CMS proposes 2018 endoscopy anesthesia updates: 5 key highlights from CRH Anesthesia

On July 13th CMS published its proposed changes to the 2018 fee schedule for sedation during upper and lower endoscopies.

CRH Anesthesia’s President, Jay Kreger, provides the 5 key highlights:

1. For two years CMS has been discussing a revaluation of the base units for upper and lower endoscopy anesthesia. This is primarily due to an increased reporting of anesthesia codes during endoscopic procedures.

2. The proposed changes would take effect January 1, 2018.

3. The updates come at a time when anesthesia-assisted endoscopy now represents approximately 50% of endoscopic procedures. It not only impacts the CPT coding but also the number of base units for anesthesia.

4. The 2 codes for sedation during upper and lower endoscopies (00740 and 00810) are to be deleted and replaced with 5 new codes.

a. Lower endoscopy: all procedures decrease by a base unit of 1 moving from a base of 5 to 4.
b. Upper endoscopy: all procedures remain at a base of 5 units.
c. Combined Upper and Lower Endoscopies: Double procedures will remain at a base of 5 units.
d. ERCP: procedures will increase to a base of 6 units.

5. The language indicates that a further reduction of 1 unit could be coming in the future for screening colonoscopies.

CRH Anesthesia acquires and develops anesthesia partnerships with Gastroenterologists. It currently partners in 27 GI ASCs across 8 states. With questions please contact CRH Anesthesia at 866-890-6550 or or visit

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