CPT code 00731: Upper GI endoscopy, non-ERCP procedure2026 Medicare rate & RVUs in Missouri
Anesthesia for upper gastrointestinal endoscopy, including diagnostic and therapeutic examinations of the esophagus, stomach, and proximal duodenum, when ERCP is not performed.
CMS doesn’t publish an office rate for 00731 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 00731 covers
This code covers anesthesia for upper gastrointestinal endoscopy when the scope passes through the mouth to examine the esophagus, stomach, or proximal duodenum. Typical cases include diagnostic or therapeutic EGD, with work such as mucosal biopsy, bleeding control, or dilation during the endoscopic session. Gastroenterologists and other qualified endoscopists perform the procedure; an anesthesiologist or CRNA reports the anesthesia service in hospital endoscopy units and ambulatory endoscopy centers.
Use 00731 for upper GI endoscopy other than ERCP; ERCP anesthesia is reported with 00732. When upper and lower endoscopy are performed in the same session, compare 00813 rather than treating the session as upper endoscopy alone. The endoscopy report should identify the procedure and scope extent, while the anesthesia record should support the service and show anesthesia start and stop times and the practitioner’s attendance. Medicare assigns 5 base units. Payment is (5 base units + time units) × the anesthesia conversion factor, which varies by locality; time is reported in minutes and converted to 15-minute units to one decimal, starting when the anesthesia practitioner begins preparing the patient for anesthesia and ending when the practitioner is no longer in personal attendance and the patient can safely be placed under postoperative care.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 00731 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the 00731 rate is calculated
Each of 00731’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 00731
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 00731
00731 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 00731
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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00731 isn’t priced in this setting.
00731 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 00732ERCP anesthesiaEndoscopic duct procedure
- 00731 covers upper GI endoscopy other than ERCP. Select 00732 when the anesthetized procedure is ERCP.
- 00811Lower GI endoscopyDiagnostic or therapeutic
- 00811 is for lower GI endoscopy. Use 00731 when the scope examines the esophagus, stomach, or proximal duodenum.
- 00812Colonoscopy anesthesiaScreening colonoscopy
- 00812 is specific to anesthesia for screening colonoscopy; 00731 is for non-ERCP upper GI endoscopy.
- 00813Combined GI anesthesiaUpper and lower endoscopy
- 00813 is for a session combining upper and lower GI endoscopy. Use 00731 when the session involves upper GI endoscopy alone.
00731 billing questions
When should 00731 be used instead of 00732?
Use 00731 for upper GI endoscopy other than ERCP. ERCP has its own anesthesia code, 00732.
What if upper and lower endoscopy are performed in one session?
Compare 00813, the anesthesia code for combined upper and lower GI endoscopic procedures, rather than reporting 00731 as though only upper endoscopy occurred.
What records support reporting 00731?
The endoscopy report should identify the upper GI procedure and scope extent. The anesthesia record should support the anesthesia service and document its start and stop times and the practitioner’s attendance.
How does Medicare calculate anesthesia units for 00731?
The code has 5 base units. Medicare adds time units and multiplies the total by the anesthesia conversion factor for the payment locality.
Is the endoscopist’s procedure reported separately from 00731?
The endoscopist reports the endoscopic procedure, while the anesthesia professional reports the anesthesia service. The anesthesia code represents anesthesia for the upper GI endoscopy, not the endoscopic work itself.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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