How much does Medicare pay for CPT 00160?

Medicare allowed an average of $150.31 per service and paid $117.77 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1601.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00160?

Anesthesia for other procedure on nose and sinuses. It was billed 9,468 times to 9,375 Medicare beneficiaries by 510 providers in 2024.

Does 00160 pay differently in an office than a hospital?

Yes. The allowed amount averaged $160.71 in an office setting and $147.99 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 00160 most?

Anesthesiology, with 5,647 services from 294 clinicians. Next are Certified Registered Nurse Anesthetist (CRNA), Anesthesiology Assistant.

CPT 00160

Anesthesia for other procedure on nose and sinuses

$150.31Medicare-allowed amount per service, averaged across 9,468 services

Providers submitted

$1601.56

Asking price, not received

Medicare allowed

$150.31

The fee schedule figure

Medicare paid

$117.77

Balance is patient coinsurance

Providers submitted an average of $1601.56 for this code and Medicare allowed $150.31 — 10.7× 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 $117.77 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $160.71
Hospital / facility: $147.99

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,730 services were billed in an office setting and 7,738 in a facility.

Services: 9,468
Beneficiaries: 9,375
Providers billing it: 510
Total allowed: $1,423,135

What Medicare pays for CPT 00160

Across 9,468 services billed by 510 providers to 9,375 beneficiaries, Medicare allowed an average of $150.31 per service. 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 00160

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	5,647	5,600	$154.15	294
Certified Registered Nurse Anesthetist (CRNA)	3,635	3,591	$146.96	203
Anesthesiology Assistant	186	184	$99.22	13

00160 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
Texas	1,480	$139.67	$111.11	75
Florida	647	$135.10	$104.39	35
Tennessee	588	$144.87	$118.18	24
Kansas	581	$106.18	$86.24	22
Arizona	556	$189.84	$151.33	23
California	489	$231.33	$175.17	28
South Carolina	483	$142.50	$115.17	22
Georgia	445	$143.35	$113.28	28
Pennsylvania	432	$140.42	$108.77	28
North Carolina	351	$111.27	$87.50	20
Alabama	279	$108.67	$89.95	18
Mississippi	266	$152.12	$122.61	16
Ohio	252	$125.49	$98.20	17
Virginia	221	$147.89	$117.41	15
Indiana	214	$157.95	$128.64	8
Missouri	206	$98.63	$76.99	12
Massachusetts	193	$192.08	$144.59	11
New York	170	$175.74	$134.60	9
Washington	140	$185.94	$142.26	9
Oklahoma	132	$196.05	$160.31	11
Maryland	125	$191.78	$141.56	9
Illinois	125	$185.34	$144.27	5
Arkansas	124	$154.09	$127.96	7
Michigan	89	$127.22	$97.98	6
Colorado	79	$193.33	$146.16	5
Minnesota	77	$129.82	$97.12	4
Kentucky	72	$144.59	$122.40	4
Utah	71	$185.81	$156.41	3
Louisiana	68	$158.56	$123.88	5
Nevada	52	$193.70	$152.21	3
Delaware	41	$114.10	$89.58	3
New Jersey	40	$124.01	$94.73	2
Hawaii	35	$211.15	$172.42	1
District of Columbia	34	$119.18	$91.28	2
Montana	33	$191.98	$153.20	2
Connecticut	33	$113.63	$86.12	2
Rhode Island	32	$95.60	$68.02	1
Nebraska	29	$178.25	$146.28	2
New Mexico	27	$157.97	$121.01	2
Alaska	26	$288.45	$167.28	2
Maine	25	$198.25	$150.58	1
New Hampshire	17	$109.71	$99.49	1
Wyoming	15	$173.74	$140.76	1
West Virginia	15	$101.65	$77.33	1
Idaho	13	$230.31	$193.00	1
Iowa	12	$179.38	$150.25	1
Oregon	12	$222.14	$176.99	1
Puerto Rico	11	$351.67	$281.58	1
ZZ	11	$179.47	$150.40	1

Related codes

00142Anesthesia for lens surgery$94.99
00140Anesthesia for other procedure on eye$123.68
00145Anesthesia for retinal surgery$148.90
00104Anesthesia for electroshock therapy$80.75
00103Anesthesia for procedure on eyelid$139.67
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.