $2,870.73
00104 Anesthesia For Electroshock Therapy $64.67 $817.66
01830 Anesthesia For Other Procedure On Forearm, Wrist, Or... $105.26 $1,374.15
01400 Anesthesia For Other Procedure Or Exam Of Knee Joint... $104.07 $1,355.65
01926 Anesthesia For X-Ray On Artery Of Brain, Heart, Or... $198.23 $2,689.37
01938 Anesthesia For Injection, Drainage Or Aspiration... $69.88 $1,246.66
00103 Anesthesia For Procedure On Eyelid $112.23 $1,264.43
00912 Anesthesia For Removal Of Urinary Bladder Tumors... $109.18 $1,425.52
01844 Anesthesia For Placement Or Revision Of Blood Flow... $157.80 $2,092.93
00914 Anesthesia For Removal Of Prostate Including Use Of An... $129.18 $1,702.73
00630 Anesthesia For Other Procedure On Lower Spine $195.30 $2,470.97
00530 Anesthesia For Insertion Of Permanent Heart Pacemaker $124.90 $1,761.86
00532 Anesthesia For Access To Central Vein $96.14 $1,279.93
00560 Anesthesia For Procedure On Heart And Large Blood... $313.56 $3,714.01
01610 Anesthesia For Procedure On Nerves, Muscles, Tendons,... $150.55 $1,959.00
00830 Anesthesia For Other Repair Of Lower Abdomen Hernia (1... $122.89 $1,593.96
01210 Anesthesia For Other Procedure On Hip Joint $169.41 $2,228.18
00160 Anesthesia For Other Procedure On Nose And Sinuses $130.41 $1,669.06
01940 Anesthesia For Nerve Destruction Procedures On Spine... $85.93 $1,462.77
00952 Anesthesia For Exam Of Uterus Using An Endoscope $88.22 $1,188.52
00860 Anesthesia For Other Procedure On Lower Abdomen... $160.64 $2,094.53
01942 Anesthesia For Nerve Modulation Procedure Spinal Cord... $123.20 $1,752.44
00862 Anesthesia For Procedure On Upper Urinary Tubes Or... $221.85 $2,801.14
01924 Anesthesia For X-Ray On Arteries $174.15 $2,576.56
01916 Anesthesia For X-Ray Exam Of Arteries And Veins Using... $142.40 $2,210.94
00567 Anesthesia For Heart Artery Bypass Grafting On... $530.81 $6,114.28
00873 Anesthesia For Shock Wave Therapy For Urinary System... $110.28 $1,404.42
00534 Anesthesia For Insertion Or Replace Of Pacing Heart... $168.67 $2,299.10
01470 Anesthesia For Other Procedure On Nerves, Muscles,... $94.37 $1,256.42
00350 Anesthesia For Other Procedure On Large Blood Vessel... $255.80 $3,243.88
00170 Anesthesia For Other Procedure On Mouth $112.93 $1,468.34
01270 Anesthesia For Other Procedure On Artery Of Upper Leg $264.47 $3,281.87
00210 Anesthesia For Other Procedure On Brain $326.79 $3,928.29
00920 Anesthesia For Other Procedure On Male Genitals $100.61 $1,337.86
00541 Anesthesia For Procedure On Chest With 1 Lung Inflated $357.65 $4,200.39
00865 Anesthesia For Extensive Removal Of Prostate $251.01 $3,160.63
00562 Anesthesia For Procedure On Heart And Large Blood... $601.52 $6,540.88
01996 Daily Hospital Management Of Continuous Spinal Drug... $49.78 $398.29
00402 Anesthesia For Reconstruction Of Breast $180.57 $2,371.36
00752 Anesthesia For Procedure To Repair Upper Abdominal... $166.61 $2,137.20
01937 Anesthesia For Injection, Drainage Or Aspiration... $71.99 $1,326.64
01941 Anesthesia For Nerve Modulation Procedure Spinal Cord... $123.65 $1,724.14
01215 Anesthesia For Revision Of Total Hip Replacement $253.90 $3,321.44
01710 Anesthesia For Other Procedures On Nerves, Muscles,... $91.84 $1,203.57
