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CPT code 00811: Lower GI endoscopy, diagnostic or therapeutic2026 Medicare rate & RVUs

Anesthesia for diagnostic or therapeutic lower intestinal endoscopy, such as colonoscopy or sigmoidoscopy, rather than screening colonoscopy or combined upper and lower endoscopy.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.4M Medicare services in 2024

Medicare rate · 00811

Lower GI endoscopy, diagnostic or therapeutic

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 00811 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 00811 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 00811 covers

00811 represents anesthesia care for endoscopic examination or treatment of the lower intestinal tract. Typical cases include diagnostic or therapeutic colonoscopy and sigmoidoscopy, including biopsy or lesion removal during the endoscopy. An anesthesiologist or CRNA reports the anesthesia service separately from the endoscopist’s procedure, in an office, ambulatory surgery center, or hospital setting.

Choose 00811 for lower-GI endoscopy that is not a screening colonoscopy; use 00812 for anesthesia for screening colonoscopy and 00813 when upper and lower GI endoscopic procedures are performed in the same session. The record should identify the lower-GI procedure and its indication, whether upper endoscopy was also performed, and anesthesia start and stop times. This code has 4 base units; Medicare payment is (base units plus time units) multiplied by the locality’s anesthesia conversion factor. Time is reported in minutes and converted to 15-minute units to one decimal place, from when the practitioner begins preparing the patient for anesthesia until the practitioner is no longer in personal attendance and the patient can safely be placed under postoperative care; the conversion factor varies by locality.

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 00811 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

00811 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

00811 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
00811 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 00811 rate is calculated

Each of 00811’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 · 00811

RVUs × geographic indexes × conversion factor

Office or facility?

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 00811

00811 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 · 00811

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

00811 isn’t priced in this setting.

00811 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 00811

    Lower GI endoscopy, diagnostic or therapeutic0 wRVU

    Not priced

  • 00812

    Colonoscopy anesthesia, screening colonoscopy0 wRVU

    Not priced

  • 00813

    Combined GI anesthesia, upper and lower endoscopy0 wRVU

    Not priced

  • 00731

    Upper GI endoscopy, non-ERCP procedure0 wRVU

    Not priced

How to choose

00812Colonoscopy anesthesiaScreening colonoscopy
Choose 00812 for anesthesia for screening colonoscopy. Choose 00811 for lower-GI endoscopy that is not a screening colonoscopy.
00813Combined GI anesthesiaUpper and lower endoscopy
00813 describes anesthesia when upper and lower GI endoscopic procedures are performed in the same session; 00811 is for the lower-GI endoscopy service.
00731Upper GI endoscopyNon-ERCP procedure
00731 is for upper-GI endoscopy. 00811 is for endoscopic procedures of the lower intestinal tract.

Codes related to 00811

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 00811
CodeHow it relatesNational office range
Used instead
00812Colonoscopy anesthesia, screening colonoscopyUsed for anesthesia for screening colonoscopy rather than other lower-GI endoscopy.No office rate
00813Combined GI anesthesia, upper and lower endoscopyUsed when upper and lower GI endoscopic procedures are performed in one session.No office rate

00811 billing questions

How is 00811 different from 00812?

00811 is for anesthesia for lower-GI endoscopy that is not a screening colonoscopy. 00812 is the screening-colonoscopy anesthesia code.

When should 00813 be considered instead?

Use 00813 when upper and lower GI endoscopic procedures are performed during the same session. 00811 describes the lower-GI endoscopy service.

Does 00811 include the endoscopist’s procedure?

No. The anesthesia professional reports the anesthesia service, while the endoscopist reports the colonoscopy or sigmoidoscopy and any endoscopic work performed.

How are units calculated for 00811?

The code has 4 base units. Medicare adds time units, calculated from anesthesia minutes in 15-minute units to one decimal place, and multiplies the total by the locality’s anesthesia conversion factor.

What should the record support?

Document the lower-GI endoscopic procedure and its indication, any upper endoscopy performed in the same session, and the anesthesia record’s start and stop times.

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

Open CMS sourceHow we calculate rates

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