How much does Medicare pay for CPT 00170?

Medicare allowed an average of $148.06 per service and paid $105.91 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1396.37, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00170?

Anesthesia for other procedure on mouth. It was billed 3,442 times to 3,331 Medicare beneficiaries by 181 providers in 2024.

Does 00170 pay differently in an office than a hospital?

Yes. The allowed amount averaged $183.94 in an office setting and $143.46 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 00170 most?

Certified Registered Nurse Anesthetist (CRNA), with 1,773 services from 83 clinicians. Next are Anesthesiology, Anesthesiology Assistant, Dentist.

CPT 00170

Anesthesia for other procedure on mouth

$148.06Medicare-allowed amount per service, averaged across 3,442 services

Providers submitted

$1396.37

Asking price, not received

Medicare allowed

$148.06

The fee schedule figure

Medicare paid

$105.91

Balance is patient coinsurance

Providers submitted an average of $1396.37 for this code and Medicare allowed $148.06 — 9.4× 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 $105.91 (72%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $183.94
Hospital / facility: $143.46

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. 391 services were billed in an office setting and 3,051 in a facility.

Services: 3,442
Beneficiaries: 3,331
Providers billing it: 181
Total allowed: $509,623

What Medicare pays for CPT 00170

Across 3,442 services billed by 181 providers to 3,331 beneficiaries, Medicare allowed an average of $148.06 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 00170

Specialty	Services	Beneficiaries	Avg allowed	Providers
Certified Registered Nurse Anesthetist (CRNA)	1,773	1,677	$148.82	83
Anesthesiology	1,561	1,548	$142.01	91
Anesthesiology Assistant	40	39	$80.71	3
Dentist	31	31	$352.92	1
General Practice	14	14	$132.91	1
Oral Surgery (Dentist only)	12	11	$545.38	1
General Surgery	11	11	$135.44	1

00170 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	422	$126.26	$96.69	23
Pennsylvania	399	$111.60	$88.87	21
Oklahoma	310	$164.51	$120.30	5
Kansas	256	$178.60	$106.07	9
California	202	$175.99	$116.02	9
Minnesota	175	$152.52	$118.32	13
Connecticut	171	$138.96	$97.90	10
Florida	162	$147.08	$102.64	10
New York	133	$174.20	$116.95	7
Indiana	123	$82.16	$57.29	7
New Jersey	121	$194.72	$126.00	5
Illinois	105	$219.01	$150.65	7
Utah	101	$207.59	$142.98	4
Missouri	69	$142.19	$96.36	3
Kentucky	64	$135.13	$102.01	5
Tennessee	55	$98.45	$80.96	3
Nebraska	54	$168.19	$124.63	3
Georgia	51	$99.35	$75.76	4
Maryland	50	$124.03	$91.71	4
South Carolina	46	$101.06	$81.20	3
Delaware	45	$188.73	$141.01	4
Arizona	44	$174.47	$140.48	3
Louisiana	42	$98.32	$79.53	3
Ohio	38	$145.37	$101.82	3
District of Columbia	34	$62.68	$48.96	1
Arkansas	29	$162.95	$131.97	2
Mississippi	27	$98.57	$86.55	2
Virginia	24	$249.76	$174.34	2
Massachusetts	19	$228.16	$164.03	1
Wisconsin	16	$257.24	$191.00	1
West Virginia	15	$66.83	$51.24	1
North Dakota	14	$98.11	$80.48	1
Colorado	14	$127.58	$101.68	1
Michigan	12	$135.74	$97.33	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
00160Anesthesia for other procedure on nose and sinuses$150.31
00144Anesthesia for procedure on eye for corneal transplant$143.81
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.