Summary & Overview
CPT 01714: Anesthesia for Tenoplasty Procedures, Upper Arm and Elbow
CPT code 01714 represents anesthesia services for tenoplasty procedures on the upper arm and elbow, covering interventions from the elbow to the shoulder. This code is significant for hospitals and anesthesia providers nationwide, as it ensures proper billing and documentation for complex surgical cases involving the upper extremity. 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 payer-specific coverage, common billing modifiers, and associated clinical taxonomies relevant to anesthesia and pain medicine. The summary also highlights typical clinical scenarios, such as procedures performed in inpatient hospital settings, and outlines related CPT codes for similar anesthesia services. Additionally, the publication provides context on ICD-10 diagnoses commonly linked to these procedures, such as various forms of osteoarthritis and the presence of artificial knee joints.
This resource is designed to inform healthcare professionals, billing specialists, and policy analysts about the national landscape for anesthesia billing under CPT 01714, including benchmarks, policy updates, and clinical context. It serves as a comprehensive reference for understanding payer coverage and the procedural scope of this anesthesia code.
CPT Code Overview
CPT 01714 is used to report anesthesia services for procedures involving the nerves, muscles, tendons, fascia, and bursae of the upper arm and elbow, specifically for tenoplasty procedures from the elbow to the shoulder. This code falls under the anesthesia service type and is most commonly performed in an inpatient hospital setting (POS 21). It is essential for accurately documenting and billing anesthesia care provided during complex upper extremity surgical interventions.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient admitted to an inpatient hospital for surgical intervention on the upper arm or elbow, such as a tenoplasty procedure from the elbow to the shoulder. The patient may have underlying conditions like osteoarthritis or a history of joint replacement, necessitating surgical repair or reconstruction of tendons. The clinical workflow includes preoperative assessment, administration of anesthesia by an anesthesiologist or certified registered nurse anesthetist, intraoperative monitoring, and postoperative care. Anesthesia services are provided to ensure patient comfort and safety during the procedure, with documentation reflecting the involvement of the anesthesia provider and any medical direction or supervision as appropriate.
Coding Specifications
| Modifier Code | Description | Usage Scenario |
|---|---|---|
AA | Anesthesia services performed personally by anesthesiologist | Used when the anesthesiologist is directly providing the anesthesia service. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures | Used when an anesthesiologist is medically directing multiple anesthesia procedures concurrently. |
QS | Monitored anesthesia care service | Used when monitored anesthesia care is provided. |
QX | CRNA service with medical direction by a physician | Used when a certified registered nurse anesthetist provides anesthesia with physician medical direction. |
Associated Provider Taxonomies:
207L00000X- Anesthesiology: Physicians specializing in anesthesia care.207LA0401X- Pain Medicine (Anesthesiology): Physicians specializing in pain management within anesthesiology.367500000X- Certified Registered Nurse Anesthetist: Advanced practice nurses specializing in anesthesia care.
Related Diagnoses
-
M17.10- Unilateral primary osteoarthritis, unspecified knee- Relevant for patients with osteoarthritis affecting one knee, which may contribute to upper extremity musculoskeletal issues requiring surgical intervention.
-
M17.11- Unilateral primary osteoarthritis, right knee- Indicates osteoarthritis in the right knee; may be associated with altered biomechanics leading to upper arm or elbow tendon pathology.
-
M17.12- Unilateral primary osteoarthritis, left knee- Indicates osteoarthritis in the left knee; similar clinical relevance as above.
-
M17.5- Other unilateral secondary osteoarthritis of knee- Represents secondary osteoarthritis, which may be due to prior injury or surgery, potentially impacting upper extremity function.
-
Z96.651- Presence of right artificial knee joint- Indicates a history of knee replacement; relevant for patients with altered musculoskeletal function requiring upper arm or elbow procedures.
-
Z96.652- Presence of left artificial knee joint- Indicates a history of left knee replacement; similar clinical relevance as above.
Related CPT Codes
| CPT Code | Description | Clinical Relationship |
|---|---|---|
01712 | Anesthesia for procedures on the nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenotomy, elbow to shoulder. | Used for anesthesia during tenotomy procedures, which involve cutting tendons; may be performed in similar clinical scenarios as tenoplasty. |
01716 | Anesthesia for procedures on the nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenodesis, rupture of long tendon of biceps. | Used for anesthesia during tenodesis procedures, which involve tendon repair or stabilization; relevant when addressing tendon ruptures. |
These codes are alternatives to 01714 depending on the specific surgical procedure performed. They are not typically used together but may be selected based on the operative technique and clinical indication.
National Reimbursement Benchmarks
National mean rates for CPT code 01714 show that Blue Cross Blue Shield and Cigna have the highest average reimbursement, at $255.15 and $299.13 respectively, while UnitedHealth Group is notably lower at $65.56. The BUCA (average commercial) mean rate stands at $150.49, which is significantly higher than typical Medicare rates for similar services, though Medicare data is not available in the input for this code.
Rate dispersion varies widely across payers. UnitedHealth Group has the tightest range between the 25th and 75th percentiles ($25.08), indicating less variability in contracted rates. In contrast, Aetna and Cigna exhibit the widest spreads ($327.50 and $344.00 respectively), reflecting substantial variation in negotiated rates. The table and chart below present the full breakdown of national benchmarks for each payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska demonstrates a significant rate spread for CPT code 01714, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $95.40 ($370.00 minus $274.60). BUCA also shows a notable spread of $159.50 ($302.00 minus $142.50), indicating substantial variability in reimbursement rates across payers. In contrast, Aetna and UnitedHealth Group have minimal spreads, with all percentiles clustered closely around $72.00 to $75.00, suggesting more uniform payment practices.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are considerably 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, highlighting these differences and the overall landscape for CPT code 01714.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 01714 in Alaska, with a mean rate of $327.76.
- UnitedHealth Group offers the lowest mean rate at $74.78.
- Alaska's mean rates for most payers are higher than national averages, especially for Blue Cross Blue Shield and BUCA.
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.