Summary & Overview
CPT 01716: Anesthesia for Upper Arm and Elbow Tenodesis (Biceps Rupture)
CPT code 01716 denotes anesthesia services for surgical repair—specifically tenodesis—for rupture of the long tendon of the biceps involving nerves, muscles, tendons, fascia, and bursae of the upper arm and elbow. This code is used to report anesthetic management tied to open procedures on the distal biceps and proximal tendon insertion where specialized perioperative anesthetic care is required. Nationally, accurate use of this anesthesia code matters for appropriate reimbursement, resource allocation in surgical suites, and consistent clinical documentation across anesthesiology teams.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of code intent and clinical context, comparisons to related anesthesia codes for the same anatomic region, common modifier usage for anesthesia services, and relevant billing considerations that affect payment and documentation. The summary covers typical sites of service, typical clinical scenarios for use, and connections to related anesthesia procedure codes.
This publication provides benchmarks and policy-relevant context for providers, coders, and payers seeking clarity on reporting anesthesia for upper arm and elbow tenodesis procedures. Data not available in the input is clearly noted where applicable.
Billing Code Overview
CPT code 01716 describes anesthesia services provided for surgical procedures 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. The service type is anesthesia for upper arm and elbow surgical procedures. The typical site of service is an operating room or surgical suite where open tendon repair and tenodesis procedures are performed.
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.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |