How much does Medicare pay for CPT 00812?

Medicare allowed an average of $82.06 per service and paid $82.06 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $959.89, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00812?

Anesthesia for exam of colon using an endoscope. It was billed 535,545 times to 534,201 Medicare beneficiaries by 16,342 providers in 2024.

Does 00812 pay differently in an office than a hospital?

Yes. The allowed amount averaged $93.26 in an office setting and $81.34 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 00812 most?

Certified Registered Nurse Anesthetist (CRNA), with 322,134 services from 9,451 clinicians. Next are Anesthesiology, Anesthesiology Assistant, Pain Management.

CPT 00812

Anesthesia for exam of colon using an endoscope

$82.06Medicare-allowed amount per service, averaged across 535,545 services

Providers submitted

$959.89

Asking price, not received

Medicare allowed

$82.06

The fee schedule figure

Medicare paid

$82.06

Balance is patient coinsurance

Providers submitted an average of $959.89 for this code and Medicare allowed $82.06 — 11.7× 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 $82.06 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $93.26
Hospital / facility: $81.34

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. 32,073 services were billed in an office setting and 503,472 in a facility.

Services: 535,545
Beneficiaries: 534,201
Providers billing it: 16,342
Total allowed: $43,946,823

What Medicare pays for CPT 00812

Across 535,545 services billed by 16,342 providers to 534,201 beneficiaries, Medicare allowed an average of $82.06 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 00812

Specialty	Services	Beneficiaries	Avg allowed	Providers
Certified Registered Nurse Anesthetist (CRNA)	322,134	321,350	$85.80	9,451
Anesthesiology	204,153	203,612	$77.09	6,512
Anesthesiology Assistant	5,741	5,733	$49.87	282
Pain Management	1,256	1,250	$84.56	42
Interventional Pain Management	905	904	$72.12	16
Internal Medicine	398	398	$86.62	9
Critical Care (Intensivists)	327	326	$60.31	14
Emergency Medicine	309	309	$88.57	4
Hospice and Palliative Care	98	95	$104.50	1
Osteopathic Manipulative Medicine	59	59	$86.84	2
Family Practice	26	26	$110.89	1
Sleep Medicine	22	22	$59.53	1
General Practice	22	22	$49.37	1
Physical Medicine and Rehabilitation	19	19	$61.08	1
Dental Anesthesiology	18	18	$49.37	1

00812 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
Pennsylvania	37,791	$72.03	$71.37	1,043
Texas	37,171	$81.52	$82.32	1,204
Florida	35,138	$81.05	$79.00	1,017
New York	32,893	$92.71	$85.05	872
California	26,818	$102.00	$97.97	852
Virginia	26,748	$80.31	$79.22	682
North Carolina	22,537	$81.25	$83.30	553
Massachusetts	22,464	$69.46	$67.42	691
Ohio	19,216	$83.64	$84.60	602
Georgia	18,642	$76.59	$76.37	538
New Jersey	16,895	$87.91	$81.77	451
Michigan	16,156	$68.18	$66.99	615
Illinois	16,096	$87.48	$84.23	614
Maryland	15,941	$96.57	$91.53	345
South Carolina	15,020	$70.91	$72.57	459
Tennessee	13,897	$80.08	$82.41	428
Missouri	12,343	$77.64	$78.73	435
Arizona	11,901	$86.39	$86.57	278
Indiana	9,229	$83.47	$86.70	389
Kentucky	9,156	$81.59	$83.33	303
Connecticut	8,621	$70.71	$67.79	269
Alabama	7,960	$63.99	$66.12	250
Colorado	7,636	$90.24	$89.99	223
Wisconsin	7,576	$72.88	$75.59	285
Kansas	7,151	$89.53	$92.17	240
Louisiana	6,955	$85.06	$86.96	257
Mississippi	6,631	$76.96	$79.34	155
Oklahoma	6,265	$87.96	$90.23	209
Washington	6,189	$96.98	$95.44	212
Minnesota	5,472	$62.81	$64.31	236
New Hampshire	4,300	$87.55	$87.06	148
Arkansas	4,012	$89.64	$94.80	121
Delaware	3,670	$69.43	$69.10	77
Oregon	3,358	$92.59	$93.31	119
Nebraska	3,191	$87.05	$91.01	94
Nevada	3,146	$88.69	$89.77	75
Iowa	3,130	$89.53	$93.62	123
Utah	2,617	$92.18	$93.14	106
West Virginia	2,520	$64.31	$64.37	106
Rhode Island	2,391	$78.79	$77.16	61
Montana	2,362	$102.66	$100.76	81
South Dakota	2,251	$63.00	$65.41	80
Maine	1,783	$72.34	$72.47	76
North Dakota	1,752	$73.23	$74.90	65
Idaho	1,543	$93.15	$97.57	49
New Mexico	1,483	$94.65	$95.88	58
District of Columbia	1,422	$82.52	$78.79	49
Vermont	939	$87.08	$89.58	34
Wyoming	867	$97.30	$96.75	29
Hawaii	838	$87.85	$87.11	39
Alaska	710	$120.58	$98.96	27
Puerto Rico	463	$95.47	$92.51	9
U.S. Virgin Islands	157	$97.53	$96.88	2
Guam	49	$113.68	$112.41	2
AP	37	$102.83	$102.17	2
ZZ	29	$75.80	$75.83	2

Related codes

00811Anesthesia for other procedure on large bowel$99.16
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.