Summary & Overview
CPT 01490: Anesthesia for Lower Leg (Below Knee) Procedures
CPT 01490 denotes anesthesia care rendered for procedures on the lower leg below the knee and is part of the anesthesia service family used across surgical specialties treating tibial, ankle, and foot conditions. Nationally, this code matters because it standardizes reporting for anesthesia time and resources tied to lower leg procedures performed in outpatient hospital settings, supporting clinical documentation, billing consistency, and payment determination.
Major commercial payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find an overview of the clinical context in which CPT 01490 is used, comparisons to closely related anesthesia codes for other lower leg surgical scenarios, and typical billing considerations relevant to outpatient hospital procedures. The publication outlines how CPT 01490 fits within anesthesia service lines and highlights common procedural indications that generate its use, enabling administrators and coders to align documentation with coding expectations.
This summary provides benchmarks and policy-relevant detail for coding accuracy, payer coverage considerations, and code selection among related lower-leg anesthesia codes. It is intended to inform billing managers, anesthesia providers, and compliance teams seeking a concise reference on CPT 01490 and its clinical billing role nationwide.
CPT Code Overview
CPT 01490 describes anesthesia services provided for procedures on the lower leg (below knee). This code is classified under Anesthesia and applies when the patient is placed under anesthesia for surgical or procedural interventions on the lower leg below the knee. The typical site of service for CPT 01490 is Outpatient Hospital (POS 22).
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with progressive right knee pain from osteoarthritis presents for operative management requiring procedures below the knee performed under anesthesia. The patient is evaluated in the outpatient hospital preoperative area (POS 22), consented, and taken to the operating room for a below-knee procedure such as arthrotomy or debridement under general or regional anesthesia. Anesthesia care is provided by a Certified Registered Nurse Anesthetist with or without physician direction; intraoperative monitoring and postoperative PACU recovery are part of the clinical workflow.
Coding Specifications
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Modifiers:
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QS— Monitored anesthesia care service. Use when anesthesia services are documented as monitored anesthesia care rather than general or regional anesthesia for the below-knee procedure. -
QX— CRNA service with medical direction by a physician. Use when a Certified Registered Nurse Anesthetist (CRNA) performs the anesthesia service and there is documented medical direction by a physician. -
Associated provider taxonomies:
| Taxonomy Code | Specialty |
|---|---|
367500000X | Certified Registered Nurse Anesthetist |
Related Diagnoses
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M23.50— Chronic instability of knee, unspecified kneeClinical relevance: Chronic knee instability can lead to procedures below the knee for stabilization, debridement, or other interventions requiring anesthesia.
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M17.11— Unilateral primary osteoarthritis, right kneeClinical relevance: Primary osteoarthritis of the knee often leads to surgical procedures below the knee such as arthroscopy, debridement, or joint-related interventions performed under anesthesia.
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M17.12— Unilateral primary osteoarthritis, left kneeClinical relevance: Same relevance as
M17.11for the left knee; may indicate laterality for procedure planning and anesthesia documentation. -
S83.241A— Other tear of medial meniscus, current injury, right knee, initial encounterClinical relevance: Acute medial meniscus tear in the right knee commonly requires operative intervention below the knee such as arthroscopy under anesthesia.
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S83.242A— Other tear of medial meniscus, current injury, left knee, initial encounterClinical relevance: Acute medial meniscus tear in the left knee similarly may require anesthesia for operative repair or debridement.
Related CPT Codes
| CPT Code | Description | Clinical relationship |
|---|---|---|
01480 | Under anesthesia for procedures on the lower leg (below knee) – open procedure on bones of lower leg, ankle, and foot | Alternative for open bone procedures below the knee; may be used instead of 01490 when the primary procedure involves open bone work rather than soft tissue or other below-knee procedures. |
01482 | Under anesthesia for procedures on the lower leg (below knee) – procedure on bones including radical resection (including below knee amputation) | Used when radical bone resection or below-knee amputation is performed; represents a different level of anesthesia complexity compared with 01490. |
01484 | Under anesthesia for procedures on the lower leg (below knee) – osteotomy or osteoplasty of tibia and/or fibula | Related when corrective osteotomy of tibia/fibula is performed; an alternative when bony osteotomy is the primary operative focus. |
01486 | Under anesthesia for procedures on the lower leg (below knee) – total ankle replacement | Related when total ankle arthroplasty is the procedure; may be selected instead of 01490 when arthroplasty of the ankle is the primary procedure. |
01500 | Under anesthesia for procedures on the lower leg (below knee) – procedure on arteries including placement of bypass graft | Related for vascular procedures below the knee such as bypass graft placement; an alternative when arterial intervention is the primary operative procedure. |
Commonly used together or as alternatives: these codes represent different procedural categories for anesthesia coverage below the knee and are chosen based on the primary operative procedure; 01490 is used for general below-knee procedures not specifically categorized under the listed alternatives.
National Reimbursement Benchmarks
National commercial mean rates exceed Medicare and BUCA average benchmarks for CPT 01490. BUCA (representing the broader commercial average) posts a mean of $104.80 while Medicare is not provided in the input, making Medicare comparison unavailable in the source data. The table and chart below present the full payer breakdown.
Rate dispersion (P75 minus P25) varies significantly by payer. Cigna and BCBS show the widest interquartile ranges (Cigna: $173.00, BCBS: $136.33), indicating greater variability in allowed amounts, while UnitedHealth Group is the tightest (UHC IQR: $25.08), followed by BUCA (IQR: $95.00). The table and chart below present the full payer breakdown.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska exhibits a significant rate spread for CPT code 01490, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $91.47 ($268.67 minus $177.20). Other payers, such as Aetna and UnitedHealth Group, show minimal spread, with all percentiles clustered at $72.00 or slightly above. This indicates that reimbursement variability is largely driven by Blue Cross Blue Shield and BUCA, while Aetna, Cigna, and UnitedHealth Group maintain more consistent rates.
Compared to national averages, Alaska's mean rates for most payers are notably higher, especially for Blue Cross Blue Shield and BUCA. However, Cigna and UnitedHealth Group in Alaska fall below their respective national mean rates. The table and chart below present the full breakdown of payer-specific reimbursement rates for CPT code 01490 in Alaska.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 01490 in Alaska, with a mean rate of $219.15.
- UnitedHealth Group offers the lowest mean rate in Alaska at $74.78.
- Alaska's mean rates for most payers are higher than national averages, except for Cigna and UnitedHealth Group, which are below their respective national means.
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.