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    OpenPayerBilling CodesAnesthesia for Procedures on the Upper Arm and ElbowCPT cpt-01716-anesthesia-upper-arm-elbow-tenodesis-biceps-rupture
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    CPT 01716: Anesthesia for Tenodesis, Long Biceps Tendon (Upper Arm/Elbow)

    Commercial payers pay $76 on average nationally for this procedure.

    CPT code 01716 describes anesthesia services provided for surgery on the nerves, muscles, tendons, fascia, and bursae of the upper arm and elbow, specifically for tenodesis addressing rupture of the long tendon of the biceps; service type: surgical anesthesia for upper arm/elbow tendon repair; typical site of service: operating room or ambulatory surgical center during a specialized orthopedic procedure.

    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 rates for CPT 01716 cluster around BUCA's average commercial benchmark of $76, with notable variation among individual payers. Blue Cross Blue Shield shows a relatively narrow interquartile spread (P75 $81.50 minus P25 $45 = $36.50), and UnitedHealth Group is similarly tight (P75 $80.40 minus P25 $51.90 = $28.50), indicating more consistent contracted ranges. Aetna and Cigna display wider dispersion: Aetna’s IQR is $69.60 (P75 $119.60 minus P25 $45) and Cigna’s is $58.60 (P75 $125.00 minus P25 $68.40), reflecting broader negotiated outcomes across networks.

    In absolute terms, Aetna and Cigna also reach higher upper bounds (Aetna max $346, Cigna max $159.20) while UnitedHealth Group and Blue Cross Blue Shield sit lower at their observed maxima ($122.70 and $201 respectively). The spread patterns suggest that payers with tighter IQRs may deliver more predictable pricing around BUCA’s $76 average, while those with larger IQRs contribute more to overall market variability.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 52-year-old recreational athlete presents with a distal biceps tendon rupture of the dominant (right) arm following an acute eccentric load while lifting. Physical exam demonstrates a palpable gap in the antecubital fossa, weakness of elbow flexion and supination, and positive Hook test. Imaging with ultrasound or MRI confirms a full-thickness rupture of the long head of the biceps tendon with retraction. The orthopedic surgeon schedules an operative tenodesis of the long tendon of the biceps at the elbow under general anesthesia with regional block support.

    Preoperative workflow: The patient undergoes pre-anesthesia evaluation by an anesthesiologist or certified registered nurse anesthetist (CRNA), including medical history, medication reconciliation, airway assessment, and consent for anesthesia. Regional anesthesia (interscalene or supraclavicular block depending on surgeon preference) is frequently used adjunctively for intraoperative and postoperative analgesia. In the operating room, standard monitors are applied; general endotracheal anesthesia or monitored anesthesia care may be used with the regional block. The anesthesiology team documents the procedure performed, anesthetic technique, start and end times, intraoperative events, and any complications. Postoperatively the patient is monitored in PACU and discharged per institutional protocols with regional block duration and analgesic plan recorded.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01714Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder

    Related Modifiers

    9 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…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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
    367500000X
    207LA0401X
    207WX0108X
    331L00000X
    225CA2500X
    364SP0812X
    173C00000X

    Related ICD-10-CM Codes

    6 rows

    ICD-10-CM CodeDescription
    Z96.651Presence of right artificial knee joint
    Z96.652Presence of left artificial knee joint
    M17.10Unilateral primary osteoarthritis, unspecified knee
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M17.5Other unilateral secondary osteoarthritis of knee

    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-01710-UPPER-ARM-ELBOW-ANESTHESIA-SOFT-TISSUE-PROCEDURES

    CPT 01710: Anesthesia for Upper Arm and Elbow Procedures

    CPT-01712-ANESTHESIA-OPEN-TENOTOMY-ELBOW-TO-SHOULDER

    CPT 01712: Anesthesia for Open Tenotomy, Elbow to Shoulder

    CPT-01714-UPPER-ARM-ELBOW-TENOPLASTY-ANESTHESIA

    CPT 01714: Anesthesia for Tenoplasty, Upper Arm and Elbow

    CPT-01730-ANESTHESIA-CLOSED-PROCEDURE-HUMERUS-ELBOW

    CPT 01730: Anesthesia for Closed Procedure on Humerus or Elbow

    CPT-01732-ELBOW-DIAGNOSTIC-ARTHROSCOPY-ANESTHESIA

    CPT 01732: Anesthesia for Diagnostic Elbow Arthroscopy

    CPT-01740-ANESTHESIA-ELBOW-OPEN-ARTHROSCOPIC-PROCEDURE

    CPT 01740: Anesthesia for Open or Arthroscopic Elbow Procedure

    CPT-01742-ANESTHESIA-OSTEOTOMY-HUMERUS-UPPER-ARM

    CPT 01742: Anesthesia for Humerus Osteotomy

    CPT-01744-ANESTHESIA-FOR-HUMERUS-NONUNION-MALUNION-REPAIR

    CPT 01744: Anesthesia for Humerus Nonunion/Malunion Repair

    CPT-01756-ELBOW-RADICAL-SURGERY-ANESTHESIA

    CPT 01756: Anesthesia for Radical Elbow Surgery

    CPT-01758-ANESTHESIA-EXCISION-CYST-TUMOR-HUMERUS

    CPT 01758: Anesthesia for Excision of Cyst or Tumor of Humerus

    Showing 1–10 of 15

    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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    Alternative anesthesia code for related tendon repair/tenoplasty procedures of the upper arm and elbow; used when the operative procedure is tenoplasty rather than tenodesis.
    01732Anesthesia for diagnostic arthroscopic procedures of elbow jointRelated when a diagnostic or therapeutic arthroscopy of the elbow is performed in conjunction with tendon procedures; anesthesia services coded according to the arthroscopic procedure.
    01730Anesthesia for all closed procedures on humerus and elbowApplicable when closed procedures on the humerus or elbow (e.g., closed reduction, closed fixation) occur in the same operative session; anesthesia coding selected per the specific closed procedure.