CPT 01992 Reimbursement Benchmarks | OpenPayer

Summary & Overview

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

CPT code 01992 represents anesthesia services for diagnostic or therapeutic nerve blocks and injections, performed when the procedure itself is conducted by a different physician or qualified health care professional. This code is specifically used when the patient is in a prone or lying flat position, and is most commonly billed in outpatient hospital settings. Nationally, this code is significant for ensuring proper reimbursement and documentation of anesthesia care in pain management and interventional procedures.

Major 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 relevant policy updates for CPT code 01992. Readers will gain insights into typical use cases, associated diagnoses, and related procedural codes, as well as common modifiers and taxonomies relevant to anesthesia billing. The summary also highlights benchmarks and trends in utilization, supporting healthcare professionals and administrators in understanding the broader landscape of anesthesia services for nerve block procedures.

This article is designed to inform stakeholders about the clinical and billing implications of CPT code 01992, offering a comprehensive overview of its role in outpatient anesthesia care and its importance in pain management protocols.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 01992anesthesianerve blockoutpatient hospitalpain managementmedical billingclinical documentationprocedure codingpolicy updatebenchmarks

CPT Code Overview

CPT code 01992 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 physician or qualified health care professional. This code applies when the patient is positioned prone or lying flat during the procedure. The typical site of service for CPT code 01992 is an outpatient hospital setting, designated as Place of Service 22. This code is essential for accurately documenting and billing anesthesia care in scenarios where nerve block or injection procedures require specialized patient positioning and are performed collaboratively by multiple providers.

Clinical & Coding Specifications

Clinical Context

A patient with chronic low back pain, cervicalgia, or fibromyalgia presents to an outpatient hospital for a diagnostic or therapeutic nerve block or injection. The procedure is performed by a pain management specialist or other qualified provider. An anesthesia provider, such as an anesthesiologist or anesthesiologist assistant, administers anesthesia while the patient is positioned prone or lying flat. The anesthesia ensures patient comfort and safety during the nerve block or injection, which is performed by a different physician or qualified health care professional. Typical workflow involves pre-procedure assessment, anesthesia induction, monitoring during the procedure, and post-procedure recovery.

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 Certified Registered Nurse Anesthetist (CRNA) provides anesthesia under physician supervision.
Provider Taxonomies:

Taxonomy Code Specialty Name

National Reimbursement Benchmarks

National mean rates for CPT code 01992 show that Blue Cross Blue Shield and Cigna have the highest average reimbursement, with Cigna at $299.26 and Blue Cross Blue Shield at $218.72. UnitedHealth Group is notably lower at $65.57, while the BUCA average is $132.11. Medicare rates are not available in the input for comparison.

Rate dispersion varies significantly across payers. Cigna exhibits the widest spread, with a difference of $344.50 between its 75th and 25th percentiles, indicating substantial variability in payment rates. In contrast, UnitedHealth Group has the tightest range, with only $25.33 separating its 75th and 25th percentiles, suggesting more consistent 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 substantial rate spread for CPT code 01992, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $95.40 ($370.00 minus $274.60). BUCA also shows a notable spread of $153.87 ($295.53 minus $141.67), indicating significant variability in reimbursement rates across payers. In contrast, Aetna and UnitedHealth Group have minimal spreads, with all percentiles clustered closely around $72.00 to $75.00, suggesting more uniform payment structures.

Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are markedly higher, while Cigna and UnitedHealth Group are closer to national levels. The table and chart below present the full breakdown of payer-specific rates for CPT code 01992 in Alaska.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 01992 in Alaska, with a mean rate of $326.52.
UnitedHealth Group offers the lowest mean rate at $74.78.
Alaska's mean rates for most payers are significantly higher than national averages, especially for Blue Cross Blue Shield and BUCA.

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

CPT-01999-UNLISTED-ANESTHESIA-PROCEDURE

CPT 01999: Unlisted Anesthesia Procedure

CPT-01996-ANESTHESIA-MANAGEMENT-CONTINUOUS-NEURAXIAL-DRUG-ADMINISTRATION

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

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.

National Reimbursement Benchmarks

National Mean Rates for CPT Code 01992 by Payer

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Mean Reimbursement Rates by Payer for CPT 01992 in Alaska

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 01992 in Alaska, with a mean rate of $326.52.
UnitedHealth Group offers the lowest mean rate at $74.78.
Alaska's mean rates for most payers are significantly higher than national averages, especially for Blue Cross Blue Shield and BUCA.

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

CPT-01999-UNLISTED-ANESTHESIA-PROCEDURE

CPT 01999: Unlisted Anesthesia Procedure

CPT-01996-ANESTHESIA-MANAGEMENT-CONTINUOUS-NEURAXIAL-DRUG-ADMINISTRATION

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

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Summary & Overview

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