Glossary · Updated Jul 6, 2026
Anesthesia Payment: Base Units, Time Units, and the Anesthesia Conversion Factor
Anesthesia services (status J) are not priced with the standard work/practice-expense/malpractice RVU formula. Instead, Medicare pays base units plus time units, multiplied by a separate anesthesia conversion factor and a locality adjuster.
The formula
Payment = (base units + time units) × anesthesia conversion factor × locality adjuster. Base units are a fixed, per-code value published by CMS that reflects the complexity and risk of the anesthesia service itself — unlike PFS RVUs, a single base-unit figure stands in for work and overhead together. Time units are derived from the anesthesia time reported on the claim, in 15-minute increments (minutes ÷ 15).
Why it is priced separately
Status J codes are excluded from the standard PFS formula entirely — see status indicators for how a rate lookup recognizes an anesthesia code rather than misreporting it as bundled or excluded. Computing an actual anesthesia amount requires a locality and the reported anesthesia time, not just the code.
Its own conversion factor, and its own QP/non-QP split
The anesthesia conversion factor is published per locality — unlike the PFS conversion factor(s), which are national. Starting with the same CY2026 change described in the 2026 conversion factor guide, the anesthesia conversion factor also has separate qualifying-APM-participant (QP) and non-QP figures for a given locality.
Anesthesia payment calculator
Enter the code's base units, the reported anesthesia time, and your locality's anesthesia conversion factor. For example, 5 base units plus 45 minutes (45 ÷ 15 = 3 time units) is 8 total units — at a $21.00 anesthesia conversion factor that is 8 × $21.00 = $168.00.
Time units are minutes ÷ 15. The anesthesia conversion factor is published per locality — find yours on its locality page. Sequestration is not applied here.
Frequently asked
Do anesthesia codes have work, PE, and MP RVUs?
No. Anesthesia (status J) codes are priced from base units and time units instead, using a wholly different formula than the standard RVU-based PFS calculation.
What do I need to compute an anesthesia amount?
A locality (to look up the anesthesia conversion factor and locality adjuster) and the anesthesia time in minutes (to compute time units) — a code alone is not enough.
Related
Sources
- CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field)
- CMS Physician Fee Schedule overview (cms.gov)
Written from primary CMS sources — see how we source, compute, and verify everything on this site.