CPT 01961: Anesthesia for Cesarean Delivery
Headline: CPT code 01961: Anesthesia for Cesarean Delivery — National Billing and Clinical Context
Lead: CPT code 01961 denotes anesthesia services for cesarean delivery, a high-volume, clinically critical obstetric procedure. Accurate use of this code ensures appropriate capture of anesthesia resources and supports national assessments of obstetric anesthesia utilization.
CPT code 01961 represents anesthesia care specifically for cesarean delivery, performed in an operating room or surgical suite. It matters nationally because cesarean deliveries constitute a significant portion of inpatient obstetric procedures, and anesthesia coding affects clinical documentation, resource allocation, and payer reimbursement across hospitals and ambulatory surgical centers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of typical clinical contexts for the code, common companion and competing anesthesia codes, and payer coverage considerations. The publication summarizes expected settings of service, typical diagnostic scenarios that justify cesarean anesthesia coding, and how 01961 fits alongside related anesthesia codes for delivery.
What readers will learn: concise benchmarks for code usage, distinctions between cesarean and vaginal delivery anesthesia codes, common clinical indications that align with cesarean anesthesia billing, and practical notes on service location and payer scope. Data not available in the input for specific utilization rates or payer-specific reimbursement is noted where applicable.
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Billing Code Overview
CPT code 01961 describes anesthesia services provided for a cesarean delivery. The service type is anesthesia for cesarean delivery, typically performed in an operating room or other hospital surgical suite during a scheduled or unscheduled cesarean section. The code indicates perioperative anesthetic management specific to cesarean delivery and includes administration and monitoring of anesthesia care for the procedure.
National Reimbursement Benchmarks
Commercial reimbursement for CPT 01961 centers on BUCA as an average benchmark with a mean of $89.50 and an interquartile band from $56.50 to $116.80. Among named commercial payers, Aetna and Cigna show the highest ceiling values (Aetna max $322.30, Cigna max $320.10), while UnitedHealth Group and Blue Cross Blue Shield sit at lower maximums. This creates a wide apparent spread among top-tier rates even though BUCA represents a mid-market average.
Dispersion measured by the IQR (P75 minus P25) highlights variability: Aetna’s IQR is $100.00 ($182.50 - $82.50), Cigna’s is $76.60 ($151.60 - $75.00), Blue Cross Blue Shield’s is $57.80 ($95.20 - $43.40), UnitedHealth Group’s is $29.60 ($80.80 - $51.20), and BUCA’s IQR is $61.30 ($116.80 - $56.50). UnitedHealth Group is the tightest payer distribution, while Aetna is the widest.