CPT CODEPerformance MeasuresStatus J

CPT Code 01937Complete Billing & Coding Guide (2026)Anes drg/aspir crv/thrc

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$0
Non-facility · National avg
Facility
$0
Total RVU
0.00
Global
XXX
Payment
$0
non-facility
Work RVU
0.00
physician effort
Global Period
XXX
no post-op
Bundling Edits
10
NCCI pairs

About CPT 01937

CPT 01937 is a Current Procedural Terminology code in the Performance Measures category maintained by the American Medical Association. The CMS short descriptor reads "Anes drg/aspir crv/thrc". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

Documentation specificity, correct ICD-10 linkage, and modifier accuracy determine whether 01937 pays cleanly or triggers a denial. Verify CMS National Physician Fee Schedule status, applicable Medicare LCDs, and any payer-specific medical policies before submission.

Pro Tip

01937 has 10 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.

Code Properties

Global Period
XXX
Not applicable (E/M, diagnostic, etc.)
Status Indicator
J
Anesthesia code. Anesthesia-specific payment rules apply.
Conversion Factor
$33.4009
CMS national rate
Effective Date
2026-04-01
per CMS publication

RVU Breakdown

Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.

RVU Composition
0.00 total RVU
Work RVU
0.00 · 0%
Physician time + skill
Practice Expense
0.00 · 0%
Office & equipment
Malpractice
0.00 · 0%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$0.00
0.00 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$0.00
0.00 RVU × $33.4009 CF

Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.

NCCI Bundling Edits

10 pairs

These codes trigger National Correct Coding Initiative edits when billed with 01937. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.

Common Denial Risk

Billing 01937 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.

AR Recovery Note

Bundling denials on 01937 are recoverable when the edit indicator is 1 and the chart documents a distinct, separately identifiable service. Our coders verify the indicator and pick the precise X-modifier (XE, XS, XP, XU) instead of defaulting to modifier 59.

Applicable Modifiers

Modifiers commonly paired with 01937 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.

33
Preventive services — when the primary purpose is delivery of an evidence-based service per USPSTF A or B recommendation
When to use · Screening services (colonoscopy, mammography, etc.) to indicate the primary purpose is preventive. Waives cost-sharing under ACA.
GA
Waiver of liability statement issued as required by payer policy (ABN on file)
When to use · Medicare: when an Advance Beneficiary Notice (ABN) has been signed by the patient for services that may not be covered.
GY
Item or service statutorily excluded or does not meet the definition of any Medicare benefit
When to use · Service is never covered by Medicare (e.g., cosmetic procedures). May bill patient directly.
GZ
Item or service expected to be denied as not reasonable and necessary — no ABN on file
When to use · When a service is expected to be denied by Medicare and no ABN was obtained. Provider cannot bill the patient.
KX
Requirements specified in the medical policy have been met
When to use · Attestation that LCD/NCD criteria have been met. Common with therapy cap exceptions and DME.
AR Recovery Note

Modifier audits catch what scrubbers miss. Our AAPC-certified team reviews every modifier choice on 01937 against the chart documentation before submission, surfacing missed and misapplied modifiers across the practice.

Supporting ICD-10 Diagnoses

These diagnosis codes commonly support medical necessity for CPT 01937. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.

1
CMS LCD: Billing and Coding: Monitored Anesthesia Care
CMS LCD
A40.3Sepsis due to Streptococcus pneumoniae
A40.9Streptococcal sepsis, unspecified
A41.01Sepsis due to Methicillin-susceptible Staphylococcus aureus
A41.02Sepsis due to Methicillin-resistant Staphylococcus aureus (MRSA)
A41.1Sepsis due to other specified Staphylococcus
A41.2Sepsis due to unspecified Staphylococcus
A41.3Sepsis due to Hemophilus influenzae
A41.4Sepsis due to anaerobes
A41.50Gram-negative sepsis, unspecified
A41.51Sepsis due to Escherichia coli (E. coli)
A41.52Sepsis due to Pseudomonas
A41.53Sepsis due to Serratia
AR Recovery Note

CARC 50 medical-necessity denials carry both rework cost and an audit-risk signal when patterns repeat. Our coders verify ICD-10 specificity and policy alignment at the coding stage so these losses get prevented upstream.

Free 90-Day AR Recovery Audit

Find the revenue leakage in your 01937 claims.

Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Performance Measures claims. Our AAPC-certified team audits your last 90 days of 01937 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

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FAQ

Everything about CPT 01937

What does CPT code 01937 cover?

CPT 01937 is a Current Procedural Terminology code in the Performance Measures category maintained by the American Medical Association. The CMS short descriptor reads "Anes drg/aspir crv/thrc". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

What is the Medicare payment for CPT 01937?

The national average Medicare payment for CPT 01937 is approximately $0 in a non-facility setting and $0 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 0 with a conversion factor of $33.4009.

What is the global period for CPT 01937?

CPT 01937 has no global period (indicator XXX). There are no post-operative day restrictions tied to this code. Refer to CMS National Physician Fee Schedule rules and any applicable NCCI edits when billing on the same date as other services.

What codes bundle with CPT 01937?

CPT 01937 has NCCI Procedure-to-Procedure edits with 10+ codes including 01996, 0213T, 0216T. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.

CMS Medicare Physician Fee ScheduleNCCI Edits · Current QuarterAMA CPT Code Set

CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.

Free 90-Day AR Recovery Audit

We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.