CPT code 00813: Combined GI anesthesia, upper and lower endoscopy2026 Medicare rate & RVUs

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

What 00813 covers

This code covers anesthesia for upper and lower gastrointestinal endoscopic procedures performed during the same anesthetic encounter. The upper examination may assess the esophagus, stomach, or duodenum; the lower examination evaluates the colon and may extend into the terminal ileum. An anesthesiologist or CRNA reports the anesthesia service in settings such as an endoscopy center or hospital outpatient department.

Choose this code for the combined upper-and-lower procedure rather than an anesthesia code for only an upper or only a lower endoscopy. The anesthesia record and endoscopy reports should establish that both examinations were performed during the same encounter and support the anesthesia start and stop times. This code has 5 base units. Anesthesia time begins when the practitioner starts preparing the patient and ends when the practitioner is no longer in personal attendance and the patient can safely be placed under postoperative care; minutes convert to 15-minute units to one decimal place, and Medicare multiplies base plus time units by the locality-specific conversion factor, which varies by location.

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 00813 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

00813 rates by state

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

How the 00813 rate is calculated

Each of 00813’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 00813

00813 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.

00813 compared with similar codes

How to choose

00811Lower GI endoscopyDiagnostic or therapeutic

00811 applies to lower GI endoscopy alone. Choose 00813 when an upper GI endoscopy is also performed under the same anesthetic.

00812Colonoscopy anesthesiaScreening colonoscopy

00812 is for anesthesia for screening colonoscopy alone; 00813 is for a combined upper and lower GI endoscopic encounter.

00731Upper GI endoscopyNon-ERCP procedure

00731 covers anesthesia for upper GI endoscopy alone. Use 00813 when a lower GI endoscopic procedure is performed during the same anesthetic encounter.

00732ERCP anesthesiaEndoscopic duct procedure

00732 covers anesthesia for upper GI endoscopy involving ERCP alone. Use 00813 when the encounter also includes a lower GI endoscopic procedure.

Codes related to 00813

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

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