Summary & Overview
CPT 01484: Anesthesia for Osteotomy or Osteoplasty of Tibia and/or Fibula
CPT code 01484 represents anesthesia services for open procedures on the bones of the lower leg, ankle, and foot, specifically osteotomy or osteoplasty of the tibia and/or fibula. This code is significant for hospitals and anesthesia providers nationwide, as it ensures proper billing and documentation for complex orthopedic surgeries requiring specialized anesthesia care. The code is most commonly used in inpatient hospital settings, reflecting the complexity and intensity of these procedures.
Major national payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will gain insights into payer coverage, clinical context, and relevant policy updates for anesthesia services associated with orthopedic surgery. The publication also highlights common modifiers, associated provider taxonomies, and related CPT codes, offering a comprehensive overview for stakeholders involved in anesthesia billing and compliance.
Key benchmarks and clinical context are provided to help readers understand the scope and application of CPT code 01484 within the broader landscape of orthopedic surgical care. The summary includes information on typical diagnoses, such as unilateral primary osteoarthritis and the presence of artificial knee joints, which are frequently associated with these procedures. This resource is designed to inform healthcare professionals, billing specialists, and policy analysts about the latest developments and requirements for anesthesia services in orthopedic surgery.
CPT Code Overview
CPT code 01484 is used to report anesthesia services for open procedures involving the bones of the lower leg, ankle, and foot, specifically for osteotomy or osteoplasty of the tibia and/or fibula. This code applies to cases where a surgical intervention is performed to cut or reshape these bones. The service type is anesthesia, and the typical site of service is an inpatient hospital setting (Place of Service 21). This code is essential for accurately documenting and billing anesthesia care provided during complex orthopedic surgeries on the lower extremities.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient admitted to an inpatient hospital for surgical correction of a bone deformity or degenerative condition affecting the tibia and/or fibula. The patient may have a diagnosis such as unilateral primary osteoarthritis of the knee or may have a history of knee joint replacement. The surgical team performs an osteotomy or osteoplasty of the tibia and/or fibula to address pain, improve function, or correct alignment. Anesthesia services are provided throughout the open procedure, ensuring patient comfort and safety during the operation.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when anesthesia is provided in a manner that allows the patient to remain responsive but comfortable, typically for procedures where full general anesthesia is not required.QX: CRNA service with medical direction by a physician. Used when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia care under the medical direction of a physician.
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207L00000X | Anesthesiology |
367500000X | Certified Registered Nurse Anesthetist |
207X00000X | Orthopaedic Surgery |
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Service Type:
- Anesthesia
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Typical Site of Service:
- Inpatient Hospital (Place of Service
21)
- Inpatient Hospital (Place of Service
Related Diagnoses
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M17.10: Unilateral primary osteoarthritis, unspecified knee- Indicates osteoarthritis affecting one knee, without specifying laterality. Relevant for patients undergoing tibia or fibula surgery due to degenerative changes.
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M17.11: Unilateral primary osteoarthritis, right knee- Specifies osteoarthritis in the right knee. May necessitate surgical intervention on the tibia or fibula to address associated deformities or pain.
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M17.12: Unilateral primary osteoarthritis, left knee- Specifies osteoarthritis in the left knee. Relevant for procedures targeting the left tibia or fibula.
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M17.5: Other unilateral secondary osteoarthritis of knee- Refers to secondary osteoarthritis in one knee, possibly due to prior injury or surgery. May require osteotomy or osteoplasty for correction.
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Z96.651: Presence of right artificial knee joint- Indicates the patient has a right knee prosthesis. Surgery on the tibia or fibula may be related to complications or alignment issues with the artificial joint.
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Z96.652: Presence of left artificial knee joint- Indicates the patient has a left knee prosthesis. Relevant for procedures addressing the tibia or fibula in the context of a prosthetic knee.
Related CPT Codes
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01480: Anesthesia for open procedures on bones of lower leg, ankle, and foot; (open procedure) of lower leg, ankle, and foot- This code covers anesthesia for a broader range of open procedures on the lower leg, ankle, and foot. It may be used when the procedure is not specifically an osteotomy or osteoplasty.
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01482: Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)- This code is used for anesthesia during more extensive procedures, such as radical resection or below knee amputation. It is an alternative to
01484when the surgical intervention is more severe.
- This code is used for anesthesia during more extensive procedures, such as radical resection or below knee amputation. It is an alternative to
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01484: Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula- This is the primary code for anesthesia during osteotomy or osteoplasty of the tibia and/or fibula. It is commonly used when the surgical procedure is focused on correcting bone deformities or performing reconstructive surgery.
These codes may be used as alternatives depending on the specific surgical procedure performed. Only one anesthesia code is typically reported per procedure.
National Reimbursement Benchmarks
National mean rates for CPT code 01484 show significant variation across commercial payers. Blue Cross Blue Shield and Cigna have the highest mean rates at $223.62 and $249.00, respectively, while UnitedHealth Group is notably lower at $65.54. The BUCA average commercial mean rate stands at $129.22. Medicare rates are not available in the input for comparison.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, is widest for Cigna ($258.00) and Aetna ($235.00), indicating greater variability in contracted rates. UnitedHealth Group has the tightest range ($24.75), suggesting more consistent reimbursement levels. Blue Cross Blue Shield and BUCA also show moderate dispersion.
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 range in reimbursement rates for CPT code 01484, with Blue Cross Blue Shield offering the highest mean rate at $267.27 and UnitedHealth Group the lowest at $74.78. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($72.70), indicating significant variability in payments, while Aetna and UnitedHealth Group show minimal spread ($0.00 and $3.00, respectively), suggesting more consistent rates.
Compared to national averages, Alaska's mean rates for Aetna, Blue Cross Blue Shield, and Cigna are higher, while UnitedHealth Group's rate is only slightly above the national benchmark. The table and chart below present the full breakdown of payer-specific reimbursement rates in Alaska for CPT code 01484.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 01484 in Alaska, with a mean rate of $267.27.
- UnitedHealth Group offers the lowest mean rate at $74.78, significantly below both the state and national averages.
- Aetna and Cigna rates in Alaska are notably higher than their respective national averages, while Blue Cross Blue Shield's mean rate is also above the national benchmark.
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.