How much does Medicare pay for CPT 00862?

Medicare allowed an average of $283.02 per service and paid $225.56 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3137.54, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00862?

Anesthesia for procedure on upper urinary tubes or removal of kidney for transplant. It was billed 1,788 times to 1,772 Medicare beneficiaries by 118 providers in 2024.

Which specialty bills 00862 most?

Anesthesiology, with 1,218 services from 80 clinicians. Next are Certified Registered Nurse Anesthetist (CRNA), Pain Management, Anesthesiology Assistant.

CPT 00862

Anesthesia for procedure on upper urinary tubes or removal of kidney for transplant

$283.02Medicare-allowed amount per service, averaged across 1,788 services

Providers submitted

$3137.54

Asking price, not received

Medicare allowed

$283.02

The fee schedule figure

Medicare paid

$225.56

Balance is patient coinsurance

Providers submitted an average of $3137.54 for this code and Medicare allowed $283.02 — 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 $225.56 (80%); the rest is the patient’s coinsurance and deductible.

Services: 1,788
Beneficiaries: 1,772
Providers billing it: 118
Total allowed: $506,040

What Medicare pays for CPT 00862

Across 1,788 services billed by 118 providers to 1,772 beneficiaries, Medicare allowed an average of $283.02 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 00862

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	1,218	1,206	$295.90	80
Certified Registered Nurse Anesthetist (CRNA)	491	487	$267.26	34
Pain Management	49	49	$165.62	2
Anesthesiology Assistant	30	30	$210.01	2

00862 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	322	$246.36	$195.25	22
New York	237	$380.50	$268.84	13
Maryland	153	$306.78	$231.28	10
Virginia	145	$207.77	$169.35	10
California	129	$379.94	$282.97	9
Florida	126	$282.57	$221.91	8
Pennsylvania	118	$286.49	$220.07	9
Ohio	116	$261.15	$210.35	9
Massachusetts	45	$198.05	$154.01	3
District of Columbia	43	$239.38	$184.91	2
North Carolina	33	$199.31	$160.57	1
Oklahoma	31	$274.09	$229.62	2
Georgia	31	$197.42	$153.33	2
Iowa	29	$318.66	$253.74	1
Tennessee	29	$182.22	$152.17	2
Minnesota	25	$216.32	$183.86	2
Kansas	24	$232.08	$179.67	2
Arkansas	21	$457.69	$385.32	1
Delaware	19	$299.35	$228.48	1
Washington	16	$191.48	$158.71	1
Indiana	14	$368.52	$299.89	1
New Jersey	13	$281.29	$199.47	1
West Virginia	13	$210.86	$168.19	1
Utah	12	$273.73	$208.58	1
Michigan	11	$209.13	$161.46	1
Colorado	11	$380.98	$355.13	1
Wisconsin	11	$296.61	$279.19	1
South Carolina	11	$172.08	$125.97	1

Related codes

00811Anesthesia for other procedure on large bowel$99.16
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
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.