The code
| Code | Used for | Base units |
|---|---|---|
| 01630 | Open or surgical arthroscopic shoulder procedures | 5 |
Base units shown are the standard values most payers use. Check your payer and the current year's CMS base unit file before relying on them.
The interscalene block
An interscalene or other brachial plexus block for pain after surgery can often be billed separately, with a single-shot or continuous catheter code. Two things decide whether you can:
- Was the block the main anesthetic? If it was, it's part of the anesthesia code.
- Did the surgeon ask for it for post-op pain? Write that down.
If the block went in before anesthesia time started, leave that time out. See nerve block billing.
Catheters
If you placed a continuous catheter, use the continuous code. Daily management after the day of surgery is billed differently, and payers vary on whether they pay for it.
This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.
Sources
- CMS: Medicare Claims Processing Manual, Chapter 12 (Anesthesia)
- Maryland Workers' Compensation Commission: anesthesia base unit values