CPT code 00811: Lower GI endoscopy, diagnostic or therapeutic2026 Medicare rate & RVUs in Texas
Anesthesia for diagnostic or therapeutic lower intestinal endoscopy, such as colonoscopy or sigmoidoscopy, rather than screening colonoscopy or combined upper and lower endoscopy.
CMS doesn’t publish an office rate for 00811 in Texas.
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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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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
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
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
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00811 isn’t priced in this setting.
00811 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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