CPT 01967
Epidural for labor
The anesthesia code for a planned epidural during labor and vaginal delivery. Unlike most anesthesia codes it is not purely time-based: payers typically cap the time or pay a flat amount, because an epidural can run for many hours. If the delivery becomes a cesarean, an add-on code (01968) is billed with it.
Billed to Medicare
$2,960
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$512
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
5.8x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 2,241 services.
Of the 4 anesthesia codes on this site with CMS figures, this one has the narrowest gap between billed and accepted. The widest is Anesthesia for total hip replacement at 10.7x.
Where this line goes wrong
Long labors, long bills
Some anesthesia groups bill every minute the epidural was in place. Many insurers cap payment at a set number of units. If you are self-pay, the full time-based charge is the number to negotiate.
Cesarean add-on
If you delivered by cesarean after an epidural, expect 01967 plus 01968. If you had a planned cesarean with no labor epidural, the code should be 01961 instead, not 01967 plus 01968.
Out of network anesthesia at an in-network hospital
This is one of the most common surprise bills in maternity care, and federal surprise billing rules cover it.
Check it, then ask
- 1
Ask for the anesthesia record and check when the epidural was placed and when it was discontinued.
- 2
Ask the insurer how it pays labor epidurals (capped units or flat amount) and whether the claim was processed that way.
- 3
If the anesthesiologist was out of network, tell the insurer and the provider that the No Surprises Act applies.
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Codes that travel with this one
People also ask
Why was my epidural billed for 14 hours?
Because the provider billed the time the catheter was in. Whether that is payable depends on your plan's policy; many cap it. Ask the plan to apply its labor epidural policy.
Sources
- CMS, Medicare Claims Processing Manual, chapter 12, section 50 (anesthesia services)
- CMS, No Surprises Act, what patients can expect
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.