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    v1.0.30
    OpenPayerBilling CodesAnesthesia for Procedures on the Lower Leg (Below Knee)CPT cpt-01472-lower-leg-ankle-foot-tendon-anesthesia-achilles-repair
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    CPT 01472: Anesthesia for Lower Leg/Ankle/Foot (Achilles Repair)

    Commercial payers pay $80 on average nationally for this procedure.

    CPT code 01472 describes anesthesia services for surgical procedures on the nerves, muscles, tendons, and fascia of the lower leg, ankle, and foot, specifically including repair of a ruptured Achilles tendon with or without graft; service type: anesthesia for lower extremity soft-tissue and tendon surgery; typical site of service: inpatient or outpatient surgical settings (operating room) where lower leg/ankle/foot procedures are performed.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    National Reimbursement Benchmarks

    Commercial reimbursement for CPT 01472 centers near the BUCA average commercial rate of $80.40, with notable variation across major carriers. Blue Cross Blue Shield and UnitedHealth Group exhibit relatively tight dispersion (BCBS P75–P25 = $36.00; UnitedHealth P75–P25 = $28.90), indicating more consistent middle-range payments, while Aetna and Cigna show wider spreads (Aetna P75–P25 = $108.10; Cigna P75–P25 = $55.00), reflecting greater variability between lower and higher commercial rates. BUCA’s interquartile band spans $49.20, placing it between the narrowest and widest payers.

    Maximum and minimum extremes differ by carrier: Aetna reaches as high as $364.00 and as low as $30.30, while Cigna’s range tops at $159.20 and bottoms at $46.90. Blue Cross Blue Shield’s central tendency sits below BUCA’s mean, and UnitedHealth’s median is close to its mean, underscoring comparatively stable contracting around the midpoints for those payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 38-year-old male presents after a sports-related injury with an acute rupture of the right Achilles tendon and impaired ambulation. Imaging confirms a complete tear of the Achilles tendon and associated soft-tissue contusion. The orthopedic surgeon schedules an operative open repair of the ruptured Achilles tendon under monitored general anesthesia with a popliteal sciatic peripheral nerve block for postoperative analgesia. Preoperative evaluation documents ASA physical status II, no known drug allergies, and informed consent for anesthesia. On the day of surgery the anesthesia team performs standard monitors, induction of general anesthesia, endotracheal intubation, placement of a popliteal sciatic nerve block under ultrasound guidance, intraoperative anesthetic management during repair of tendons and fascia in the distal lower leg and ankle, and emergence with immediate postoperative pain control plan.

    A typical clinical workflow includes preoperative assessment and documentation of history/physical and ASA status; airway evaluation; consent for anesthesia; pre-block timeout; performance of regional nerve block (if planned) and documentation of neurologic baseline; induction and maintenance of general or monitored anesthesia care; intraoperative management of hemodynamics and analgesia; timed anesthesia start and end for billing; handoff to PACU with block efficacy and limb neurovascular status recorded. Relevant postoperative instructions include pain regimen and limb elevation; follow-up with orthopedics for wound checks and rehabilitation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01470

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    207RA0401X
    367500000X
    224ZE0001X
    207SG0202X
    2355S0801X
    202D00000X
    2085N0700X

    Related ICD-10-CM Codes

    5 rows

    ICD-10-CM CodeDescription
    S93.401ASprain of unspecified ligament of right ankle, initial encounter
    S82.101AUnspecified fracture of upper end of right tibia, initial encounter for closed fracture
    S82.102AUnspecified fracture of upper end of left tibia, initial encounter for closed fracture
    M25.571Pain in right ankle and joints of right foot
    M25.572Pain in left ankle and joints of left foot

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-01462-ANESTHESIA-CLOSED-PROCEDURES-LOWER-LEG-ANKLE-FOOT

    CPT 01462: Anesthesia for Closed Procedures on Lower Leg, Ankle, Foot

    CPT-01464-ANKLE-FOOT-ARTHROSCOPY-ANESTHESIA

    CPT 01464: Anesthesia for Ankle/Foot Arthroscopic Procedure

    CPT-01470-ANESTHESIA-LOWER-LEG-ANKLE-FOOT-SOFT-TISSUE-PROCEDURE

    CPT 01470: Anesthesia for Lower Leg, Ankle, and Foot Soft-Tissue Procedures

    CPT-01474-ANESTHESIA-LOWER-LEG-ANKLE-FOOT-SOFT-TISSUE-PROCEDURES

    CPT 01474: Anesthesia for Lower Leg/Ankle/Foot Soft-Tissue Procedures

    CPT-01480-ANESTHESIA-OPEN-LOWER-LEG-ANKLE-FOOT-BONE-PROCEDURE

    CPT 01480: Anesthesia for Open Lower Leg, Ankle, and Foot Procedures

    CPT-01482-ANESTHESIA-LOWER-LEG-ANKLE-FOOT-RADICAL-RESECTION

    CPT 01482: Anesthesia for Lower Leg, Ankle, and Foot Procedures

    CPT-01484-ANESTHESIA-OSTEOTOMY-OSTEOPLASTY-TIBIA-FIBULA

    CPT 01484: Anesthesia for Tibia/Fibula Osteotomy or Osteoplasty

    CPT-01486-TOTAL-ANKLE-REPLACEMENT-ANESTHESIA

    CPT 01486: Anesthesia for Total Ankle Replacement

    CPT-01490-ANESTHESIA-LOWER-LEG-CAST-APPLICATION-REMOVAL-REPAIR

    CPT 01490: Anesthesia for Lower Leg Cast Application/Removal/Repair

    CPT-01500-LOWER-LEG-ARTERIAL-BYPASS-ANESTHESIA

    CPT 01500: Anesthesia for Lower Leg Arterial Bypass Graft

    Showing 1–10 of 13

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified
    Alternative anesthesia code for lower leg/ankle/foot procedures when the specific procedure mapping differs; used when procedure complexity fits NOS descriptor.
    01474Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, Strayer procedure)Related anesthesia code for specific myofascial lengthening procedures of the gastrocnemius that may be performed in the same operative field or for differential coding when the primary surgical procedure is gastrocnemius recession.