Medicare rate for CPT 00630 in 2026
CPT 00630 has no national Medicare rate on the CMS 2026 October release, because it carries status J on the 2026 Physician Fee Schedule, which means anesthesia, priced by base + time units (not RVU-based). There is no Medicare allowed amount to quote for it, and any figure presented as one did not come from this fee schedule.
Anesthesia for lower-back procedures
Code name above: S2Reason’s own label. CMS’s CPT descriptor is AMA-licensed text and is not shown · Status J: Anesthesia, priced by base + time units (not RVU-based) · Source: CMS 2026 October (RVU26D, non-QP conversion factor), effective 10/2026.
Anesthesia is priced by base units plus time units multiplied by an anesthesia conversion factor, so there is no single dollar figure for the code.
What CPT 00630 means
The anesthesia service for a procedure in the lumbar region of the spine. It is billed by the anesthesiologist or nurse anesthetist, separately from the surgeon's code, with the minutes of anesthesia time.
Where CPT 00630 gets a price
Medicare pays anesthesia from base units plus time units multiplied by a locality anesthesia conversion factor, not from RVUs. The Medicare Claims Processing Manual, chapter 12 section 50.A, states the rule: the fee schedule amount “is, with the exceptions noted, based on allowable base and time units multiplied by an anesthesia conversion factor specific to that locality.” Chapter 12 section 50.G adds that the A/B MAC “computes time units by dividing reported anesthesia time by 15 minutes.” The anesthesia conversion factor lookup publishes the locality conversion factors. On a New Jersey PIP claim the state’s own fee schedule governs, and the NJ PIP fee schedule lookup shows whether New Jersey lists the code.
Checking a different code, state or year
The Medicare rate lookup prices all 17,000-plus codes in the Physician Fee Schedule for any state and any fee-schedule year from 2023 to 2026. Ambulance codes are priced separately on the ambulance fee schedule, because Medicare does not pay for ambulance transport under this schedule at all.
Other codes with a rate page
- CPT 99213 Established patient office visit, low complexity
- CPT 99214 Established patient office visit, moderate complexity
- CPT 99204 New patient office visit, moderate complexity
- CPT 99284 Emergency department visit, moderate complexity
- CPT 72148 MRI, lumbar spine, without contrast
- CPT 72141 MRI, cervical spine, without contrast
Medicare rates are a benchmark, not an allowance. What a no-fault, workers’ compensation or commercial carrier owes for CPT 00630 is set by the fee schedule or policy that governs the claim.
One code is one line of a bill.
Desk prices a whole case against the schedule that actually governs the claim, with every line cited to the document it came from. Fair Measure Billing Experts prepares and signs the report when you need someone else to write it.