CPT 01392: Anesthesia for Open Upper Tibia/Fibula/Patella Procedure
Commercial payers pay $97 on average nationally for this procedure.
CPT code 01392 describes anesthesia services provided for patients undergoing any open surgical procedure involving the upper ends of the tibia, fibula, and/or patella; service type: anesthesia for open orthopedic surgery of the proximal lower leg/knee region; typical site of service: hospital operating room or ambulatory surgery center where open knee/upper tibia procedures are performed.
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National Reimbursement Benchmarks
For CPT 01392, BUCA’s average commercial rate sits at $96.50 and serves as a national benchmark for commercial reimbursement. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $47.70, Cigna’s spread is $41.50, UnitedHealth Group’s spread is $29.10, and Aetna shows the widest spread at $175.80. These spreads indicate that Aetna’s commercial payments are far more variable across markets, while UnitedHealth Group displays the tightest clustering of rates around its midrange.
Across the five payers, payer-specific medians and means vary substantially around BUCA’s mean. Blue Cross Blue Shield and Cigna cluster relatively close to BUCA’s average, while Aetna’s high maximum and wide spread drive larger upside variation. UnitedHealth Group’s narrower spread suggests more consistent commercial pricing nationally compared with the others.