CPT 01634: Anesthesia for Open or Arthroscopic Shoulder Procedures
Commercial payers pay $66 on average nationally for this procedure.
CPT code 01634 describes anesthesia services provided for open or surgical arthroscopic procedures involving the humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint, including shoulder disarticulation; this represents anesthesia for upper extremity/shoulder surgical procedures and is typically delivered in operating room or surgical center settings as a general or regional anesthesia service for orthopedic shoulder surgery.
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National Reimbursement Benchmarks
Across national commercial contracts for CPT 01634, BUCA’s mean commercial rate sits at $66.40 as a practical market average. Blue Cross Blue Shield shows a broad spread between its 25th and 75th percentiles ($41.50 to $75.00), while Cigna’s center is higher (median $85.70) and its upper tail extends to a $147.40 90th percentile. UnitedHealth Group and Aetna occupy mid-to-upper ranges with UnitedHealth Group median $63.70 and Aetna median $48.00; Cigna posts the highest mean at $93.40.
Measuring dispersion via P75 minus P25 highlights which payers are tightest and widest. Aetna’s interquartile range is $28.50, UnitedHealth Group’s is $26.40, Blue Cross Blue Shield’s is $33.50, Cigna’s is $52.00, and BUCA’s is $34.10 — Cigna is the widest (IQR $52.00) and UnitedHealth Group the tightest (IQR $26.40). These differences indicate variable variability in contracted commercial rates across payers.