CPT code 00811: Lower GI endoscopy, diagnostic or therapeutic2026 Medicare rate & RVUs in Washington, DC area

CMS doesn’t publish a rate for 00811 in Washington, DC area.

Check a contract rate as a % of Medicare · 00811 nationwide

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

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.

How Washington, DC area compares for 00811

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00811 rates by state

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

See 00811 in every payment locality

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.

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.

Codes related to 00811

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

How 00811 has changed in Washington, DC area

Price 00811 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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