Anesthesiology Billing Cheat Sheet (2026)

Anesthesia is the one specialty that does not bill on RVUs. Payment is base units plus time units times a conversion factor, adjusted by who directed the case and how sick the patient was. The denials come from time documentation and the medical-direction modifiers.

AAPC-Certified
2026 Medicare Fee Schedule
10 Codes Priced

Quick reference for anesthesiology billers. Last updated .

Top Anesthesiology CPT Codes & 2026 Medicare Allowables

CodeDescriptionNon-FacilityFacilityTotal RVU
00400Anesthesia for procedures on integumentary systemn/an/a0.00
00170Anesthesia for intraoral proceduresn/an/a0.00
00832Anesthesia for hernia repairsn/an/a0.00
01402Anesthesia for total knee arthroplastyn/an/a0.00
01967Neuraxial labor analgesia (epidural)n/an/a0.00
01996Daily management of epidural drug administrationn/an/a0.00
64483Lumbar transforaminal epidural injection$264.87$99.537.93
62323Lumbar or sacral epidural injection$273.22$89.188.18
99155Moderate sedation, first 15 minutes$81.50$81.502.44
99100Anesthesia for patient of extreme age (under 1 year, 70+)n/an/a0.00

National 2026 Medicare Physician Fee Schedule estimates (total RVU multiplied by the conversion factor). These are adjusted by state locality. See the per-state table on the Anesthesiology billing services page.

Modifiers That Prevent Anesthesiology Denials

AA

Anesthesia personally performed by the anesthesiologist, the highest payment tier.

QK

Medical direction of two to four concurrent procedures by the anesthesiologist.

QX

CRNA service with medical direction by a physician.

QZ

CRNA service without medical direction.

QY

Medical direction of one CRNA by an anesthesiologist.

P1 to P6

ASA physical status, which adds units for a sicker patient where the payer recognizes it.

Top Anesthesiology Denials → Quick Fix

Anesthesia time not supportedCO-16

Document continuous anesthesia start and stop times. Time units are computed from recorded minutes; an unsupported time is a coding-accuracy denial.

Medical-direction modifier mismatchCO-4

The direction modifier (AA, QK, QX, QY, QZ) must match the actual staffing and concurrency. A mismatch with the records reprices or denies the claim.

Labor epidural time billed incorrectlyCO-16

Bill neuraxial labor analgesia per the payer's methodology (incremental time, flat fee, or capped time). Document placement and management time per that rule.

Daily epidural management bundledCO-97

Daily management of epidural drug administration (01996) is separate from the placement and is billed per day with documentation.

Qualifying circumstances not documentedCO-16

Add-on qualifying circumstances such as extreme age (99100) require the documented condition. Without it the add-on units are denied.

NCCI Bundling Watch-Outs

Code pairs from this specialty's set that carry NCCI edits. Billing both without a justified modifier triggers a bundling denial.

CodeBundles WithRationale
0040001996Standard preparation/monitoring services for anesthesia
004000213TStandard preparation/monitoring services for anesthesia
0017001996Standard preparation/monitoring services for anesthesia
001700213TStandard preparation/monitoring services for anesthesia
0083200834Misuse of Column Two code with Column One code
0083200836Misuse of Column Two code with Column One code
0140201996Standard preparation/monitoring services for anesthesia
014020213TStandard preparation/monitoring services for anesthesia

Documentation That Holds Up on Appeal

Every anesthesia case

Continuous start and stop times, since time units come directly from recorded minutes.

Concurrency and staffing

Who performed and who directed, and how many concurrent cases, supporting the AA, QK, QX, QY, or QZ modifier.

Physical status

The ASA physical status and the conditions supporting P3 and above where the payer adds units.

Labor analgesia (01967)

Placement time and management per the payer's labor methodology.

Qualifying circumstances (99100, 99140)

The condition (extreme age, emergency, hypothermia) that supports the add-on units.

Revenue Anesthesiology Practices Leave on the Table

$

Time units short of the record because anesthesia minutes were not continuously documented.

$

Direction modifier that does not match staffing, which reprices the case down or denies it.

$

Not billing daily epidural management separately from the placement.

$

Missing qualifying-circumstance and physical-status units the documentation would support.

Anesthesiology Billing FAQ

How is anesthesia payment calculated?

Base units for the procedure plus time units from recorded minutes, times a conversion factor, adjusted by physical status and qualifying circumstances. Continuous start and stop times are what make the time units defensible.

Why do direction modifiers cause denials?

Because AA, QK, QX, QY, and QZ each describe a specific staffing and concurrency arrangement. If the modifier does not match the anesthesia record, the payer reprices or denies.

How is a labor epidural billed?

Per the payer's neuraxial labor methodology, which varies between incremental time, a flat fee, and capped time. Placement and management time have to be documented to that payer's rule.

Is daily epidural management separate?

Yes. Daily management of epidural drug administration (01996) is billed per day and is separate from the placement procedure, with documentation each day.

Stop Losing Anesthesiology Revenue to Preventable Denials

Our AAPC-certified anesthesiology coders apply every rule on this sheet to your claims. Call 888-701-6090 for a free billing assessment.