00700 Anesthesia For Other Procedure On Upper Front Abdomen $105.94 $1,467.86
01991 Anesthesia For Nerve Block And Injection $62.34 $1,059.97
00940 Anesthesia For Other Procedure On Female Genitals $80.10 $1,078.55
00800 Anesthesia For Other Procedure On Lower Front Abdomen $97.60 $1,325.61
01392 Anesthesia For Procedure On Kneecap And/or Upper Part... $148.10 $1,943.78
00120 Anesthesia For Other Procedure On External Middle And... $151.53 $1,940.10
00144 Anesthesia For Procedure On Eye For Corneal Transplant $123.13 $1,486.58
00832 Anesthesia For Repair Of Abdominal Wall Hernia $167.88 $2,338.46
01925 Anesthesia For X-Ray On Artery Of Neck Or Heart $190.34 $2,604.36
01740 Anesthesia For Other Procedure On Elbow $152.79 $1,974.88
00942 Anesthesia For Repair Or Removal Of Vagina And Urinary... $131.82 $1,695.78
01939 Anesthesia For Nerve Destruction Procedures On Spine... $82.20 $1,477.52
01482 Anesthesia For Open Amputation Below The Knee $134.69 $1,767.41
01250 Anesthesia For Procedure On Nerves, Muscles, Tendons,... $119.65 $1,558.54
01112 Anesthesia For Bone Marrow Aspiration And/or Biopsy At... $88.91 $1,231.17
01360 Anesthesia For Procedure On Lower 1/3rd Of Thigh Bone $170.18 $2,229.86
01930 Anesthesia For Other X-Ray On Vein Or Lymph System $139.01 $1,805.33
00797 Anesthesia For Procedure On Stomach For Weight Loss $235.88 $3,162.84
00868 Anesthesia For Kidney Transplant $318.68 $3,905.84
01380 Anesthesia For Closed Procedure On Knee Joint $55.24 $776.03
01220 Anesthesia For Closed Procedure On Upper 2/3rd Of... $112.01 $1,485.03
00750 Anesthesia For Other Repair Of Upper Abdomen Hernia $116.32 $1,567.78
01200 Anesthesia For Closed Procedure On Hip Joint $73.48 $1,112.68
01160 Anesthesia For Closed Procedure On Pubic Bone Or... $95.81 $1,645.68
01920 Anesthesia For X-Ray On Heart Vessels And Chambers $162.08 $2,211.53
00211 Anesthesia For Removal Of Blood Collection From Brain $239.44 $3,100.38
00600 Anesthesia For Other Procedure On Upper Spine $235.81 $3,037.77
00944 Anesthesia For Vaginal Removal Of Uterus $199.03 $2,523.53
01320 Anesthesia For Procedure On Nerves, Muscles, Tendons,... $118.32 $1,619.38
00620 Anesthesia For Other Procedure On Middle Spine $221.73 $2,838.69
00220 Anesthesia For Procedure To Drain Brain And Spinal... $222.25 $2,786.59
00100 Anesthesia For Procedure On Saliva Gland $174.41 $2,193.55
01232 Anesthesia For Amputation On Upper 2/3rd Of Thigh Bone $145.66 $1,977.22
00190 Anesthesia For Other Procedure On Face Bones Or Skull $161.03 $2,137.21
00126 Anesthesia For Incision Of Ear Drum $70.94 $917.30
00352 Anesthesia For Tying Large Blood Vessels Of Neck $114.62 $1,489.66
00794 Anesthesia For Removal Of Pancreas Including Use Of An... $381.82 $4,570.04
00540 Anesthesia For Other Procedure On Chest $295.86 $3,553.73
00214 Anesthesia For Procedure To Create Holes In Skull... $201.47 $2,533.29
01820 Anesthesia For Closed Procedure On Bones Of Forearm,... $81.47 $1,074.41
01472 Anesthesia For Repair Of Achilles Tendon $140.41 $1,827.82
01120 Anesthesia For Procedure On Hip Bone $154.60 $2,015.23
00846 Anesthesia For Removal Of Uterus Including Use Of An... $264.21 $3,293.73
00880 Anesthesia For Other Procedure On Large Blood Vessel... $383.15 $3,929.40
