How much does Medicare pay for CPT 00731?

Medicare allowed an average of $102.80 per service and paid $80.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1107.15, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00731?

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope. It was billed 1,174,579 times to 1,153,442 Medicare beneficiaries by 39,671 providers in 2024.

Does 00731 pay differently in an office than a hospital?

Yes. The allowed amount averaged $121.36 in an office setting and $102.19 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 00731 most?

Certified Registered Nurse Anesthetist (CRNA), with 589,610 services from 20,851 clinicians. Next are Anesthesiology, Anesthesiology Assistant, Pain Management.

CPT 00731

Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope

$102.80Medicare-allowed amount per service, averaged across 1,174,579 services

Providers submitted

$1107.15

Asking price, not received

Medicare allowed

$102.80

The fee schedule figure

Medicare paid

$80.25

Balance is patient coinsurance

Providers submitted an average of $1107.15 for this code and Medicare allowed $102.80 — 10.8× 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 $80.25 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $121.36
Hospital / facility: $102.19

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. 36,960 services were billed in an office setting and 1,137,619 in a facility.

Services: 1,174,579
Beneficiaries: 1,153,442
Providers billing it: 39,671
Total allowed: $120,746,721

What Medicare pays for CPT 00731

Across 1,174,579 services billed by 39,671 providers to 1,153,442 beneficiaries, Medicare allowed an average of $102.80 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 00731

Specialty	Services	Beneficiaries	Avg allowed	Providers
Certified Registered Nurse Anesthetist (CRNA)	589,610	579,828	$105.31	20,851
Anesthesiology	551,878	541,042	$101.57	17,385
Anesthesiology Assistant	24,950	24,588	$71.71	1,183
Pain Management	3,133	3,056	$103.12	104
Critical Care (Intensivists)	1,709	1,693	$84.16	66
Interventional Pain Management	1,658	1,622	$99.32	38
Internal Medicine	729	719	$111.88	17
Emergency Medicine	228	223	$106.43	6
Sleep Medicine	150	141	$96.47	1
Osteopathic Manipulative Medicine	104	102	$108.55	3
Hospitalist	77	77	$88.46	3
Physical Medicine and Rehabilitation	70	69	$69.23	1
Hospice and Palliative Care	49	48	$140.16	1
General Practice	35	35	$64.49	1
Pediatric Medicine	30	30	$113.15	2

00731 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	92,036	$105.50	$80.35	2,955
Texas	85,038	$97.27	$76.49	2,854
New York	78,802	$120.87	$86.97	2,276
California	76,055	$136.57	$102.72	2,657
Pennsylvania	71,308	$87.94	$68.26	2,361
Ohio	47,453	$97.38	$76.60	1,710
Illinois	45,246	$106.13	$79.40	1,735
North Carolina	41,626	$89.95	$72.04	1,351
Massachusetts	41,535	$93.61	$70.61	1,370
Michigan	39,591	$85.80	$65.25	1,497
Virginia	38,269	$92.75	$72.42	1,212
Georgia	37,916	$89.57	$69.94	1,325
New Jersey	36,970	$113.14	$82.75	1,087
Tennessee	33,435	$98.10	$79.02	1,051
South Carolina	30,830	$87.19	$69.81	847
Missouri	28,649	$100.73	$79.14	1,018
Maryland	24,095	$111.37	$84.18	747
Arizona	23,086	$113.80	$88.94	743
Alabama	22,991	$76.35	$62.43	684
Indiana	22,837	$104.51	$83.98	796
Kentucky	18,246	$105.60	$84.76	688
Louisiana	17,854	$104.26	$83.36	593
Minnesota	16,394	$88.35	$69.30	612
Wisconsin	15,914	$92.67	$74.90	735
Washington	15,784	$116.93	$89.36	640
Kansas	15,136	$101.40	$81.29	524
Mississippi	14,972	$97.62	$77.91	376
Connecticut	14,253	$91.78	$68.73	527
Colorado	14,044	$104.36	$81.07	611
Oklahoma	13,121	$112.56	$90.45	410
Arkansas	11,228	$118.68	$97.67	334
West Virginia	8,072	$89.78	$69.80	279
Nebraska	7,394	$106.44	$87.63	272
Nevada	6,986	$119.96	$94.48	213
New Hampshire	6,811	$106.44	$82.65	267
South Dakota	6,023	$78.35	$62.86	200
Iowa	5,492	$116.10	$93.23	217
Oregon	5,384	$122.11	$95.60	250
Maine	5,050	$83.88	$64.74	221
Delaware	4,793	$96.39	$75.02	137
Utah	4,748	$121.63	$94.77	215
District of Columbia	4,503	$101.39	$74.70	170
North Dakota	4,455	$85.61	$67.79	163
Rhode Island	4,052	$91.43	$69.83	128
New Mexico	3,338	$121.89	$95.39	126
Montana	2,899	$131.59	$102.09	118
Idaho	2,239	$120.80	$98.14	83
Hawaii	1,945	$118.97	$93.07	66
Alaska	1,423	$167.63	$101.80	72
Wyoming	1,321	$126.87	$98.57	46
Vermont	1,259	$104.48	$82.73	56
Puerto Rico	1,141	$124.20	$96.97	25
U.S. Virgin Islands	151	$147.84	$113.66	2
AE	96	$105.49	$80.97	3
ZZ	86	$118.84	$91.52	4
Guam	78	$144.94	$107.55	5

Related codes

00790Anesthesia for other procedure on upper abdomen$223.12
00732Anesthesia for procedure on gallbladder$139.32

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.