Cost analysis for CPT 00813 — Anesthesia for procedure on small and large bowel using an endoscope
Average Medicare Payment
$97.10
2023 data
Total Payments (2023)
$40.6M
Services (2023)
410.8K
Price Change (2018–2023)
-5.1%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2018 | $102.28 | $43.8M | 425.7K | — |
| 2019 | $103.64 | $46.7M | 447.6K | +1.3% |
| 2020 | $105.08 | $38.4M | 361.7K | +1.4% |
| 2021 | $102.93 | $47.3M | 452.9K | -2.0% |
| 2022 | $100.71 | $44.0M | 429.0K | -2.2% |
| 2023 | $97.10 | $40.6M | 410.8K | -3.6% |
The most expensive state pays 2.2x more than the cheapest for this procedure. AK averages $157.32 vs AL at $71.35.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $157.32 | $54.7K | 348 | 20 |
| CA | $127.37 | $3.6M | 28.3K | 1.1K |
| PR | $118.93 | $99.4K | 836 | 14 |
| MT | $118.60 | $125.7K | 1.1K | 50 |
| WY | $118.40 | $111.1K | 938 | 33 |
| HI | $117.53 | $110.9K | 944 | 32 |
| ID | $117.19 | $78.9K | 673 | 31 |
| WA | $117.15 | $523.4K | 4.5K | 221 |
| NM | $116.66 | $175.8K | 1.5K | 63 |
| UT | $114.81 | $122.5K | 1.1K | 58 |
| MD | $112.42 | $1.5M | 13.1K | 412 |
| NV | $112.09 | $274.7K | 2.5K | 73 |
| NY | $111.79 | $3.0M | 26.4K | 974 |
| OR | $111.05 | $165.7K | 1.5K | 81 |
| OK | $109.57 | $561.9K | 5.1K | 178 |
| CO | $109.02 | $341.1K | 3.1K | 144 |
| AR | $107.14 | $351.3K | 3.3K | 109 |
| AZ | $104.17 | $736.7K | 7.1K | 259 |
| FL | $103.89 | $4.4M | 42.1K | 1.3K |
| IA | $101.95 | $190.8K | 1.9K | 86 |
| IL | $101.33 | $2.1M | 20.5K | 874 |
| NJ | $100.87 | $1.3M | 13.3K | 448 |
| LA | $100.86 | $568.3K | 5.6K | 203 |
| KY | $99.85 | $783.5K | 7.8K | 325 |
| NE | $99.45 | $215.2K | 2.2K | 89 |
| TX | $97.08 | $3.3M | 33.9K | 1.2K |
| TN | $97.03 | $1.1M | 10.8K | 427 |
| KS | $96.28 | $513.4K | 5.3K | 250 |
| DE | $96.26 | $237.3K | 2.5K | 82 |
| IN | $95.72 | $563.5K | 5.9K | 282 |
| OH | $93.00 | $1.2M | 12.5K | 553 |
| NH | $92.73 | $195.4K | 2.1K | 114 |
| MS | $92.39 | $486.3K | 5.3K | 160 |
| DC | $91.24 | $127.5K | 1.4K | 65 |
| ND | $91.20 | $97.6K | 1.1K | 48 |
| MO | $90.83 | $731.5K | 8.1K | 356 |
| NC | $89.89 | $1.2M | 13.6K | 540 |
| WI | $89.54 | $336.1K | 3.8K | 188 |
| VT | $88.76 | $29.3K | 330 | 14 |
| CT | $88.41 | $632.9K | 7.2K | 272 |
| RI | $88.24 | $140.1K | 1.6K | 66 |
| ME | $88.17 | $102.0K | 1.2K | 66 |
| GA | $88.04 | $965.5K | 11.0K | 451 |
| AE | $86.56 | $10.4K | 120 | 3 |
| VA | $86.27 | $1.2M | 14.2K | 596 |
| SC | $86.18 | $985.9K | 11.4K | 374 |
| PA | $85.06 | $1.8M | 21.3K | 830 |
| MA | $84.08 | $1.1M | 13.2K | 600 |
| MI | $79.40 | $823.6K | 10.4K | 499 |
| SD | $78.70 | $175.7K | 2.2K | 111 |
| WV | $78.29 | $218.5K | 2.8K | 129 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Anna Tomlinson | Certified Registered Nurse Anesthetist (CRNA) | MD | $43.9K | 333 | $131.69 |
| Daniel Huther | Certified Registered Nurse Anesthetist (CRNA) | KY | $43.5K | 407 | $106.93 |
| Bruce Wilburn | Certified Registered Nurse Anesthetist (CRNA) | FL | $39.2K | 350 | $112.01 |
| Celestine Ukah | Anesthesiology | FL | $37.5K | 356 | $105.30 |
| Jeffrey Falk | Anesthesiology | NY | $33.3K | 495 | $67.23 |
| Betty Nemeth | Certified Registered Nurse Anesthetist (CRNA) | FL | $30.4K | 261 | $116.34 |
| Lilliana Villar Menendez | Certified Registered Nurse Anesthetist (CRNA) | PR | $26.9K | 207 | $130.17 |
| Barbara Sorensen | Anesthesiology | NJ | $26.7K | 245 | $108.99 |
| Mike Nickless | Certified Registered Nurse Anesthetist (CRNA) | FL | $26.3K | 239 | $109.89 |
| Daniel Rust | Certified Registered Nurse Anesthetist (CRNA) | WY | $25.6K | 234 | $109.58 |
| Barbara Ann Simchak | Certified Registered Nurse Anesthetist (CRNA) | MD | $25.6K | 214 | $119.80 |
| Kevin Pollak | Anesthesiology | NY | $25.4K | 187 | $135.64 |
| Paula Clark | Certified Registered Nurse Anesthetist (CRNA) | CA | $25.2K | 203 | $124.29 |
| Brenda Moody | Certified Registered Nurse Anesthetist (CRNA) | FL | $25.0K | 219 | $113.97 |
| Kelly Gignac | Certified Registered Nurse Anesthetist (CRNA) | FL | $24.8K | 202 | $122.63 |
| Lamona Monteiro | Anesthesiology | MD | $24.8K | 206 | $120.20 |
| Naga Danthuluri | Anesthesiology | AL | $24.2K | 217 | $111.58 |
| Daniel Schlichting | Certified Registered Nurse Anesthetist (CRNA) | TX | $24.1K | 227 | $106.10 |
| Mark Williams | Certified Registered Nurse Anesthetist (CRNA) | FL | $24.1K | 170 | $141.66 |
| Lauren Famularo | Certified Registered Nurse Anesthetist (CRNA) | FL | $23.8K | 183 | $130.17 |
The data suggests significant pricing inconsistencies for CPT 00813. With a 2.2x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
While costs have decreased 5.1% since 2018, the wide state-by-state variation suggests the pricing formula may not adequately account for regional differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.