00770 Anesthesia For Procedure On Large Blood Vessels In... $404.36 $4,927.09
00563 Anesthesia For Procedure On Heart And Large Blood... $682.81 $7,176.76
00938 Anesthesia For Insertion Of Penile Prosthesis $145.49 $1,980.04
01486 Anesthesia For Open Total Ankle Joint Replacement $219.34 $2,761.33
01744 Anesthesia For Repair Of Nonhealed Broken Upper Arm... $195.04 $2,509.97
00450 Anesthesia For Other Procedure On Collar Bone And... $152.83 $1,930.48
00566 Anesthesia For Heart Artery Bypass Grafting $594.69 $6,980.18
01474 Anesthesia For Repair Of Calf Muscle $157.59 $1,980.35
01620 Anesthesia For Closed Procedure On Top Of Arm Bone And... $75.38 $1,046.93
00792 Anesthesia For Partial Removal Of Liver Or Management... $384.39 $4,234.84
00542 Anesthesia For Removal Of Tissue From Around Lung $339.97 $4,268.96
00904 Anesthesia For Extensive Procedure On Perineum $181.66 $2,344.97
01462 Anesthesia For Closed Procedure On Lower Leg, Ankle,... $85.62 $1,160.96
00864 Anesthesia For Total Removal Of Bladder $360.65 $4,390.50
00906 Anesthesia For Removal Of External Female Genitals $102.02 $1,352.96
01500 Anesthesia For Other Procedure On Artery Of Lower Leg $209.63 $1,582.37
00404 Anesthesia For Removal Of All Or Part Of Breast $188.63 $2,287.30
00529 Anesthesia For Closed Exam Of Chest Using An Endoscope... $253.72 $3,172.89
01440 Anesthesia For Other Procedure On Artery Of Knee $201.53 $1,659.63
01464 Anesthesia For Procedure On Ankle Or Foot Using An... $110.11 $1,437.90
00528 Anesthesia For Closed Exam Of Chest Using An Endoscope $188.53 $2,467.78
01770 Anesthesia For Other Procedure On Arteries Of Upper... $171.00 $2,169.09
01840 Anesthesia For Other Procedure On Arteries Of Forearm,... $157.54 $2,129.44
01931 Anesthesia For X-Ray On Vein Of Liver $204.66 $2,645.63
01520 Anesthesia For Other Procedure On Vein Of Lower Leg $111.11 $1,409.86
00550 Anesthesia For Removal Of Breast Bone Tissue $241.90 $2,816.97
00635 Anesthesia For Spinal Tap $98.50 $1,346.73
01170 Anesthesia For Procedure On Pubic Bone Or Pelvic Joint $188.88 $2,435.56
01382 Anesthesia For Exam Of Knee Joint Using An Endoscope $81.61 $1,327.91
01202 Anesthesia For Procedure On Hip Joint Using An... $130.13 $1,763.37
01274 Anesthesia For Removal Of Blood Clot In Artery Of... $210.78 $2,738.61
01961 Anesthesia For Cesarean Delivery $164.42 $1,964.91
01952 Anesthesia For Treatment Of Second And Third Degree... $159.36 $2,001.68
01967 Anesthesia For Labor During Planned Vaginal Delivery $405.62 $3,136.64
00176 Anesthesia For Extensive Surgery On Mouth $335.19 $4,264.88
00702 Anesthesia For Biopsy Of Liver $90.94 $1,195.64
00866 Anesthesia For Removal Of Adrenal Gland $285.32 $3,414.39
01716 Anesthesia For Procedure On Tendon Of Upper Arm Muscle $146.60 $1,890.48
00500 Anesthesia For Procedure On Esophagus $520.90 $5,861.38
00192 Anesthesia For Extensive Surgery On Face Bones Or Skull $250.31 $3,178.86
00844 Anesthesia For Procedure On Large Bowel $314.36 $3,728.49
01173 Anesthesia For Repair Of Broken Hip Bone $290.95 $3,617.08
01714 Anesthesia For Repair Of Elbow To Shoulder Tendon $136.69 $1,763.00
00524 Anesthesia For Closed Drainage Of Lung Fluid $94.00 $1,316.70
00215 Anesthesia For Procedure To Repair Skull Or Skull... $250.50 $3,137.41
