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CPT 0102T: Extracorporeal Shock Wave Therapy for Lateral Epicondyle
CPT code 0102T denotes physician-performed extracorporeal shock wave treatment targeting the lateral humeral epicondyle under anesthesia more than local, most commonly used to treat epicondylitis (tennis elbow). Nationally, this code captures a specific, anesthesia-requiring therapeutic intervention for refractory or severe cases of lateral elbow tendinopathy where in-office, local procedures are insufficient. Its correct use influences procedure grouping, site-of-service designation, and anesthesia billing.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of clinical context and service characteristics, payer coverage considerations, common procedural links, and where this code fits among related interventional spine and pain procedures. The publication summarizes benchmarks for utilization and billing relationships to associated imaging and injection codes, highlights relevant coding relationships, and outlines common clinical scenarios in which the code is used.
This summary is intended for health policy analysts, coding professionals, and clinical administrators seeking a national-level orientation to CPT code 0102T, its clinical role in managing epicondylitis, and the payer landscape that commonly adjudicates claims for this anesthesia-requiring shock wave procedure.
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Billing Code Overview
CPT code 0102T describes a physician-administered extracorporeal shock wave treatment applied to the lateral humeral epicondyle of an anesthetized patient. The procedure is performed with anesthesia that is more than local (regional or general anesthesia), and is typically used to treat epicondylitis (tennis elbow), a repetitive-use injury of the elbow.
Service Type: Minimally invasive therapeutic procedure (extracorporeal shock wave therapy)
Typical Site of Service: Operating room or procedure suite with anesthesia support
National Reimbursement Benchmarks
National commercial rates for CPT 0102T cluster around the BUCA average commercial benchmark of $432.60, with notable variation across major carriers. Blue Cross Blue Shield and UnitedHealth Group display higher central tendencies ($418.10 median and $433.50 median, respectively) while Aetna and Cigna sit lower on median/mean measures; BUCA represents the overall commercial mean at $432.60. Maximums are elevated for Blue Cross Blue Shield ($1,896.10) and UnitedHealth Group ($1,182.00), indicating occasional high-end contract outliers.
Dispersion measured as the interquartile range (P75 minus P25) highlights which payers are tight versus wide: Blue Cross Blue Shield has the widest IQR at $340.00 ($603.80 − $293.80), followed by UnitedHealth Group at $284.10 ($596.50 − $312.40). BUCA’s IQR is $254.70 ($530.30 − $267.60). Cigna’s IQR is $180.90 ($347.30 − $167.40) and Aetna is the tightest at $135.00 ($353.00 − $218.00). These dispersion differences reflect varying contract variability across carriers.