Summary & Overview
CPT 01480: Anesthesia for Lower Leg Bone Surgery
CPT code 01480 represents anesthesia services for lower leg bone surgery, a critical component in orthopedic procedures requiring pain management and patient safety. This code is widely recognized across the United States and is utilized in facility settings such as hospitals and ambulatory surgery centers. The publication examines coverage and policy considerations from major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
Readers will gain insight into the clinical context of lower leg bone surgeries, typical billing practices, and relevant modifiers such as QS for monitored anesthesia care and QX for Certified Registered Nurse Anesthetist services with physician direction. The summary also highlights associated provider taxonomies and common ICD-10 diagnoses linked to lower leg fractures. Additionally, related CPT codes for orthopedic procedures are discussed to provide a comprehensive view of the billing landscape.
This article offers benchmarks, policy updates, and a clear overview of how anesthesia services for lower leg bone surgery are coded and reimbursed, supporting stakeholders in understanding national trends and payer requirements.
CPT Code Overview
CPT code 01480 is used to report anesthesia services for surgical procedures involving the lower leg bones. This code is specifically designated for anesthesiology care provided during lower leg bone surgery. The typical site of service for procedures billed under 01480 is a facility setting, such as a hospital or ambulatory surgery center. These services are essential for ensuring patient comfort and safety during complex orthopedic interventions on the lower extremities.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to a hospital or ambulatory surgery center with a closed fracture of the tibia, such as a fracture of the upper, shaft, or lower end of the right or left tibia. The patient is scheduled for lower leg bone surgery, which may include open reduction and internal fixation or other surgical repair. An anesthesiology provider, such as an anesthesiologist, certified registered nurse anesthetist (CRNA), or anesthesiology assistant, administers anesthesia for the procedure. The workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative care in a facility setting.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care (MAC) during the procedure.QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia services under the medical direction of a physician.
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207L00000X | Anesthesiology |
367500000X | Certified Registered Nurse Anesthetist |
207RA0401X | Anesthesiology Assistant |
- Specialties Represented:
- Anesthesiology
- Certified Registered Nurse Anesthetist
- Anesthesiology Assistant
Related Diagnoses
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S82.101A: Fracture of upper end of right tibia, initial encounter for closed fracture- Indicates a closed fracture at the upper end of the right tibia, relevant for lower leg bone surgery requiring anesthesia.
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S82.102A: Fracture of upper end of left tibia, initial encounter for closed fracture- Represents a closed fracture at the upper end of the left tibia, necessitating surgical intervention and anesthesia.
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S82.201A: Fracture of shaft of right tibia, initial encounter for closed fracture- Describes a closed fracture of the shaft of the right tibia, commonly managed with surgical repair under anesthesia.
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S82.202A: Fracture of shaft of left tibia, initial encounter for closed fracture- Refers to a closed fracture of the shaft of the left tibia, often requiring lower leg bone surgery with anesthesia.
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S82.301A: Fracture of lower end of right tibia, initial encounter for closed fracture- Indicates a closed fracture at the lower end of the right tibia, relevant for procedures involving anesthesia for lower leg bone surgery.
Related CPT Codes
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27814: Open treatment of bimalleolar ankle fracture, includes internal fixation, when performed- This code is used for surgical repair of bimalleolar ankle fractures and may require anesthesia services billed with
01480.
- This code is used for surgical repair of bimalleolar ankle fractures and may require anesthesia services billed with
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27792: Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed- This code represents surgical treatment of distal fibular fractures, often performed in conjunction with anesthesia services.
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20680: Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)- This code is used for removal of deep orthopedic implants, which may require anesthesia for lower leg bone surgery.
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27650: Repair, primary, open or percutaneous, of ruptured Achilles tendon- This code is for surgical repair of a ruptured Achilles tendon, a procedure that may involve anesthesia services for the lower leg.
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Clinical Workflow Relation:
- These codes represent surgical procedures commonly performed on the lower leg. Anesthesia services billed with
01480are typically provided during these procedures. Codes such as27814and27792are often used together with01480in the same surgical session, while20680and27650may be alternatives or additional procedures depending on the clinical scenario.
- These codes represent surgical procedures commonly performed on the lower leg. Anesthesia services billed with
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 01480 among commercial payers (BUCA) is $145.76, while UnitedHealth Group (UHC) has the lowest mean rate at $65.57. Aetna stands out with the highest mean rate at $271.29. Medicare rates are not available in the input for comparison.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Aetna exhibits the widest spread ($314.85), indicating substantial variability in contracted rates. In contrast, UnitedHealth Group shows the tightest range ($25.18), suggesting more consistent reimbursement levels. Blue Cross Blue Shield and Cigna fall in between, with ranges of $80.05 and $173.42, respectively.
The table and chart below present a detailed breakdown of national benchmarks for each payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a wide spread in reimbursement rates for CPT code 01480 across commercial payers. Blue Cross Blue Shield shows the largest rate spread, with a 75th percentile of $266.54 and a 25th percentile of $177.20, resulting in a $89.34 difference. Aetna's spread is also notable, with a $30.00 difference between the 75th and 25th percentiles. Cigna and UnitedHealth Group have much narrower spreads, both under $10.00, indicating less variability in their rates.
Compared to national averages, Aetna and Blue Cross Blue Shield mean rates in Alaska are substantially higher, while Cigna and UnitedHealth Group are below their respective national means. The table and chart below present the full breakdown of payer-specific rates in Alaska for CPT code 01480.
Key Insights for Alaska
- Aetna is the highest paying payer for CPT 01480 in Alaska, with a mean rate of $223.63, while UnitedHealth Group is the lowest at $74.78.
- Blue Cross Blue Shield and Aetna both offer mean rates significantly above the national averages for their respective payers.
- Cigna and UnitedHealth Group rates in Alaska are notably lower than Aetna and Blue Cross Blue Shield, with Cigna's mean rate also falling well below its national average.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.