How much does Medicare pay for CPT 00912?

Medicare allowed an average of $127.00 per service and paid $100.17 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1364.11, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00912?

Anesthesia for removal of urinary bladder tumors including use of an endoscope. It was billed 10,933 times to 10,483 Medicare beneficiaries by 617 providers in 2024.

Does 00912 pay differently in an office than a hospital?

Yes. The allowed amount averaged $103.57 in an office setting and $127.91 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 00912 most?

Anesthesiology, with 6,888 services from 394 clinicians. Next are Certified Registered Nurse Anesthetist (CRNA), Pain Management, Critical Care (Intensivists).

CPT 00912

Anesthesia for removal of urinary bladder tumors including use of an endoscope

$127.00Medicare-allowed amount per service, averaged across 10,933 services

Providers submitted

$1364.11

Asking price, not received

Medicare allowed

$127.00

The fee schedule figure

Medicare paid

$100.17

Balance is patient coinsurance

Providers submitted an average of $1364.11 for this code and Medicare allowed $127.00 — 10.7× 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 $100.17 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $103.57
Hospital / facility: $127.91

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 408 services were billed in an office setting and 10,525 in a facility.

Services: 10,933
Beneficiaries: 10,483
Providers billing it: 617
Total allowed: $1,388,491

What Medicare pays for CPT 00912

Across 10,933 services billed by 617 providers to 10,483 beneficiaries, Medicare allowed an average of $127.00 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 00912

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	6,888	6,618	$126.43	394
Certified Registered Nurse Anesthetist (CRNA)	3,779	3,607	$129.11	208
Pain Management	139	133	$106.15	6
Critical Care (Intensivists)	43	42	$149.74	3
Anesthesiology Assistant	35	35	$80.57	3
Family Practice	19	18	$95.45	1
Interventional Pain Management	17	17	$162.38	1
Internal Medicine	13	13	$89.63	1

00912 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
New York	1,207	$133.27	$94.79	70
Florida	1,072	$136.03	$103.08	58
Texas	994	$107.41	$84.67	50
Virginia	858	$95.88	$76.49	37
Maryland	780	$161.83	$121.66	41
Pennsylvania	716	$107.54	$82.85	35
New Jersey	571	$130.47	$99.14	27
California	514	$169.66	$130.80	31
Tennessee	412	$122.16	$97.99	25
South Carolina	384	$108.93	$88.17	19
Illinois	381	$135.19	$100.26	26
Massachusetts	373	$122.33	$92.09	26
Ohio	251	$118.79	$93.87	17
Missouri	204	$120.78	$96.79	13
North Carolina	185	$91.25	$73.80	13
Oklahoma	169	$128.01	$104.91	10
Georgia	165	$117.10	$91.80	11
Arizona	158	$142.19	$112.69	10
Kansas	151	$133.77	$108.32	9
Michigan	122	$111.97	$81.56	8
Minnesota	118	$201.28	$157.19	6
Kentucky	109	$95.02	$79.46	7
Mississippi	106	$146.29	$118.06	7
Delaware	100	$135.62	$105.49	6
Louisiana	94	$105.80	$87.08	6
Indiana	87	$98.00	$81.79	5
Oregon	79	$147.17	$119.58	4
Iowa	74	$161.44	$131.38	6
New Hampshire	63	$116.99	$93.07	5
Washington	48	$175.00	$136.58	4
Colorado	48	$163.20	$120.95	2
Alabama	47	$84.91	$69.48	3
Connecticut	46	$130.55	$94.53	3
Nebraska	39	$123.37	$104.35	2
Maine	32	$84.77	$70.09	2
Arkansas	30	$177.32	$144.14	2
District of Columbia	26	$140.97	$107.16	2
Wisconsin	26	$101.44	$71.59	2
Idaho	25	$150.10	$128.60	2
South Dakota	23	$87.29	$72.41	2
West Virginia	18	$114.99	$88.17	1
New Mexico	17	$167.99	$131.72	1
Rhode Island	11	$120.99	$91.96	1

Related codes

00910Anesthesia for other procedure on urinary system through urethra$82.98
00902Anesthesia for procedure on anus and rectum$110.44
00918Anesthesia for fragmenting$125.80
00914Anesthesia for removal of prostate including use of an endoscope$151.41
00952Anesthesia for exam of uterus$114.51

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.