How much does Medicare pay for CPT 01942?

Medicare allowed an average of $152.21 per service and paid $119.41 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1754.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does 01942 pay differently in an office than a hospital?

Yes. The allowed amount averaged $151.59 in an office setting and $152.26 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 01942 most?

Certified Registered Nurse Anesthetist (CRNA), with 8,433 services from 301 clinicians. Next are Anesthesiology, Pain Management, Anesthesiology Assistant.

CPT 01942

Anesthesia for nerve modulation procedure spinal cord or repair of bone of spine of lower back accessed through skin using imaging guidance

$152.21Medicare-allowed amount per service, averaged across 12,192 services

Providers submitted

$1754.56

Asking price, not received

Medicare allowed

$152.21

The fee schedule figure

Medicare paid

$119.41

Balance is patient coinsurance

Providers submitted an average of $1754.56 for this code and Medicare allowed $152.21 — 11.5× 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 $119.41 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $151.59
Hospital / facility: $152.26

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 979 services were billed in an office setting and 11,213 in a facility.

Services: 12,192
Beneficiaries: 11,293
Providers billing it: 459
Total allowed: $1,855,744

What Medicare pays for CPT 01942

Across 12,192 services billed by 459 providers to 11,293 beneficiaries, Medicare allowed an average of $152.21 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 01942

Specialty	Services	Beneficiaries	Avg allowed	Providers
Certified Registered Nurse Anesthetist (CRNA)	8,433	7,767	$156.27	301
Anesthesiology	3,672	3,440	$143.80	152
Pain Management	38	37	$105.88	2
Anesthesiology Assistant	23	23	$98.37	2
Physical Medicine and Rehabilitation	14	14	$122.83	1
Interventional Pain Management	12	12	$159.48	1

01942 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	1,436	$153.89	$122.02	51
Florida	1,377	$167.96	$128.42	57
Georgia	1,240	$157.24	$120.65	37
Pennsylvania	1,064	$147.50	$114.14	33
New Jersey	686	$146.81	$111.28	23
California	675	$176.55	$137.10	26
Arizona	480	$161.72	$129.18	17
Oklahoma	467	$136.95	$111.36	17
Tennessee	458	$155.27	$123.46	20
Mississippi	355	$123.29	$105.65	14
Louisiana	321	$127.53	$103.82	9
Virginia	280	$156.89	$116.51	6
Michigan	280	$141.89	$108.14	14
Nebraska	272	$160.43	$131.05	7
New York	259	$149.04	$110.70	12
West Virginia	255	$102.48	$77.87	8
Kansas	227	$161.69	$125.65	14
Indiana	186	$143.57	$118.96	6
Kentucky	185	$131.24	$102.66	10
Illinois	172	$162.56	$121.86	9
North Carolina	163	$99.13	$77.68	9
Maryland	140	$172.28	$121.04	5
Washington	125	$159.56	$124.31	3
Arkansas	120	$152.27	$127.18	5
Missouri	116	$138.51	$107.27	6
Colorado	115	$155.81	$123.65	2
Minnesota	107	$151.75	$122.36	6
Ohio	86	$126.89	$99.20	5
Alabama	62	$122.01	$100.52	4
Delaware	61	$147.58	$111.18	2
Hawaii	47	$177.43	$136.29	2
Wisconsin	44	$133.55	$109.14	2
New Hampshire	43	$148.19	$114.12	3
Idaho	39	$192.44	$155.26	1
Alaska	38	$156.71	$125.91	1
Oregon	33	$181.65	$142.59	2
Massachusetts	32	$144.45	$113.54	2
Connecticut	24	$222.82	$169.25	1
Utah	24	$146.89	$128.01	1
North Dakota	23	$213.36	$175.22	2
South Carolina	22	$148.25	$117.97	1
Iowa	16	$151.25	$119.13	1
New Mexico	13	$139.13	$116.19	1
District of Columbia	13	$203.13	$160.25	1
Wyoming	11	$167.85	$135.72	1

Related codes

01922Anesthesia for x-ray or radiation therapy$135.98
01992Anesthesia for nerve block and injection procedure$117.33
01938Anesthesia for injection$85.34
01926Anesthesia for x-ray on artery of brain$227.98
01940Anesthesia for nerve destruction procedures on spine or spinal cord of$107.14
01996Daily hospital management of continuous spinal drug administration$62.53
01937Anesthesia for injection$89.46
01924Anesthesia for x-ray on arteries$214.93
01939Anesthesia for nerve destruction procedures on spine or spinal cord of$107.35
01916Anesthesia for x-ray exam of arteries and veins$162.11
01991Anesthesia for nerve block and injection$78.53
01920Anesthesia for x-ray on heart vessels and chambers$181.92

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.