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    v1.0.30
    OpenPayerBilling CodesAnesthesia for Procedures on the Upper Arm and ElbowCPT cpt-01742-anesthesia-osteotomy-humerus-upper-arm
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    CPT 01742: Anesthesia for Humerus Osteotomy

    Commercial payers pay $70 on average nationally for this procedure.

    CPT code 01742 describes anesthesia services provided for a patient undergoing an osteotomy of the humerus, a surgical excision or cutting of the upper-arm long bone; the service type is anesthesia for upper arm/shoulder surgical procedures and the typical site of service is an operating room or surgical suite where orthopedic humeral surgery is 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

    National commercial rates for CPT 01742 center near BUCA’s average commercial rate of $69.90, with notable variation across major insurers. Cigna and Blue Cross Blue Shield show higher central tendencies ($96.50 mean for Cigna; $65.10 mean for Blue Cross Blue Shield) while Aetna ($60.30 mean) and UnitedHealth Group ($67.40 mean) cluster closer to BUCA. Minima and maxima vary by payer, with Aetna’s values spanning $31 to $148 and UnitedHealth Group’s top end at $122.70; BUCA is presented as an average commercial benchmark at $69.90.

    Dispersion measured by the interquartile range (P75–P25) is widest for Cigna at $58.60 (P75 $125.00 minus P25 $68.40), followed by BUCA at $38.30, Blue Cross Blue Shield at $36.40, and UnitedHealth Group at $28.90. Aetna shows the tightest IQR at $33.20, indicating relatively less variability in mid-distribution rates compared with Cigna’s broader spread.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 56-year-old patient with chronic shoulder pain and deformity presents for surgical correction with an open osteotomy of the humerus to realign the proximal humerus for improved function and pain relief. The patient has failed conservative measures including physical therapy and analgesics. Preoperative assessment by the anesthesia team includes airway evaluation, review of medical comorbidities, medication reconciliation, and consent for general anesthesia with regional blockade as indicated.

    On the day of surgery the patient arrives to the ambulatory surgery center or hospital operating room. The anesthesia provider (anesthesiologist, certified registered nurse anesthetist, or anesthesiology assistant) places standard monitors, establishes intravenous access, and induces general anesthesia. A peripheral nerve block (e.g., interscalene or axillary block) may be performed for intraoperative and postoperative analgesia. Intraoperative management includes airway control (endotracheal tube or laryngeal mask), maintenance of anesthesia, hemodynamic support, fluid management, and pain control. At procedure end, the anesthesia team coordinates emergence and handoff to the post-anesthesia care unit (PACU), provides analgesic plan and nerve block instructions, and documents the anesthesia time and any intraoperative events for billing using 01742 for anesthesia services for osteotomy of the humerus.

    Typical site of service: hospital operating room or ambulatory surgery center.

    Service type: anesthesia for major upper extremity orthopedic surgery (open osteotomy of the humerus).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    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…
    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…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    367500000X
    207RA0401X
    332H00000X
    3336S0011X
    229N00000X
    261QM0850X
    207UN0903X

    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-01716-ANESTHESIA-UPPER-ARM-ELBOW-TENODESIS-BICEPS-RUPTURE

    CPT 01716: Anesthesia for Tenodesis, Long Biceps Tendon (Upper Arm/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-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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    01740Anesthesia for procedures on the upper arm and elbowRelated anesthesia code covering other upper arm/elbow procedures; used if osteotomy involves adjacent anatomic zones or alternative coding is appropriate.
    01744Anesthesia for procedures on the upper arm and elbowRelated anesthesia code for upper arm/elbow procedures; used for variations in surgical approach or coding specificity relative to 01742.