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    OpenPayerBilling CodesAnesthesia for Procedures on the Upper Arm and ElbowCPT cpt-01758-anesthesia-excision-cyst-tumor-humerus
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    CPT 01758: Anesthesia for Excision of Cyst or Tumor of Humerus

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

    CPT code 01758 describes anesthesia services provided for arthroscopic or open excision of a cyst or tumor of the humerus, indicating intraoperative anesthesia management for a surgical procedure on the upper arm bone; service type: anesthesia for orthopedic surgical excision, typical site of service: hospital operating room or ambulatory surgical center.

    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 01758 cluster around the BUCA average commercial rate of $70.30, with notable variation by payer. Blue Cross Blue Shield’s interquartile span ($80.40 - $44.00) equals a $36.40 IQR, while Aetna’s IQR ($88.00 - $42.00) is $46.00. UnitedHealth Group shows a tighter middle distribution with an IQR of $30.90 ($80.90 - $50.20). Cigna displays the widest dispersion in the middle 50% with an IQR of $58.00 ($125.00 - $68.40), indicating broader variability among negotiated commercial prices.

    Looking at central tendencies, Cigna’s mean of $96.50 and median of $86.00 sit above the BUCA average, while UnitedHealth Group and Blue Cross Blue Shield have medians closer to BUCA’s midpoint ($61.00). Aetna’s median of $49.00 is lower than the BUCA average. Overall, UnitedHealth Group presents the tightest payer IQR and Cigna the widest, suggesting more consistent commercial positioning for UnitedHealth Group and greater spread for Cigna around the BUCA benchmark.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01742Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus

    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
    207P00000X
    202K00000X
    207U00000X
    2084B0040X
    2080P0201X
    2471V0106X
    390200000X
    342000000X

    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-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

    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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    Related anesthesia code used when the operative procedure includes osteotomy of the humerus rather than simple excision of a cyst/tumor.
    01744Anesthesia 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.