CPT 01650 Reimbursement Benchmarks | OpenPayer

Summary & Overview

CPT 01650: Anesthesia for Knee Arthroscopy Procedures

CPT code 01650 covers anesthesia for arthroscopic procedures on the knee joint, a common intervention in orthopedic surgery. This code is nationally significant due to the prevalence of knee arthroscopy for conditions such as osteoarthritis, meniscal tears, and chronic instability. The code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting its widespread use and importance in outpatient hospital settings.

This publication provides a comprehensive overview of CPT code 01650, including payer coverage, clinical context, and relevant billing benchmarks. Readers will gain insight into the typical site of service, associated clinical diagnoses, and related procedural codes. The analysis also highlights key modifiers used in billing, such as QS for monitored anesthesia care and QX for CRNA services with physician direction. Policy updates and coding trends are discussed to inform stakeholders about current practices and compliance requirements. The content is designed to support healthcare professionals, administrators, and policy analysts in understanding the nuances of anesthesia billing for knee arthroscopy procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 01650AnesthesiologyKnee ArthroscopyOutpatient HospitalMedical BillingClinical CodingPolicy UpdatesOrthopedic SurgeryBenchmarksModifiers

CPT Code Overview

CPT code 01650 is used to report anesthesia services for procedures performed on the knee joint, specifically arthroscopic interventions. This code falls under the Anesthesiology service type and is most commonly utilized in the Outpatient Hospital setting (Place of Service 22). The code is essential for accurately documenting and billing anesthesia care provided during minimally invasive knee surgeries, ensuring proper reimbursement and compliance with national standards.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves an adult presenting to the outpatient hospital with knee pain, instability, or mechanical symptoms such as locking or catching. The patient may have a history of chronic instability, osteoarthritis, or a recent meniscal injury. After clinical evaluation and imaging, the orthopedic surgeon recommends an arthroscopic procedure on the knee joint to address the underlying pathology. An anesthesia provider, such as an anesthesiologist, certified registered nurse anesthetist (CRNA), or anesthesiology assistant, administers anesthesia for the procedure. The workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative recovery in the outpatient setting.

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care during the procedure.
- QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia services under the medical direction of a physician.
Provider Taxonomies:

Taxonomy Code Specialty Name

National Reimbursement Benchmarks

National mean rates for CPT code 01650 show that Blue Cross Blue Shield and Cigna have the highest average reimbursement, at $337.04 and $351.90 respectively, while UnitedHealth Group is notably lower at $65.64. The BUCA (average commercial) mean rate stands at $157.38, which is substantially higher than UnitedHealth Group but well below Blue Cross Blue Shield and Cigna. Medicare rates are not available in the input for comparison.

Rate dispersion varies significantly across payers. UnitedHealth Group has the tightest range between the 25th and 75th percentiles ($25.17), indicating less variability in payment rates. In contrast, Cigna and Aetna exhibit the widest dispersions, with Cigna's range at $430.54 and Aetna's at $324.00, reflecting greater variability in their reimbursement levels. The table and chart below present the full breakdown of national benchmarks for each payer.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska demonstrates a wide rate spread for CPT code 01650, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $212.80. Other payers, such as Aetna and UnitedHealth Group, show minimal spread, with all percentile values clustered closely together. This suggests that Blue Cross Blue Shield has more variability in reimbursement, while other payers maintain consistent rates.

Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and Aetna are substantially higher, while Cigna and UnitedHealth Group are closer to or slightly above national benchmarks. The table and chart below present the full breakdown of payer-specific rates in Alaska.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 01650, with a mean rate of $416.19.
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, are notably higher than national benchmarks, indicating a substantial regional premium.

CPT 01636: Anesthesia for Procedures on the Shoulder and Axilla

01634-ANESTHESIA-FOR-OPEN-OR-SURGICAL-ARTHROSCOPIC-PROCEDURES-ON

CPT 01634: Anesthesia for Shoulder Disarticulation Procedures

01620-ANESTHESIA-FOR-PROCEDURES-ON-THE-KNEE-ANDOR-POPLITEAL-AREA

CPT 01620: Anesthesia for Knee and Popliteal Area Procedures

01638-ANESTHESIA-FOR-PROCEDURES-ON-THE-SHOULDER-AND

CPT 01638: Anesthesia for Shoulder and Axilla Procedures

01630-UNDER-ANESTHESIA-FOR-PROCEDURES-ON-THE-SHOULDER-AND

CPT 01630: Anesthesia for Shoulder and Axilla Procedures

01670-ANESTHESIA-FOR-PROCEDURES-ON-THE-SHOULDER-AND

CPT 01670: Anesthesia for Procedures on the Shoulder and Axilla

01610-ANESTHESIA-FOR-PROCEDURES-ON-THE-KNEE-JOINT-NOT-OTHERWISE

CPT 01610: Anesthesia for Knee Joint Procedures, Unspecified

01656-UNDER-ANESTHESIA-FOR-PROCEDURES-ON-THE-SHOULDER-AND-AXILLA

CPT 01656: Anesthesia for Axillary to Femoral Artery Bypass Graft

01622-01622-ANESTHESIA-FOR-DIAGNOSTIC-ARTHROSCOPIC-PROCEDURE-OF

CPT 01622: Anesthesia for Diagnostic Shoulder Arthroscopy

01680-UNDER-ANESTHESIA-FOR-PROCEDURES-ON-THE-SHOULDER-AND-AXILLA

CPT 01680: Anesthesia for Shoulder Cast Application, Removal, or Repair

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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.

`207L00000X`	Anesthesiology
`367500000X`	Certified Registered Nurse Anesthetist (CRNA)
`207RA0401X`	Anesthesiology Assistant

OpenPayer

Summary & Overview

CPT 01650: Anesthesia for Knee Arthroscopy Procedures

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes