How much does Medicare pay for CPT 00520?

Medicare allowed an average of $146.70 per service and paid $116.04 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1621.47, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00520?

Anesthesia for other closed procedure on chest. It was billed 50,722 times to 49,483 Medicare beneficiaries by 2,647 providers in 2024.

Does 00520 pay differently in an office than a hospital?

Yes. The allowed amount averaged $138.18 in an office setting and $146.78 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 00520 most?

Anesthesiology, with 31,930 services from 1,625 clinicians. Next are Certified Registered Nurse Anesthetist (CRNA), Anesthesiology Assistant, Critical Care (Intensivists).

CPT 00520

Anesthesia for other closed procedure on chest

$146.70Medicare-allowed amount per service, averaged across 50,722 services

Providers submitted

$1621.47

Asking price, not received

Medicare allowed

$146.70

The fee schedule figure

Medicare paid

$116.04

Balance is patient coinsurance

Providers submitted an average of $1621.47 for this code and Medicare allowed $146.70 — 11.1× 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 $116.04 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $138.18
Hospital / facility: $146.78

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 469 services were billed in an office setting and 50,253 in a facility.

Services: 50,722
Beneficiaries: 49,483
Providers billing it: 2,647
Total allowed: $7,440,917

What Medicare pays for CPT 00520

Across 50,722 services billed by 2,647 providers to 49,483 beneficiaries, Medicare allowed an average of $146.70 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 00520

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	31,930	31,110	$147.16	1,625
Certified Registered Nurse Anesthetist (CRNA)	16,953	16,570	$148.33	925
Anesthesiology Assistant	1,077	1,055	$110.70	59
Critical Care (Intensivists)	304	300	$122.55	16
Pain Management	181	178	$128.23	12
Interventional Pain Management	108	105	$165.54	4
Internal Medicine	71	69	$225.18	3
Sleep Medicine	56	55	$172.25	1
Physical Medicine and Rehabilitation	30	30	$96.55	1
Allergy/ Immunology	12	11	$111.71	1

00520 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
Florida	5,733	$135.97	$104.53	290
Texas	4,466	$138.76	$110.14	202
New York	3,352	$175.34	$124.70	174
California	3,211	$195.79	$146.70	150
Pennsylvania	3,030	$138.37	$107.52	166
Arizona	2,520	$147.24	$117.20	117
Ohio	2,478	$130.31	$104.12	117
North Carolina	2,312	$103.67	$84.99	123
Tennessee	2,272	$130.57	$106.39	107
Illinois	2,133	$165.16	$122.96	121
Massachusetts	1,837	$198.39	$147.79	78
Georgia	1,691	$129.95	$102.35	88
South Carolina	1,327	$109.52	$89.03	78
Indiana	1,219	$145.44	$119.38	68
Maryland	1,092	$173.03	$133.65	57
Kentucky	1,075	$132.11	$106.69	51
Michigan	1,044	$126.56	$96.89	62
Virginia	1,021	$169.74	$130.07	46
New Jersey	863	$138.53	$103.58	57
Missouri	812	$124.53	$99.33	56
Kansas	803	$150.67	$121.13	49
Mississippi	728	$116.16	$93.81	43
Connecticut	548	$155.88	$118.13	27
Minnesota	496	$152.00	$118.83	31
Alabama	402	$117.69	$98.18	22
Louisiana	386	$160.09	$128.88	24
Oklahoma	365	$179.21	$143.73	24
Colorado	351	$158.19	$121.97	14
Delaware	328	$143.62	$113.69	19
South Dakota	322	$102.11	$84.30	22
District of Columbia	292	$143.10	$105.23	16
Arkansas	257	$166.21	$137.33	17
West Virginia	248	$128.52	$102.48	13
Washington	234	$183.50	$141.78	17
Wisconsin	234	$148.24	$123.33	17
Nebraska	203	$140.98	$119.49	14
New Hampshire	180	$148.20	$117.01	13
Oregon	139	$169.74	$134.60	7
Iowa	135	$156.04	$121.88	9
North Dakota	122	$121.79	$98.36	9
Utah	93	$197.29	$146.79	6
Nevada	53	$145.87	$117.86	4
Maine	49	$113.55	$84.59	4
New Mexico	43	$202.04	$140.38	3
Hawaii	43	$154.62	$120.22	2
Rhode Island	37	$131.16	$94.18	3
Puerto Rico	29	$97.03	$76.42	2
Vermont	26	$124.69	$94.51	2
Idaho	25	$184.25	$154.40	2
Wyoming	23	$105.70	$80.39	1
Alaska	15	$357.11	$207.09	1
AE	14	$220.96	$161.21	1
Montana	11	$82.13	$68.59	1

Related codes

00537Anesthesia for procedure to assess heart electrical activity$288.91
00560Anesthesia for procedure on heart and large blood vessels$396.34
00530Anesthesia for insertion of permanent heart pacemaker$150.20
0055TMusculoskeletal surgical navigational orthopedic operation$185.99
00567Anesthesia for heart artery bypass grafting on heart-lung machine$659.46
00562Anesthesia for procedure on heart and large blood vessels$749.69
0054TComputer-assisted$168.86
00532Anesthesia for access to central vein$105.90
00534Anesthesia for insertion or replace of pacing heart defibrillator$204.12
00541Anesthesia for procedure on chest$495.59

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.