Summary & Overview
CPT 01952: Anesthesia for Burn Excision/Debridement, 4–9% TBSA
CPT 01952 designates anesthesia care for excision or debridement of second- and third‑degree burns when 4–9% of total body surface area (TBSA) is treated without skin grafting. This code is used in facility-based anesthesiology contexts, primarily in hospital inpatient and outpatient surgical settings, and captures the anesthetic complexity associated with burn wound management that does not include grafting procedures. Nationally, accurate coding for burn excision/debridement cases affects clinical documentation, facility billing workflows, and payer adjudication because TBSA thresholds determine appropriate code selection and bundling with related services.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find a concise explanation of what CPT 01952 represents, how it fits into anesthesiology service delivery, and how it relates to adjacent codes for smaller or additional TBSA levels. The publication also outlines relevant clinical context for burn debridement without grafting, common sites of service, and operational considerations for facility-based billing. If supplementary metadata for service lines or payer-specific policy language is required, note that some service line metadata is not provided in the input. Data not available in the input.
CPT Code Overview
CPT 01952 describes anesthesia for second- and third‑degree burn excision or debridement without skin grafting when a total body surface area (TBSA) of 4–9 percent is treated during the anesthesia and surgery. The procedure falls under the Anesthesiology service line and is delivered in a facility-based environment. Typical sites of service include hospital inpatient and hospital outpatient surgical settings where operative management of partial- and full-thickness burns occurs.
Clinical & Coding Specifications
Clinical Context
A middle-aged patient presents to a hospital-based operating room for surgical excision and debridement of second- and third-degree burns involving multiple body regions. The anesthesia team documents total body surface area (TBSA) treated during the procedure as 4–9 percent and provides general anesthetic care for excision and debridement without skin grafting. The workflow includes preoperative assessment in the hospital or outpatient surgical setting, anesthesia induction and intraoperative management tailored to burn physiology (airway, fluid status, and pain control), surgical excision/debridement of the affected areas, and postoperative handoff to recovery or the inpatient burn service for monitoring and wound care planning.
Coding Specifications
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Modifiers:
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QS— Monitored anesthesia care service. Use when anesthesia services provided meet monitored anesthesia care (MAC) definitions for the case. -
P1— A normal healthy patient. Use to indicate the patient’s physical status classification when appropriate documentation supports ASA P1. -
Provider Taxonomies:
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207L00000X— Anesthesiology: Physicians specializing in anesthetic management of surgical patients. -
207LP2900X— Pediatric Anesthesiology: Anesthesiologists with focus on pediatric patients. -
207LP3000X— Pain Medicine: Providers specializing in pain management, including perioperative pain considerations. -
Notes:
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Use modifier
QSonly where monitored anesthesia care applies; otherwise report appropriate anesthesia modality. ModifierP1is reported when the ASA physical status documented is P1. If documentation for a listed modifier is missing, do not append the modifier.
Related Diagnoses
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T31.0— Burns involving less than 10% of body surfaceClinical relevance: Indicates overall burn burden consistent with procedures treating limited TBSA such as 4–9% during excision/debridement.
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T21.31— Burn of third degree of chest wallClinical relevance: Describes a third-degree burn in the chest region that may require excision/debridement under anesthesia.
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T22.31— Burn of third degree of shoulder and upper limbClinical relevance: Third-degree burns of the shoulder/upper limb that can be included in the TBSA treated during the procedure.
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T23.301— Burn of third degree of wrist and handClinical relevance: Third-degree wrist/hand burns that often require surgical debridement managed under anesthesia.
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T24.301— Burn of third degree of lower limbClinical relevance: Third-degree burns of the lower limb that are indications for excision/debridement performed with anesthesia.
Related CPT Codes
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01951— Anesthesia for second‑ and third‑degree burn excision or debridement w/o skin grafting, TBSA less than 4 percent.Clinical relation: Used for smaller burn areas (TBSA < 4%). It is an alternative when the treated TBSA is under the 4% threshold.
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01953— Anesthesia for second‑ and third‑degree burn excision or debridement w/o skin grafting, each additional 9 percent TBSA.Clinical relation: Billed for each additional 9% TBSA treated beyond the initial TBSA range covered by the primary code. Commonly used in combination when treated TBSA exceeds the 4–9% range of
01952.
National Reimbursement Benchmarks
National mean commercial rates for CPT 01952 vary considerably, with Blue Cross Blue Shield and Cigna above the BUCA (average commercial) mean and UnitedHealth Group well below. Medicare mean is not provided in the input and is therefore not available for direct numeric comparison; BUCA at $145.20 serves here as the representative average commercial benchmark relative to available commercial payers.
Rate dispersion (P75 minus P25) is widest for Cigna and Aetna, reflecting broader variability (Cigna: $345.00 range; Aetna: $316.00 range). UnitedHealth Group shows the tightest distribution (range $25.08), followed by BUCA and BCBS with moderate dispersion. The table and chart below present the full payer breakdown.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a wide rate spread for CPT code 01952, particularly among commercial payers. Blue Cross Blue Shield shows the largest spread, with a 75th percentile rate of $370.00 and a 25th percentile rate of $274.60, resulting in a $95.40 difference. BUCA also demonstrates a substantial spread of $155.47 between its 75th and 25th percentiles. In contrast, Aetna and UnitedHealth Group have minimal spreads, with all percentiles clustered closely around $72.00 to $75.00, indicating little variation in their reimbursement rates.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are significantly higher, while Cigna and UnitedHealth Group are below their national means. The table and chart below present the full breakdown of payer-specific rates in Alaska, highlighting the substantial differences in reimbursement levels across payers.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 01952, with a mean rate of $327.79.
- UnitedHealth Group offers the lowest mean rate at $74.78, significantly below both the state and national averages.
- Alaska's mean rates for most payers, especially Blue Cross Blue Shield and BUCA, are notably higher than their respective national averages, indicating a premium reimbursement environment.
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