Summary & Overview
CPT 01958: Anesthesia for External Cephalic Version
CPT code 01958 represents anesthesia for external cephalic version, a procedure performed to reposition a fetus from breech to cephalic presentation prior to delivery. This code is significant in obstetric care, as external cephalic version can reduce the need for cesarean sections and improve maternal and fetal outcomes. The code is most commonly billed in outpatient hospital settings and is relevant to anesthesiology professionals providing care during this intervention.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. The publication provides a comprehensive overview of clinical context, typical billing practices, and policy updates related to CPT code 01958. Readers will gain insight into payer coverage, common modifiers, associated taxonomies, and relevant ICD-10 diagnoses for maternal care involving breech presentation. Additionally, the summary highlights related CPT codes for anesthesia during vaginal and cesarean deliveries, offering a broader perspective on anesthesia billing in obstetric settings.
This article is designed for healthcare professionals, billing specialists, and policy analysts seeking up-to-date information on anesthesia coding for external cephalic version. It delivers benchmarks, clinical context, and policy considerations to support accurate and compliant billing practices nationwide.
CPT Code Overview
CPT code 01958 is used to report anesthesia services provided for external cephalic version procedures. This code falls under the anesthesiology service type and is typically performed in an outpatient hospital setting (Place of Service 22). External cephalic version is a clinical intervention aimed at turning a fetus from a breech position to a head-down position before delivery, requiring specialized anesthesia care to ensure patient comfort and safety during the procedure.
Clinical & Coding Specifications
Clinical Context
A pregnant patient presents to the outpatient hospital with a breech fetal presentation, as identified by clinical assessment or ultrasound. The obstetrician recommends an external cephalic version (ECV) to attempt to reposition the fetus to a cephalic (head-down) position prior to delivery. An anesthesiologist is consulted to provide anesthesia for the ECV procedure, ensuring patient comfort and safety during the manipulation. The procedure is typically performed in a controlled setting with monitoring, and anesthesia may be delivered as monitored anesthesia care or other appropriate techniques, depending on patient and provider preference.
Coding Specifications
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Modifier
QS: Indicates that monitored anesthesia care (MAC) was provided during the procedure. Used when the anesthesiologist is present and monitoring the patient, but not necessarily providing general anesthesia. -
Modifier
P1: Denotes that the patient is a normal, healthy individual with no systemic disease. Used to indicate the physical status of the patient for anesthesia risk assessment.
| Modifier Code | Description |
|---|---|
QS | Monitored anesthesia care service |
P1 | A normal healthy patient |
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Provider Taxonomies:
207L00000X- Anesthesiology: Physicians specializing in anesthesia and perioperative care.207LA0401X- Pain Medicine (Anesthesiology): Anesthesiologists with additional expertise in pain management.207LC0200X- Critical Care Medicine (Anesthesiology): Anesthesiologists specializing in critical care settings.
Related Diagnoses
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O32.1XX0- Maternal care for breech presentation, not applicable or unspecified- Indicates maternal care for a breech fetus where the specific fetus is not identified or is unspecified. Relevant for ECV as the procedure is performed to correct breech presentation.
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O32.1XX1- Maternal care for breech presentation, fetus 1- Used when the breech presentation involves fetus 1 in a multiple gestation. ECV may be attempted for this fetus.
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O32.1XX2- Maternal care for breech presentation, fetus 2- Used for breech presentation involving fetus 2. Relevant for ECV in multiple gestations.
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O32.1XX3- Maternal care for breech presentation, fetus 3- Indicates breech presentation for fetus 3. ECV may be performed for this fetus in a multiple pregnancy.
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O32.1XX4- Maternal care for breech presentation, fetus 4- Used for breech presentation involving fetus 4. Relevant for ECV in higher-order multiple gestations.
All these codes are clinically relevant as they document the indication for external cephalic version, which is the correction of breech presentation in single or multiple pregnancies.
Related CPT Codes
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01960- Anesthesia for vaginal delivery- Used when anesthesia is provided for a vaginal delivery. May be an alternative if the ECV is unsuccessful and the patient proceeds to vaginal delivery.
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01968- Anesthesia for cesarean delivery (after neuraxial anesthetic)- Used when anesthesia is required for a cesarean section following neuraxial anesthesia. Relevant if the ECV is unsuccessful and a cesarean delivery is indicated.
These codes are related to 01958 as they represent anesthesia services for obstetric procedures. 01960 and 01968 may be used in the same clinical workflow if the patient transitions from ECV to delivery, depending on the outcome.
National Reimbursement Benchmarks
National mean rates for CPT code 01958 show that Cigna and Blue Cross Blue Shield have the highest average reimbursement, at $299.28 and $288.62 respectively, while UnitedHealth Group is notably lower at $65.63. The BUCA (average commercial) mean rate stands at $147.96, which is significantly higher than UnitedHealth Group but well below the top commercial payers. Medicare data is not available in the input for comparison.
Rate dispersion varies considerably across payers. UnitedHealth Group has the tightest range between the 25th and 75th percentiles ($75.50 - $50.25 = $25.25), indicating less variability in rates. In contrast, Aetna and Cigna display much wider ranges ($303.50 and $344.00 respectively), suggesting greater variability in reimbursement amounts. The table and chart below present the full breakdown of national benchmarks for each payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska shows a significant spread in reimbursement rates for CPT code 01958, with Blue Cross Blue Shield exhibiting the widest range between the 25th and 75th percentiles ($370.00 minus $274.60 = $95.40). In contrast, Aetna, Cigna, and UnitedHealth Group have minimal rate spreads, indicating little variation in their payments. Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are notably higher, while Cigna and UnitedHealth Group remain below national means.
The table and chart below present the full breakdown of mean rates and percentile values by payer for Alaska, highlighting the differences in reimbursement across the major commercial insurers.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 01958 in Alaska, with a mean rate of $327.89.
- 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.