How much does Medicare pay for CPT 00104?

Medicare allowed an average of $80.75 per service and paid $63.53 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $824.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00104?

Anesthesia for electroshock therapy. It was billed 67,785 times to 31,315 Medicare beneficiaries by 1,514 providers in 2024.

Does 00104 pay differently in an office than a hospital?

Yes. The allowed amount averaged $63.45 in an office setting and $80.99 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 00104 most?

Anesthesiology, with 49,030 services from 1,036 clinicians. Next are Certified Registered Nurse Anesthetist (CRNA), Anesthesiology Assistant, Critical Care (Intensivists).

CPT 00104

Anesthesia for electroshock therapy

$80.75Medicare-allowed amount per service, averaged across 67,785 services

Providers submitted

$824.56

Asking price, not received

Medicare allowed

$80.75

The fee schedule figure

Medicare paid

$63.53

Balance is patient coinsurance

Providers submitted an average of $824.56 for this code and Medicare allowed $80.75 — 10.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $63.53 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $63.45
Hospital / facility: $80.99

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 899 services were billed in an office setting and 66,886 in a facility.

Services: 67,785
Beneficiaries: 31,315
Providers billing it: 1,514
Total allowed: $5,473,639

What Medicare pays for CPT 00104

Across 67,785 services billed by 1,514 providers to 31,315 beneficiaries, Medicare allowed an average of $80.75 per service. That is 2.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 00104

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	49,030	22,055	$86.84	1,036
Certified Registered Nurse Anesthetist (CRNA)	16,635	8,166	$65.66	425
Anesthesiology Assistant	1,252	719	$51.89	39
Critical Care (Intensivists)	570	248	$68.40	7
Pain Management	213	55	$52.36	2
Internal Medicine	50	41	$105.42	3
Pediatric Medicine	23	20	$102.24	1
Urology	12	11	$110.62	1

00104 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	7,043	$97.73	$70.03	97
Massachusetts	7,034	$60.79	$45.26	82
Minnesota	5,563	$61.41	$49.32	163
California	5,169	$108.10	$80.11	115
Illinois	3,219	$85.51	$64.06	84
Florida	2,888	$93.05	$71.40	49
Michigan	2,797	$68.19	$52.51	70
New Jersey	2,538	$101.72	$74.90	48
Texas	2,108	$86.23	$67.58	49
Missouri	1,900	$75.15	$59.86	45
Ohio	1,881	$61.77	$49.30	37
Tennessee	1,858	$77.48	$63.42	38
Pennsylvania	1,716	$81.97	$62.84	25
Georgia	1,551	$69.23	$53.47	27
New Hampshire	1,480	$54.36	$42.97	62
Nebraska	1,357	$89.11	$74.88	17
North Carolina	1,269	$76.63	$62.62	47
Vermont	1,202	$53.08	$43.51	39
Indiana	1,122	$92.41	$76.06	25
Colorado	1,095	$94.55	$75.01	35
Maryland	1,091	$98.00	$73.51	22
South Dakota	1,062	$45.84	$37.68	25
South Carolina	893	$83.60	$67.06	27
Virginia	885	$67.52	$54.53	41
Iowa	854	$85.70	$69.79	17
Arizona	755	$109.33	$82.77	14
Maine	667	$56.68	$45.00	28
Utah	637	$103.70	$84.43	10
New Mexico	618	$79.70	$61.66	16
Connecticut	604	$95.19	$71.98	15
Wisconsin	569	$56.95	$46.59	16
Rhode Island	555	$66.10	$50.23	6
District of Columbia	523	$109.46	$80.61	18
Oklahoma	517	$97.58	$79.06	9
Alabama	474	$54.97	$45.60	17
Washington	436	$105.10	$78.09	18
North Dakota	423	$101.26	$82.01	12
Mississippi	311	$79.85	$65.26	9
Kansas	291	$61.02	$50.13	14
Kentucky	223	$101.08	$81.21	3
Oregon	147	$60.53	$47.00	4
Delaware	128	$94.91	$76.88	7
Louisiana	117	$93.57	$76.37	5
Arkansas	105	$83.71	$72.97	3
Puerto Rico	33	$112.73	$85.63	1
Nevada	28	$50.59	$39.69	1
West Virginia	27	$50.77	$41.81	1
AA	22	$90.97	$73.70	1

Related codes

00142Anesthesia for lens surgery$94.99
00140Anesthesia for other procedure on eye$123.68
00145Anesthesia for retinal surgery$148.90
00103Anesthesia for procedure on eyelid$139.67
00160Anesthesia for other procedure on nose and sinuses$150.31
00144Anesthesia for procedure on eye for corneal transplant$143.81
00170Anesthesia for other procedure on mouth$148.06
00120Anesthesia for other procedure on external middle and inner ear$184.90

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.