00470 Anesthesia For Other Partial Removal Of Rib $168.18 $2,150.76
00580 Anesthesia For Heart Or Heart-Lung Transplant $805.09 $8,261.21
00796 Anesthesia For Liver Transplant Recipient Including... $920.11 $9,138.33
01622 Anesthesia For Exam Of Shoulder Joint Using An... $119.09 $1,889.06
01712 Anesthesia For Procedure On Tendon Of Elbow To Shoulder $110.17 $1,420.17
00216 Anesthesia For Procedure On Blood Vessels In Brain $454.47 $5,529.55
00820 Anesthesia For Procedure On Lower Rear Abdomen $108.71 $1,408.81
01260 Anesthesia For Procedure On Veins In Upper Leg $115.40 $1,244.79
00640 Anesthesia For Manipulation Or Closed Procedure Of... $89.59 $1,426.78
00802 Anesthesia For Removal Of Excess Tissue Of Lower Rear... $185.84 $2,431.29
00916 Anesthesia For Procedure To Control Urinary System... $126.19 $1,545.87
01772 Anesthesia For Removal Of Blood Clot From Upper Arm Or... $177.81 $2,284.17
00872 Anesthesia For Shock Wave Therapy For Urinary System... $125.23 $1,533.57
01760 Anesthesia For Total Elbow Joint Replacement $234.08 $3,167.44
00162 Anesthesia For Extensive Surgery On Nose And Sinuses $261.94 $3,019.97
01656 Anesthesia For Bypass Graft From Groin Artery To... $336.48 $4,163.64
01444 Anesthesia For Repair Of Bulging (aneurysm) Defect In... $304.79 $3,683.21
00926 Anesthesia For Removal Of Testicle Through Groin $118.47 $1,485.13
01951 Anesthesia For Treatment Of Second And Third Degree... $107.31 $1,296.34
01390 Anesthesia For Closed Procedure On Kneecap And/or... $94.48 $1,362.46
00124 Anesthesia For Exam Of Ear Using An Endoscope $71.02 $931.16
00147 Anesthesia For Procedure On Eye For Removal Of Iris $99.10 $1,267.49
01502 Anesthesia For Removal Of Blood Clot In Artery Of... $215.20 $2,813.42
01756 Anesthesia For Extensive Procedure On Elbow $173.55 $2,048.92
01932 Anesthesia For X-Ray On Vein Of Chest Or Neck $178.35 $2,561.33
01730 Anesthesia For Closed Procedure On Upper Arm And Elbow $93.89 $1,230.99
00730 Anesthesia For Procedure On Upper Rear Abdomen $110.57 $1,376.96
01965 Anesthesia For Incomplete Or Missed Abortion $85.67 $1,159.84
00870 Anesthesia For Removal Of Urinary Bladder Stone $138.59 $1,566.57
01340 Anesthesia For Closed Procedure On Lower 1/3rd Of... $126.73 $1,675.35
01953 Anesthesia For Treatment Of Second And Third Degree... $16.46 $159.36
01484 Anesthesia For Open Reconstruction Of Lower Leg,... $167.81 $2,130.30
01650 Anesthesia For Other Procedure On Arteries Of Shoulder... $197.26 $2,493.50
00625 Anesthesia For Procedure On Middle Spine Through Chest... $312.27 $3,577.33
01150 Anesthesia For Extensive Removal Of Growth Of Hip Bone $313.92 $3,375.77
01404 Anesthesia For Removal Of Leg At Knee Joint $161.76 $1,940.27
00848 Anesthesia For Removal Of Pelvic Organs Including Use... $402.01 $4,208.06
01522 Anesthesia For Removal Of Obstruction In Vein Of Lower... $186.16 $2,459.09
01652 Anesthesia For Repair Of Bulging Artery Of Shoulder... $239.23 $3,210.22
00222 Anesthesia For Procedure On Nerve In Brain $136.30 $1,649.39
01430 Anesthesia For Other Procedure On Vein Of Knee $119.37 $638.70
01842 Anesthesia For Removal Of Blood Clot In Artery Of... $183.24 $2,357.60
01442 Anesthesia For Removal Of Blood Clot Of Artery Behind... $281.11 $3,678.44
