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.
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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 | Use when work required is substantially greater than typical for the anesthesia service due to complexity or complications. |
23 | Unusual anesthesia | Use when anesthesia is medically necessary for a procedure that ordinarily is performed without anesthesia, and documentation supports additional risk. |
50 | Bilateral procedure | Use if the procedure is performed bilaterally during the same operative session (rare for unilateral biceps tenodesis). |
52 | Reduced services | Use when the planned procedure is partially reduced or not completed as documented. |
53 | Discontinued procedure | Use when the procedure is started but halted for patient safety or intraoperative complication. |
54 | Surgical care only | Use when the billing provider furnishes only the surgical portion and not postoperative care (applies to surgeons rather than anesthesiologists; included for multidisciplinary workflow relevance). |
55 | Postoperative management only | Use when the provider performs only postoperative care. |
62 | Two surgeons | Use when two surgeons with different specialties share responsibility for the procedure. |
78 | Unplanned return to OR | Use when patient returns to the operating room for a related procedure during the postoperative period. |
AA | Anesthesia services performed personally by anesthesiologist | Use when the anesthesiologist personally performs the anesthesia service. |
AD | Medical supervision by physician; more than four concurrent anesthesia procedures | Use when the anesthesiologist supervises multiple concurrently administered anesthesia services. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | Use when an advanced practice clinician provides assistance in surgery per payer rules. |
QK | Medical direction by a qualified non-physician anesthetist (CRNA) | Use when the physician medically directs up to four concurrent CRNA-administered anesthesia cases and meets medical direction requirements. |
QS | Monitored anesthesia care (MAC) service | Use when MAC is provided instead of general anesthesia and needs to be reported where applicable. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physicians providing perioperative anesthesia care for upper extremity tendon procedures. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs delivering anesthesia services, alone or under medical direction/supervision. |
207LA0401X | Pain Medicine (Anesthesiology) | Anesthesiologists with pain medicine expertise who may provide regional/nerve block and postoperative pain management. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M17.10 | Unilateral primary osteoarthritis, unspecified knee | May appear in the record as a comorbidity; relevant for perioperative risk assessment and mobility considerations but not the primary indication for biceps tenodesis. |
M17.11 | Unilateral primary osteoarthritis, right knee | Comorbid degenerative joint disease on the right may affect functional status and postoperative rehabilitation planning. |
M17.12 | Unilateral primary osteoarthritis, left knee | Comorbid degenerative joint disease on the left may affect mobility and discharge planning. |
M17.5 | Other unilateral secondary osteoarthritis of knee | Secondary osteoarthritis listed as a comorbidity influencing perioperative management. |
Z96.651 | Presence of right artificial knee joint | Presence of prosthetic joint noted as comorbidity that may influence VTE prophylaxis and positioning. |
Z96.652 | Presence of left artificial knee joint | Presence of prosthetic joint noted as comorbidity affecting perioperative considerations. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01714 | Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of upper arm and elbow; tenoplasty, elbow to shoulder | 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. |
01732 | Anesthesia for diagnostic arthroscopic procedures of elbow joint | Related when a diagnostic or therapeutic arthroscopy of the elbow is performed in conjunction with tendon procedures; anesthesia services coded according to the arthroscopic procedure. |
01730 | Anesthesia for all closed procedures on humerus and elbow | Applicable 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. |