CPT Anesthesia fees calculator


Once a CPT Anesthesia code was selected, Text2Codes will help you calculate the Anesthesia fees in your region

Enter the Time and Modifying units in the appropriate boxes and hit the return key
Text2Codes will recalculate the Anesthesia fees

Below the fees you can find the Anesthesia Modifiers


Background

How to determine the Anesthesia Fees:
. Determine the appropriate CPT code(s) for the surgical procedure(s) performed and the appropriate ASA code.
. The ASA code will determine the number of base units.
. Set the appropriate number of time units.
. Assign the appropriate physical status modifier, modifier to identify MAC services
. Set the appropriate modifying units.
. Determine the total units for the anesthesia services

The general formula for calculating anesthesia charges is as follows:

(Base units + Time units + Modifying units) x Conversion factor = Anesthesia fees

Base units
Each anesthesia CPT code has a base unit value. The Base units are published once a year by CMS.
The base unit value is reflective of the difficulty and skill required for the procedure.
Crosswalk all surgical procedures performed and pick the anesthesia code with the highest base units value - that is best describing the anesthetic services provided.
Only one anesthesia code is reported

Time Units = Total Minutes of Service / 15
Begins: When the anesthesia provider prepares the patient for the induction of anesthesia in the operating room or equivalent area
Ends: When the anesthesia provider is no longer in personal attendance (patient is safely placed under post-operative supervision)
A "Time Unit" is a measure of each 15-minute interval, or fraction thereof, during which anesthesiology services are performed.
This value must be calculated based upon the length of time spent by the provider rendering the service.
AMA and ASA recommend that 1 unit of time is equal to 15 minutes of anesthesia time
Time is rounded up to the next unit after 7 ½ minutes is reached or it may be submitted as a decimal like 3.6
Refer to your local payer contracts and policies for specific guidance for reporting time.
Note: Not all carriers accept rounding the Time Unit or a fraction of Time Unit. Check with you local carrier if time units such as 3.6 are accepted and what are the rounding rules.

Modifying Units
Modifying units such as ASA Physical Status, Age, Position, Additional Circumstances, Lines and etc. may or may not be accepted by you local carrier.
Note: Not all carriers accept Modifying Units. Check with you local carrier the details of the accepted Modifying Units.

Conversion Factor
The Conversion Factor is specific to each carrier and location and it is published once a year by CMS.

For more information on Anesthesia Fee visit the Anesthesiologists Center at CMS web site
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