00148 Anesthesia For Exam Of Inner Eye Using An Endoscope $75.73 $816.37
00522 Anesthesia For Closed Needle Biopsy Of Lung $98.39 $1,141.32
00930 Anesthesia For Relocation Of Undescended Testicle Into... $128.10 $1,667.07
00756 Anesthesia For Procedure To Repair Abdominal Hernia $257.39 $2,835.97
00472 Anesthesia For Partial Removal Of Rib And Chest Wall... $270.52 $2,967.61
01212 Anesthesia For Removal Of Hip Bone At Joint $282.23 $3,420.26
01780 Anesthesia For Other Procedure On Veins Of Upper Arm... $132.19 $1,342.92
01968 Anesthesia For Cesarean Delivery Following Labor $113.34 $1,325.29
00474 Anesthesia For Extensive Partial Removal Of Rib $348.20 $4,315.11
00604 Anesthesia For Procedure On Upper Spine With Sitting Up $288.30 $3,303.42
01234 Anesthesia For Removal Of Muscle Or Tissue On Upper... $244.74 $2,706.80
00218 Anesthesia For Procedure On Brain While Sitting Up $334.78 $3,918.60
00851 Anesthesia For Tying Or Incision Of Fallopian Tubes... $141.14 $1,585.77
00322 Anesthesia For Needle Biopsy Of Thyroid $84.36 $1,696.18
01832 Anesthesia For Total Wrist Joint Replacement $184.99 $2,268.21
01933 Anesthesia For X-Ray On Vein Of Brain $194.64 $2,760.70
01654 Anesthesia For Bypass Graft On Artery Of Shoulder And... $272.86 $3,387.13
01758 Anesthesia For Removal Of Cyst Or Growth Of Upper Arm $141.02 $1,752.44
00548 Anesthesia For Procedure On Airway $376.34 $3,948.26
00539 Anesthesia For Reconstruction Of Airway $531.71 $6,047.66
00908 Anesthesia For Removal Of Prostate $226.92 $3,265.84
00932 Anesthesia For Complete Amputation Of Penis $192.39 $2,437.84
00921 Anesthesia For Vasectomy $76.77 $1,019.12
00454 Anesthesia For Biopsy Of Collar Bone $79.68 $989.22
01990 Physiological Support For Harvesting Of Organs $251.59 $2,821.90
00406 Anesthesia For Removal Of Breast And Lymph Nodes $366.26 $5,507.61
01742 Anesthesia For Incision Or Partial Removal Of Upper... $187.58 $2,299.57
01420 Anesthesia For Application, Removal, Or Repair Of Cast... $87.31 $1,161.85
00948 Anesthesia For Suture Closure Of Cervix $105.94 $1,182.68
01829 Anesthesia For Exam Of Wrist Using An Endoscope $92.37 $1,429.75
00172 Anesthesia For Procedure On Mouth To Repair Palate... $177.23 $2,120.17
01272 Anesthesia For Tying Of Artery Of Upper Leg $159.74 $2,061.83
00164 Anesthesia For Biopsy Of Soft Tissue Of Nose And Sinus $87.98 $1,121.58
01850 Anesthesia For Other Procedure On Veins Of Forearm,... $116.44 $1,650.91
00882 Anesthesia For Tying Of Large Vein Of Lower Abdomen $282.70 $3,014.40
00626 Anesthesia For Procedure On Middle Spine Through Chest... $445.92 $6,143.52
01490 Anesthesia For Application, Removal, Or Repair Of Cast... $78.41 $1,068.81
01966 Anesthesia For Induced Abortion $96.79 $1,205.13
01782 Anesthesia For Suture Of Vein Of Upper Arm And Elbow $175.77 $2,362.39
01999 Other Anesthesia Procedure $146.96 $1,284.05
01962 Anesthesia For Procedure To Remove Uterus Following... $241.79 $3,131.47
00754 Anesthesia For Procedure To Repair Upper Abdominal... $161.95 $1,709.83
01732 Anesthesia For Exam Of Elbow Joint Using An Endoscope $100.76 $1,627.18
01432 Anesthesia For Repair Of Abnormal Artery-Vein... $238.19 $2,822.26
00924 Anesthesia For Procedure On Undescended Testicle $120.20 $1,567.40
