CPT 01758: Anesthesia for Excision of Cyst or Tumor of Humerus
CPT code 01758 designates anesthesia services for arthroscopic or open excision of a cyst or tumor of the humerus. This code captures perioperative anesthesia care tied to procedures on the humeral shaft or proximal humerus where surgical removal of a lesion is performed. Accurate use of this code matters nationally for consistent anesthesia billing, resource planning in surgical suites, and appropriate aggregation of procedure-specific utilization for hospitals and payers.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 01758, how it is typically applied in hospital operating rooms and ambulatory surgical centers, and the common clinical indications that generate use of the code.
The publication summarizes benchmarks and comparators for anesthesia services associated with upper-arm surgical excision, highlights intersections with related elbow and humerus anesthesia codes, and outlines clinical scenarios where 01758 is relevant. It also explains typical sites of service and service type to support coding accuracy and billing alignment across major national payers.
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Billing Code Overview
CPT code 01758 describes anesthesia services provided for a patient undergoing arthroscopic or open excision of a cyst or tumor of the humerus, the long bone of the upper arm. This service typically involves administration of general, regional, or monitored anesthesia care as required for surgical removal of a humeral cyst or tumor.
Service Type: Anesthesia for excision of cyst or tumor of the humerus
Typical Site of Service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient presents with several months of progressive lateral elbow pain, decreased range of motion, and focal tenderness over the distal humerus. Imaging demonstrates a bone cyst adjacent to the humeral shaft and MRI excludes active infection. The orthopedic surgeon schedules an arthroscopic or open excision of the cyst or tumor of the humerus. Preoperative evaluation is performed by the anesthesiology team (taxonomy 207P00000X) including airway assessment, review of comorbidities, and medication reconciliation. On the day of surgery the patient undergoes standard monitors placement, induction of general anesthesia with endotracheal intubation, intraoperative anesthetic maintenance, perioperative analgesia (regional block or multimodal analgesia as indicated), and postoperative emergence and handoff to post-anesthesia care unit nursing. Typical intraoperative considerations include positioning for humeral exposure, blood loss management, neurovascular protection of the radial and ulnar nerves, and temperature control. The anesthesiologist documents the start and end times of anesthesia, any intraoperative complications, and applies applicable modifiers (for example, for a concurrent regional block or unusual anesthesia complexity). Typical recovery occurs in the ambulatory surgical unit or inpatient postanesthesia care unit depending on intraoperative course and comorbidities.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia services required substantially greater work than typical for 01758 due to complexity or prolonged management. |
23 | Unusual anesthesia | Use when anesthesia is medically necessary but general anesthesia is contraindicated and an alternative unusual anesthesia technique is used. |
50 | Bilateral procedure | Use when identical procedures on both upper extremities are performed during the same operative session. |
52 | Reduced services | Use when the planned excision is partially completed or scope of anesthesia services is reduced. |
53 | Discontinued procedure | Use when anesthesia is provided but the surgical procedure is terminated for medical reasons prior to completion. |
54 | Surgical care only | Use when the anesthesiologist bills only for intraoperative care and another clinician provides pre/postoperative anesthesia services. |
55 | Postoperative management only | Use when the anesthesiologist provides only postoperative pain management and not intraoperative care. |
62 | Two surgeons | Use when two surgeons of different specialties concurrently perform portions of the operative procedure affecting anesthesia billing considerations. |
78 | Return to OR for related procedure | Use when a complication requires return to the operating room for further excision or management under anesthesia. |
AA | Anesthesia services performed personally by anesthesiologist | Use when the named anesthesiologist personally performs the anesthesia. |
AD | Medical supervision by physician; more than four concurrent anesthetizations | Use when the physician supervises multiple concurrent anesthesia providers and meets criteria for medical direction by supervision. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for anesthesia | Use when qualified non-physician clinician furnishes anesthesia services under appropriate supervision and billing rules permit. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | Use when the physician medically directs the anesthesia team for 01758 with 2–4 concurrent cases. |
QS | Monitored anesthesia care (MAC) delivery by a physician direction | Use when monitored anesthesia care is furnished instead of general anesthesia for this procedure. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207P00000X | Anesthesiology | Primary specialty for delivery of anesthesia services for 01758. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M25.521 | Pain in right elbow | May be the presenting symptom prompting imaging that identifies a humeral cyst or tumor requiring excision under anesthesia. |
M25.522 | Pain in left elbow | Same relevance for left-sided symptoms leading to surgical management of humeral lesion. |
M75.121 | Incomplete rotator cuff tear or rupture of right shoulder, not specified as traumatic | Shoulder pathology that may coexist with humeral lesions and affect perioperative positioning and analgesic planning. |
M75.122 | Incomplete rotator cuff tear or rupture of left shoulder, not specified as traumatic | Same as above for the left side; may influence surgical approach and anesthesia considerations. |
M77.11 | Lateral epicondylitis, right elbow | Common elbow pathology that may be present concurrently; differentiating pain sources guides surgical indication. |
M77.12 | Lateral epicondylitis, left elbow | Same as above for the left elbow and may be documented when present alongside humeral lesions. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01742 | Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus | Related anesthesia code used when the operative procedure includes osteotomy of the humerus rather than simple excision of a cyst/tumor. |
01744 | Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus (Includes repair of humeral shaft fractures) | Related anesthesia code used when the operative procedure involves repair of humeral shaft fractures or nonunion/malunion instead of cyst/tumor excision. |