Summary & Overview
CPT 01926: Anesthesia for Therapeutic Interventional Radiological Procedures
CPT code 01926 represents anesthesia services for therapeutic interventional radiological procedures involving the intracranial arteries, intracardiac regions, or the aorta. This code is significant nationally due to its application in complex vascular and cardiac interventions, which require specialized anesthesia care in inpatient hospital settings. The procedures covered by this code are critical for patients undergoing advanced radiological treatments, often addressing serious conditions such as chronic pain, neurological disorders, or cardiovascular issues.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. The publication provides an overview of payer coverage, clinical context, and policy updates relevant to CPT code 01926. Readers will gain insights into typical sites of service, associated clinical diagnoses, and the importance of anesthesia in interventional radiology. The summary also highlights related codes and modifiers commonly used in billing, offering a comprehensive understanding of how this code fits within broader anesthesia and radiology service lines. This information is essential for healthcare professionals, administrators, and policy analysts seeking to stay informed about national trends and benchmarks in anesthesia billing for interventional radiological procedures.
CPT Code Overview
CPT code 01926 is used for anesthesia services provided during therapeutic interventional radiological procedures involving the arteries that are intracranial (within the skull), intracardiac (within the heart), or the aorta (the main artery distributing blood from the heart to the body). This code specifically covers anesthesia for complex radiological interventions that require specialized expertise due to the critical nature of the anatomical sites involved. The typical site of service for procedures billed under CPT code 01926 is an inpatient hospital setting, designated as Place of Service 21. These procedures are essential for patients undergoing advanced vascular or cardiac interventions, where anesthesia management is crucial for patient safety and procedural success.
Clinical & Coding Specifications
Clinical Context
A patient is admitted to an inpatient hospital for a therapeutic interventional radiological procedure involving the arteries within the skull (intracranial), the heart (intracardiac), or the aorta. The procedure may be indicated for conditions such as chronic pain, intervertebral disc disorders, or other specified disorders of the central nervous system. An anesthesia provider, such as an anesthesiologist or a certified registered nurse anesthetist (CRNA), administers anesthesia to ensure patient comfort and safety during the radiological intervention. The clinical workflow involves pre-procedure assessment, anesthesia induction, monitoring throughout the procedure, and post-procedure recovery.
Coding Specifications
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Modifiers:
Modifier Code Description QSMonitored anesthesia care service QXCRNA service with medical direction by a physician - Use
QSwhen monitored anesthesia care is provided. - Use
QXwhen a CRNA provides the service under physician medical direction.
- Use
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Provider Taxonomies:
Taxonomy Code Specialty Name 207L00000XAnesthesiology 367500000XCertified Registered Nurse Anesthetist 207LP2900XPain Medicine (Anesthesiology) 207L00000X: Represents anesthesiology specialists.367500000X: Represents certified registered nurse anesthetists.207LP2900X: Represents pain medicine specialists within anesthesiology.
Related Diagnoses
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M54.2– Cervicalgia- Relevant for patients experiencing neck pain, which may necessitate interventional radiological procedures for pain management.
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M54.5– Low back pain- Indicates low back pain, potentially requiring therapeutic intervention for pain relief.
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M51.9– Intervertebral disc disorder, unspecified- Represents disc disorders that may be treated with interventional radiological procedures.
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G89.29– Other chronic pain- Used for patients with chronic pain not otherwise specified, supporting the need for therapeutic intervention.
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G96.8– Other specified disorders of central nervous system- Indicates other CNS disorders that may require interventional radiological treatment with anesthesia.
Related CPT Codes
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01916– Anesthesia for diagnostic arteriography/venography01916is used for anesthesia services during diagnostic arteriography or venography procedures. It relates to01926as both involve anesthesia for radiological vascular procedures, but01926is specifically for therapeutic interventions involving intracranial, intracardiac, or aortic arteries.01916may be used as an alternative when the procedure is diagnostic rather than therapeutic. These codes are not typically used together in the same encounter.
National Reimbursement Benchmarks
National mean rates for CPT code 01926 show that BUCA (average commercial) reimbursement is $264.31, while Medicare rates are not available in the input. Among commercial payers, Cigna has the highest mean rate at $547.45, and UnitedHealth Group has the lowest at $65.57.
Rate dispersion varies significantly across payers. Cigna exhibits the widest spread, with a difference of $771.00 between its 75th and 25th percentiles, indicating substantial variability in payment rates. In contrast, UnitedHealth Group has the tightest range, with only $25.13 separating its 75th and 25th percentiles, suggesting more consistent reimbursement levels.
The table and chart below present a detailed breakdown of national benchmarks for each payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska exhibits a wide range in reimbursement rates for CPT code 01926, with Blue Cross Blue Shield showing the largest spread between the 25th and 75th percentiles ($208.25), indicating significant variability in payments. In contrast, Aetna and UnitedHealth Group have minimal rate spreads, with all percentiles clustered closely around $72.00, suggesting consistent but lower payments. Cigna also demonstrates a narrow spread, with rates ranging from $85.00 to $93.00.
When compared to national averages, Blue Cross Blue Shield in Alaska pays considerably more, while Cigna and UnitedHealth Group pay less than their national counterparts. The table and chart below present the full breakdown of payer-specific rates for Alaska, highlighting these differences and the overall distribution of reimbursement levels.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 01926 in Alaska, with a mean rate of $629.71, while UnitedHealth Group is the lowest at $74.78.
- The rate spread in Alaska is substantial, especially for Blue Cross Blue Shield, with a 75th percentile of $726.25 and a 25th percentile of $518.00.
- Compared to national averages, Cigna and UnitedHealth Group pay significantly less in Alaska, while Blue Cross Blue Shield pays notably more.
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.