Anesthesia Payment Calculator
Anesthesia pays on units, not RVUs. Enter the base units, anesthesia time and any qualifying circumstances, and price the case with the official CY 2026 conversion factor for your locality.
Anesthesia is the one corner of the fee schedule that does not use RVUs. Payment is built from units: the base units assigned to the anesthesia code, plus time units (one for every 15 minutes of anesthesia time), plus any qualifying-circumstance units — all multiplied by an anesthesia conversion factor (CF) that varies by Medicare locality. Enter your case below and see the full unit math with the official CY 2026 conversion factors.
Calculate an anesthesia payment
Where the numbers come from
- Conversion factors are official. The locality list and CF amounts are the CY 2026 anesthesia conversion factors CMS publishes in the Relative Value File (ANES2026). The national CF is $20.49754, or $20.599835 for Qualifying APM Participants — both figures already include the 2.5% statutory increase for 2026.
- Base units are yours to enter — honestly. CMS does not publish anesthesia base units: the Medicare fee schedule file carries every anesthesia code with zero RVUs, because base units are assigned by the American Society of Anesthesiologists' Relative Value Guide (a licensed publication). Rather than invent or scrape values we cannot verify, this calculator asks you to type the base units from your RVG or billing system and does everything else for you.
- Time units = minutes ÷ 15. Medicare counts anesthesia time from when the anesthesiologist begins preparing the patient until care is transferred; some payers round time units, so treat the result as an estimate.
- Medicare does not pay qualifying circumstances separately. Medicare considers 99100–99140 included and does not add their units, and it does not add units for physical-status modifiers either. Many commercial payers follow the full ASA unit formula — which is why those inputs are here — but for a Medicare estimate, leave the boxes unchecked.
Data: CMS CY 2026 Physician Fee Schedule Relative Value File (RVU26D), ANES2026 anesthesia conversion factors. Looking for a non-anesthesia code? Use the Medicare Fee Schedule Calculator.
Disclaimer: This tool is for educational and estimation purposes only and does not constitute billing, coding or medical advice. Coverage, coding and payment rules vary by payer and change over time — always verify with the current CMS files and the payer's own policy before submitting claims or making financial decisions.
Frequently asked questions
How is anesthesia payment calculated?
Payment = (base units + time units + modifying units) × the anesthesia conversion factor. Time units are the anesthesia minutes divided by 15. The conversion factor is locality-specific; CMS publishes the CY 2026 factors in its Relative Value File, and this tool's locality list and amounts come straight from that file.
Why do I have to enter the base units myself?
Because CMS does not publish them. In the Medicare fee schedule file every anesthesia code carries zero RVUs — base units are assigned by the American Society of Anesthesiologists in its Relative Value Guide, which is a licensed publication. Any free tool showing you base units without a licence is republishing ASA data; we ask you to read the value from your own RVG or billing system instead.
Does Medicare pay extra for qualifying circumstance codes 99100–99140?
No. Medicare does not separately pay the qualifying circumstance codes or add units for physical-status modifiers — it considers them included in the base value of the anesthesia service. Many commercial payers do follow the full ASA unit formula, which is why this calculator lets you include those units for non-Medicare estimates.