The anesthesia fee: base units, time and a local factor
Anesthesia is the only line of a surgery bill built from a public formula; pick a procedure and a time to see it.
Anesthesia for facelift at national rates
$312
(5 base units + 10.2 time units) x $20.50.
| Base units, anesthesia code 00300 | 5 |
| Time units for 153 minutes | 10.2 |
| Conversion factor of the locality | $20.50 |
| Each extra 15 minutes | $20 |
Medicare 2026 conversion factor; the default time is the median skin-to-skin time CMS records for the codes, or a published series where CMS records none.
Compiled by Radif Partners · Where each line comes from · CMS 2026 rate files · not a quote
An anesthesia bill follows a formula that Medicare publishes: a fixed number of base units for the type of operation, plus one time unit for every fifteen minutes of anesthesia, the sum multiplied by a dollar conversion factor. For 2026 the national factor is $20.50 and each Medicare locality has its own, from $19.60 in the locality of Nashville to $22.81 in that of New York City among the metro areas priced here. A tummy tuck carries 5 base units; at the 120 minutes CMS records for it, that makes 13 units and $266 at the national factor. A facelift of 153 minutes comes to $312. Private anesthesia groups bill their own conversion factor, usually higher than Medicare's, on the same units.
Base units
Each anesthesia code describes a region and type of operation and carries a number of base units that reflects its difficulty. The CMS base unit file lists them; its latest edition on the CMS site is that of 2022. Cosmetic operations use few codes: 3 base units for skin procedures on the limbs and front of the trunk, 5 for breast reconstruction or augmentation, 5 for the lower abdominal wall, 5 for the skin of the head and neck, 5 for the nose. When several procedures share a session, only the highest base units count.
| Procedure | Anesthesia code | Base units | Default minutes | Time units | At the national factor |
|---|---|---|---|---|---|
| Tummy tuck | 00802 | 5 | 120 | 8 | $266 |
| Liposuction | 00400 | 3 | 174 | 11.6 | $299 |
| Brazilian butt lift | 00300 | 5 | 174 | 11.6 | $340 |
| Breast augmentation | 00402 | 5 | 60 | 4 | $184 |
| Breast lift | 00402 | 5 | 120 | 8 | $266 |
| Rhinoplasty | 00160 | 5 | 120 | 8 | $266 |
| Facelift | 00300 | 5 | 153 | 10.2 | $312 |
| Brow lift | 00300 | 5 | 70 | 4.7 | $199 |
| Upper eyelid surgery | 00103 | 5 | 33 | 2.2 | $148 |
| Lower eyelid surgery | 00103 | 5 | 36 | 2.4 | $152 |
| Chin implant | 00190 | 5 | 55 | 3.7 | $178 |
| Otoplasty | 00120 | 5 | 120 | 8 | $266 |
| Arm lift | 00400 | 3 | 113 | 7.5 | $215 |
| Thigh lift | 00400 | 3 | 150 | 10 | $266 |
| Gynecomastia surgery | 00400 | 3 | 50 | 3.3 | $129 |
Time units
Anesthesia time runs from when the anesthesia provider starts preparing the patient to when the patient is safely handed over after the operation, which is longer than the surgical time. Medicare divides it by fifteen and keeps one decimal. The defaults of this site are surgical times recorded by CMS or measured in published series, so real anesthesia time, and the real bill, are higher. Typing the minutes on your estimate gives a better figure.
Your anesthesia time
Anesthesia for tummy tuck at national rates
$348
| Base units, anesthesia code 00802 | 5 |
| Time units for 180 minutes | 12 |
| Conversion factor of the locality | $20.50 |
| Each extra 15 minutes | $20 |
The conversion factor and who bills it
The CMS conversion factors for 2026 differ by locality to reflect local costs, and the site uses the column for providers outside advanced payment models. An anesthesiologist, a nurse anesthetist or a team of both can give the anesthesia. A team splits the payment, the total staying the same under Medicare. In private cosmetic practice, the anesthesia group sets its own conversion factor and may bill separately from the surgeon and the facility, sometimes after the operation: asking for its rate and the expected time beforehand avoids the surprise.
MedlinePlus explains that some operations, such as eyelid surgery or small liposuctions, can be done with local anesthesia given by the surgeon, sometimes with medicine to relax. In that case there may be no anesthesia line at all, and the calculator's anesthesia quote field can be set to the amount you were given. The facility page covers the operating room line.