CPT 01991 (CPT) Reimbursement Benchmarks | OpenPayer

Summary & Overview

CPT 01991: Anesthesia for Nerve Blocks and Injections (Non-Prone Position)

CPT code 01991 represents anesthesia services for diagnostic or therapeutic nerve blocks and injections, when the block or injection is performed by a different provider and the patient is not in the prone position. This code is significant for ensuring proper billing and documentation of anesthesia care in outpatient surgical settings, particularly Ambulatory Surgical Centers. Nationally, the code is relevant for a range of pain management and musculoskeletal procedures, supporting accurate reimbursement and compliance across multiple specialties.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. The publication provides an overview of payer coverage, clinical context, and policy benchmarks related to 01991. Readers will gain insights into the typical use cases for this code, associated clinical diagnoses, and related procedural codes. The summary also highlights common modifiers and taxonomies relevant to anesthesia and pain medicine, offering a comprehensive view of how 01991 fits into broader medical billing and clinical workflows. This information is valuable for understanding national trends in anesthesia billing for nerve block and injection procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 01991anesthesianerve blockambulatory surgical centerpain managementmedical billingoutpatient surgeryclinical codingpolicy benchmarksprocedure documentation

CPT Code Overview

CPT code 01991 is used to report anesthesia services provided for diagnostic or therapeutic nerve blocks and injections, specifically when the block or injection is performed by a different provider. This code applies to procedures conducted in positions other than the prone position. The typical site of service for this anesthesia procedure is an Ambulatory Surgical Center (POS 24), reflecting its use in outpatient surgical settings. This code is essential for accurately documenting and billing anesthesia care associated with nerve block and injection procedures performed by separate healthcare professionals.

Clinical & Coding Specifications

Clinical Context

A patient presents to an ambulatory surgical center with chronic low back pain that has not responded to conservative management. The pain medicine specialist evaluates the patient and determines that a diagnostic or therapeutic nerve block is indicated. The procedure is performed by a pain medicine physician, while an anesthesiology provider administers anesthesia for the nerve block. The patient is positioned supine (not prone) for the injection. The anesthesia provider monitors the patient throughout the procedure, ensuring comfort and safety, and documents the anesthesia care provided. This workflow is typical for procedures coded with 01991 in settings such as ambulatory surgical centers.

Coding Specifications

Modifiers:

Modifier Code Description Usage Context
QS Monitored anesthesia care service Used when anesthesia care is monitored during the procedure
P1 A normal healthy patient

Modifier Code	Description	Usage Context
`QS`	Monitored anesthesia care service	Used when anesthesia care is monitored during the procedure
`P1`	A normal healthy patient

National Reimbursement Benchmarks

National mean rates for CPT code 01991 show that commercial payers such as Blue Cross Blue Shield, Aetna, Cigna, and BUCA (average commercial) generally reimburse at higher levels than UnitedHealth Group. Cigna has the highest mean rate at $197.88, while UnitedHealth Group is the lowest among the listed payers at $65.59. The BUCA mean rate of $108.60 is notably higher than UnitedHealth Group, but lower than the other commercial payers.

Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Aetna exhibits the widest spread ($188.83), indicating substantial variability in rates, while UnitedHealth Group has the tightest range ($25.08), suggesting more consistent reimbursement levels. Cigna and BUCA also show considerable dispersion, with ranges of $173.00 and $95.25, respectively. Blue Cross Blue Shield's range is $79.50, reflecting moderate variability.

The table and chart below present a detailed breakdown of national benchmarks for CPT code 01991 by payer, including mean rates and percentile values.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska demonstrates a substantial rate spread for CPT code 01991, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $89.47 ($266.67 minus $177.20). BUCA also shows a wide spread of $93.60, while Aetna and UnitedHealth Group have minimal spreads, indicating more consistent rates. Compared to national averages, Alaska's mean rates for most payers are significantly higher, especially for Blue Cross Blue Shield and BUCA, highlighting a premium market for this code in the state.

The table and chart below present the full breakdown of mean rates and percentile distributions for each payer in Alaska, allowing for a clear comparison of reimbursement levels across the major commercial insurers.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 01991 in Alaska, with a mean rate of $218.62.
UnitedHealth Group offers the lowest mean rate at $74.78.
Alaska's mean rates for most payers are notably higher than national averages, especially for Blue Cross Blue Shield and BUCA.

CPT 01996: Anesthesia Management for Continuous Epidural or Subarachnoid Drug Administration

01990-ANESTHESIOLOGY-PROVIDER-GIVES-PHYSIOLOGICAL-SUPPORT-TO-A

CPT 01990: Anesthesia for Physiological Support During Organ Procurement

CPT-01999-UNLISTED-ANESTHESIA-PROCEDURE

CPT 01999: Unlisted Anesthesia Procedure

01992-ANESTHESIA-FOR-DIAGNOSTIC-OR-THERAPEUTIC-NERVE-BLOCKS-AND

CPT 01992: Anesthesia for Nerve Blocks and Injections, Prone or Flat Position

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.

Taxonomy Code	Specialty Name
`207L00000X`	Anesthesiology
`207LP2900X`	Pain Medicine
`207RA0401X`	Anesthesiology Assistant

National Reimbursement Benchmarks

The table and chart below present a detailed breakdown of national benchmarks for CPT code 01991 by payer, including mean rates and percentile values.

National Mean Rates for CPT Code `01991` by Payer

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Mean Reimbursement Rates by Payer for CPT 01991 in Alaska

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 01991 in Alaska, with a mean rate of $218.62.
UnitedHealth Group offers the lowest mean rate at $74.78.
Alaska's mean rates for most payers are notably higher than national averages, especially for Blue Cross Blue Shield and BUCA.

CPT 01996: Anesthesia Management for Continuous Epidural or Subarachnoid Drug Administration

01990-ANESTHESIOLOGY-PROVIDER-GIVES-PHYSIOLOGICAL-SUPPORT-TO-A

CPT 01990: Anesthesia for Physiological Support During Organ Procurement

CPT-01999-UNLISTED-ANESTHESIA-PROCEDURE

CPT 01999: Unlisted Anesthesia Procedure

01992-ANESTHESIA-FOR-DIAGNOSTIC-OR-THERAPEUTIC-NERVE-BLOCKS-AND

CPT 01992: Anesthesia for Nerve Blocks and Injections, Prone or Flat Position

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Summary & Overview

CPT 01991: Anesthesia for Nerve Blocks and Injections (Non-Prone Position)

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