How much does Medicare pay for CPT 00811?

Medicare allowed an average of $99.16 per service and paid $79.24 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1030.30, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00811?

Anesthesia for other procedure on large bowel using an endoscope. It was billed 1,166,576 times to 1,161,886 Medicare beneficiaries by 31,539 providers in 2024.

Does 00811 pay differently in an office than a hospital?

Yes. The allowed amount averaged $108.56 in an office setting and $98.61 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 00811 most?

Certified Registered Nurse Anesthetist (CRNA), with 656,272 services from 17,271 clinicians. Next are Anesthesiology, Anesthesiology Assistant, Pain Management.

CPT 00811

Anesthesia for other procedure on large bowel using an endoscope

$99.16Medicare-allowed amount per service, averaged across 1,166,576 services

Providers submitted

$1030.30

Asking price, not received

Medicare allowed

$99.16

The fee schedule figure

Medicare paid

$79.24

Balance is patient coinsurance

Providers submitted an average of $1030.30 for this code and Medicare allowed $99.16 — 10.4× 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 $79.24 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $108.56
Hospital / facility: $98.61

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. 64,551 services were billed in an office setting and 1,102,025 in a facility.

Services: 1,166,576
Beneficiaries: 1,161,886
Providers billing it: 31,539
Total allowed: $115,677,676

What Medicare pays for CPT 00811

Across 1,166,576 services billed by 31,539 providers to 1,161,886 beneficiaries, Medicare allowed an average of $99.16 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 00811

Specialty	Services	Beneficiaries	Avg allowed	Providers
Certified Registered Nurse Anesthetist (CRNA)	656,272	654,029	$103.14	17,271
Anesthesiology	485,732	483,352	$95.16	13,338
Anesthesiology Assistant	17,892	17,859	$63.32	748
Pain Management	2,674	2,660	$98.68	81
Interventional Pain Management	1,659	1,648	$91.77	31
Critical Care (Intensivists)	901	898	$76.76	34
Internal Medicine	750	745	$102.19	15
Emergency Medicine	161	161	$98.97	3
General Practice	121	121	$124.78	2
Osteopathic Manipulative Medicine	98	98	$106.02	3
Hospitalist	71	71	$81.17	2
Physical Medicine and Rehabilitation	40	40	$65.30	1
Sleep Medicine	38	38	$91.53	1
Hospice and Palliative Care	38	38	$127.86	1
Nurse Practitioner	22	22	$67.34	1

00811 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	83,802	$96.59	$77.95	2,164
Florida	81,046	$101.65	$79.52	2,052
Pennsylvania	81,014	$89.36	$70.85	2,079
New York	74,708	$114.64	$83.82	1,729
California	66,036	$124.54	$95.70	1,900
Illinois	48,944	$103.00	$78.83	1,472
Massachusetts	45,778	$85.42	$67.11	1,156
Virginia	44,246	$88.26	$69.87	1,097
Ohio	42,868	$96.00	$76.93	1,325
New Jersey	39,420	$105.43	$77.99	898
Michigan	38,035	$81.72	$64.50	1,183
North Carolina	37,513	$97.17	$78.85	984
Georgia	35,535	$87.85	$69.71	992
Tennessee	34,193	$99.14	$81.73	822
South Carolina	29,879	$90.86	$74.03	698
Missouri	25,317	$97.83	$79.20	804
Maryland	25,265	$110.81	$85.56	584
Indiana	23,334	$98.63	$81.46	713
Arizona	20,645	$104.07	$82.65	580
Minnesota	20,439	$75.64	$62.82	532
Washington	19,039	$117.35	$92.54	565
Alabama	18,257	$77.38	$62.84	566
Kentucky	17,909	$97.93	$80.52	540
Wisconsin	17,785	$88.07	$71.80	675
Connecticut	16,411	$86.23	$65.18	444
Mississippi	15,698	$102.73	$83.86	293
Louisiana	15,002	$105.09	$86.79	377
Kansas	14,904	$99.38	$81.00	443
Colorado	13,819	$100.06	$79.83	436
Arkansas	10,796	$114.31	$95.91	241
Oklahoma	10,737	$109.49	$89.28	317
Nebraska	10,160	$105.59	$88.85	243
South Dakota	7,235	$80.48	$66.15	225
West Virginia	7,170	$85.28	$66.28	244
New Hampshire	7,070	$109.90	$87.56	215
Delaware	6,603	$98.49	$78.81	129
Oregon	6,259	$117.79	$96.15	205
Iowa	5,915	$110.04	$90.71	184
Nevada	5,886	$110.70	$86.63	138
Maine	5,757	$84.23	$67.11	205
North Dakota	5,601	$80.93	$64.28	141
Utah	5,059	$118.22	$95.38	179
District of Columbia	4,395	$98.86	$74.25	146
New Mexico	4,235	$118.06	$95.70	95
Rhode Island	3,717	$75.67	$57.71	94
Montana	2,840	$121.52	$98.63	121
Hawaii	2,580	$115.07	$90.17	68
Alaska	1,853	$157.16	$98.71	62
Idaho	1,708	$116.99	$97.01	70
Puerto Rico	1,426	$120.03	$92.38	19
Vermont	1,194	$99.61	$77.25	44
Wyoming	1,114	$120.38	$96.02	40
AE	195	$94.85	$71.42	3
ZZ	80	$119.49	$100.53	2
U.S. Virgin Islands	65	$144.71	$115.65	1
Guam	31	$146.74	$109.06	2

Related codes

00812Anesthesia for exam of colon$82.06
00813Anesthesia for procedure on small and large bowel$125.41
00840Anesthesia for other procedure on lower abdomen$197.81
00873Anesthesia for shock wave therapy for urinary system stones without wa$129.00
00830Anesthesia for other repair of lower abdomen hernia (1 year or older)$137.91
00865Anesthesia for extensive removal of prostate$273.52
00860Anesthesia for other procedure on lower abdomen outside abdominal cavi$170.50
00862Anesthesia for procedure on upper urinary tubes or removal of kidney f$283.02
00880Anesthesia for other procedure on large blood vessel of lower abdomen$445.90

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.