CPT 01490: Anesthesia for Lower Leg (Below Knee) Procedures - OpenPayer

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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.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 01490AnesthesiaOutpatient HospitalLower Leg ProceduresSurgical CodingBilling ComplianceOrthopedicsProcedure Codes

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

Modifiers:
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

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.

Related Codes

01654

CPT 01654: Anesthesia for Lower Leg Procedures, Not Otherwise Specified

01212

CPT 01212: Anesthesia for Open Hip Joint Procedures, Hip Disarticulation

01462

CPT 01462: Anesthesia for Open Bone Procedures of Lower Leg/Ankle/Foot

01272

CPT 01272: Anesthesia for Upper Leg Vascular Procedures (Femoral Artery)

01502

CPT 01502: Anesthesia for Lower Leg Procedures, Inpatient Hospital

01382

CPT 01382: Anesthesia for Diagnostic Arthroscopy of the Knee Joint

01442

CPT 01442: Anesthesia for Knee and Popliteal Area Procedures

01740

CPT 01740: Anesthesia for Open or Arthroscopic Elbow Procedures

01472

CPT 01472: Anesthesia for Achilles Tendon Repair

01770

CPT 01770: Anesthesia for Upper Arm and Elbow Procedures

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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 Mean Rates for CPT `01490` by Payer

State Benchmarks

State: AK1 / 50

Alaska Benchmarks

Mean Reimbursement Rates by Payer in Alaska for CPT 01490

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.