CPT 00811 cost and Medicare rate
For code 00811, anesthesia for other procedure on large bowel using an endoscope, Medicare's typical allowed amount nationally was about $98 in 2024, and providers typically billed about $1,021. Medicare rates are a common benchmark, not what every plan pays.
What CPT 00811 is
Anesthesia for other procedure on large bowel using an endoscope.
Code 00811 is an anesthesia code paid on a separate scale. The figures here are Medicare's typical allowed amounts from 2024 instead.
What Medicare pays for 00811 nationally
| Setting | Medicare allowed 2024 | Typically billed 2024 |
|---|---|---|
| Office or clinic | $107.10 | $1,183.82 |
| Hospital or other facility | $98.36 | $1,021.47 |
00811 by state
Where you were treated changes the benchmark. These are Medicare's typical allowed amounts in each state in 2024. Billed amounts are what providers typically billed in a hospital or other facility in 2024.
| State | Medicare allowed 2024 | Typically billed 2024 |
|---|---|---|
| California | $125.34 | $1,180.67 |
| New York | $108.93 | $1,467.85 |
| Texas | $96.11 | $1,182.87 |
| Florida | $101.86 | $1,242.23 |
| Illinois | $101.37 | $1,132.53 |
| Ohio | $94.66 | $848.57 |
| Georgia | $86.22 | $1,169.43 |
| Washington | $116.59 | $959.13 |
| Pennsylvania | $87.74 | $791.28 |
| Arizona | $105.12 | $1,220.88 |
What your charge for 00811 means
Med Bill Check compares a charge with Medicare's rate and with what providers typically billed. Here is how it reads three national charges:
- Charged $100: Your $100 is close to the Medicare rate, which is a good sign. Medicare rates are a common benchmark, not what every plan pays.
- Charged $200: Your $200 is about 2 times the Medicare rate, though below what providers typically billed. That is a common benchmark rather than a verdict, and asking for an itemized bill or a self-pay discount is a sensible next step.
- Charged $390: Your $390 is about 4 times the Medicare rate, though below what providers typically billed. That is a common benchmark rather than a verdict, and asking for an itemized bill or a self-pay discount is a sensible next step.
Medicare rates are a common benchmark, not what every plan or provider charges, and never proof a bill is wrong. Enter your own charge and state on the home page for your figures.
Common billing questions for 00811
- Duplicates and services you did not get: Look for duplicate lines, services you did not receive, and unit counts that look high.
How to question a charge for 00811
- Ask for an itemized bill with codes, units and prices. Itemized bill letter.
- Compare each line with your Explanation of Benefits if you have insurance.
- Ask the billing office to review the charge in writing, and to hold the account from collections meanwhile. Charge review letter.
- Ask for a prompt-pay or self-pay discount, or an interest-free payment plan. Discount letter.
- If it was a hospital, ask for its financial assistance policy. Financial assistance letter and which hospitals must offer it.
With your code and amount, the review letter adds the benchmark for you, for example: For reference, Medicare's published 2024 data shows a typical allowed amount of about $98 for code 00811 in the US, and a typical billed amount of about $1,021.
Keep a copy of everything you send, and note the date and the name of anyone you speak to. If you have insurance, call your insurer too. They can check whether the claim was processed correctly.
Quick answers
- What is CPT 00811?
- Anesthesia for other procedure on large bowel using an endoscope.
- How much does Medicare pay for 00811?
- Code 00811 is an anesthesia code paid on a separate scale. Medicare's typical allowed amount nationally was $98.36 in 2024.
- What do providers typically charge for 00811?
- In 2024, providers nationally typically billed $1,021.47 for 00811 in a hospital or other facility.
- Is $390 for 00811 too much?
- Your $390 is about 4 times the Medicare rate, though below what providers typically billed. That is a common benchmark rather than a verdict, and asking for an itemized bill or a self-pay discount is a sensible next step.
- How much is 00811 in Texas?
- For code 00811, anesthesia for other procedure on large bowel using an endoscope, Medicare's typical allowed amount in Texas was about $96 in 2024, and providers typically billed about $1,183. Medicare rates are a common benchmark, not what every plan pays.
Sources
- CMS Medicare Physician and Other Practitioners by Geography and Service, 2024 data (data.cms.gov)
General information, not medical, legal or financial advice. Medicare rates are a common benchmark, not what every plan or provider charges. For your own bill, check with the billing office, your insurer or your doctor.
Ask Med Bill Check yourself
Enter the code or the service in plain words, your state and what you were charged, and see how it compares with Medicare's rate. Open Med Bill Check, free, no sign-up.
In Claude or any app that takes MCP connectors, add https://goodturn-mcp.pages.dev/medbillcheck/mcp and ask: “Is $200 for 00811 in Texas too much?”
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