CPT code 01938: Spinal procedure anesthesia, lumbar or sacral2026 Medicare rate & RVUs in New York
Anesthesia for image-guided injections, drainage, or aspiration involving the lumbar or sacral spine or spinal cord.
CMS doesn’t publish an office rate for 01938 in New York.
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 01938 covers
This service covers anesthesia for percutaneous procedures that use imaging to guide an injection, drainage, or aspiration in the lumbar or sacral spine or spinal cord. An anesthesiologist or CRNA may provide and report the anesthesia; the clinician performing the spinal procedure reports that procedure separately.
Choose this code for the lumbar or sacral region, not the cervical or thoracic counterpart, 01937. It covers injection, drainage, or aspiration procedures rather than lumbar or sacral procedures using a neurolytic agent or neuromodulation. The record should identify the procedure, lumbar or sacral site, image-guided percutaneous approach, and anesthesia practitioner’s time. Medicare payment is (4 base units + time units) × the anesthesia conversion factor. Time starts when the practitioner begins preparing the patient for anesthesia and ends when the practitioner is no longer personally attending and the patient can safely be placed under postoperative care; minutes are converted to 15-minute units to one decimal place, and 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 01938 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | Unavailable | Unavailable |
| NYC suburbs and Long Island, NY | Unavailable | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | Unavailable | Unavailable |
| Queens, NY | Unavailable | Unavailable |
| Rest of New York | Unavailable | Unavailable |
How the 01938 rate is calculated
Each of 01938’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 · 01938
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 01938
01938 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 · 01938
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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01938 isn’t priced in this setting.
01938 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 01937Spinal procedure anesthesiaCervical or thoracic region
- Both cover image-guided injection, drainage, or aspiration procedures, but 01937 is for the cervical or thoracic region; 01938 is lumbar or sacral.
- 01940Spinal neurolysis anesthesiaLumbar or sacral
- 01940 is for lumbar or sacral procedures using a neurolytic agent. Choose 01938 for image-guided injection, drainage, or aspiration procedures instead.
- 01942Spinal procedure anesthesiaLumbar and sacral
- 01942 covers lumbar or sacral neuromodulation or intravertebral procedures, rather than the injection, drainage, or aspiration service covered by 01938.
01938 billing questions
When should 01938 be chosen over 01937?
Use 01938 for the lumbar or sacral region. Use 01937 for the cervical or thoracic region when the procedure is an image-guided injection, drainage, or aspiration.
Does 01938 include the spinal procedure itself?
No. It represents the anesthesia service; the clinician performing the injection, drainage, or aspiration reports the procedure separately.
What documentation supports the code?
The record should show the lumbar or sacral site, the image-guided percutaneous procedure and its type, and the anesthesia service and time.
How are anesthesia units calculated for 01938?
The code has 4 base units. Medicare adds time units, calculated from anesthesia minutes in 15-minute units to one decimal place, and applies the locality’s anesthesia conversion factor.
Is 01938 appropriate for lumbar neurolytic procedures?
No. Use 01940 for a lumbar or sacral procedure using a neurolytic agent; 01938 covers image-guided injection, drainage, or aspiration procedures.
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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