01670 Anesthesia For Procedure On Veins Of Shoulder And... $174.91 $2,114.54
00212 Anesthesia For Removal Of Fluid From Brain $150.60 $2,073.27
01140 Anesthesia For Amputation Of Leg Including Pelvic Bone $459.48 $5,575.13
01860 Anesthesia For Application, Removal, Or Repair Cast To... $113.73 $1,193.50
00102 Anesthesia For Plastic Repair Of Lip Defect $161.68 $2,329.54
00632 Anesthesia For Removal Of Nerves In Lower Spine $197.21 $2,560.09
00546 Anesthesia For Removal Of Lung With Chest Wall Repair $394.31 $3,421.09
01634 Anesthesia For Removal Of Arm At Shoulder Joint $231.46 $2,600.02
00922 Anesthesia For Procedure On Male Genital Glands $181.33 $2,200.32
01636 Anesthesia For Open Or Endoscopic Amputation Of Arm,... $343.30 $4,030.91
01852 Anesthesia For Suture Of Forearm, Wrist, Or Hand Vein $149.41 $1,475.31
00928 Anesthesia For Removal Of Testicle Through Incision In... $221.19 $2,837.74
01960 Anesthesia For Vaginal Delivery $178.48 $1,254.40

Reading Anesthesia Pricing Data

The 262 procedure codes grouped under Anesthesia share a common clinical taxonomy in the CMS Medicare Physician & Other Practitioners dataset. Across this category, the average Medicare payment is $188.65 — the figure Medicare actually reimburses providers for the allowed amount after geographic and specialty adjustments. Anesthesia services for surgical procedures Each CPT/HCPCS code in the table above carries its own fee schedule value determined by CMS's Resource-Based Relative Value Scale (RBRVS), which weights physician work, practice expense, and professional liability.

Billed charges — the "Billed" column — often run several multiples above Medicare allowed amounts. This is expected under US chargemaster pricing practices: providers list a gross rate, then accept negotiated write-offs from Medicare, Medicaid, and commercial insurers under participation agreements. A high markup ratio does not necessarily indicate overcharging, because almost no payer pays the full billed charge. However, uninsured and out-of-network patients can be exposed to amounts closer to the billed rate, which is why federal rules now require providers to publish cash and negotiated prices through the Hospital Price Transparency initiative.

Volume matters when interpreting category-level data. Procedures with millions of annual services — evaluation visits, common diagnostic work — reflect stable, well-benchmarked pricing. Lower-volume codes may show wider variation across providers and settings because small sample sizes produce less stable averages. When comparing specific procedures, drill into the individual procedure page for state-level breakdowns, provider counts, and commercial pricing estimates derived from RAND 2024 research. This page presents CMS reference data for educational use; it does not constitute medical, legal, or financial advice.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial  · Verify with CMS →

Disclaimer: This information is provided for informational purposes only and does not constitute professional advice. Data is sourced from CMS (Centers for Medicare and Medicaid Services). Consult a qualified professional before making decisions based on this data.

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