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Health Insurance companies will continue to push the limits on how much they don't need to cover until there is a regulation change.
Guess what the CEO of Anthem's last job was.
I would guess that doctors might find problematic for a patient to regain conciseness mid operation for a patient who can't afford full anesthesia.
Anthem's own press release:

https://providernews.anthem.com/connecticut/articles/anesthe...

They don't say what the "established number of minutes" are. Presumably there's a table somewhere. I darkly suspect it's based on the average time -- in which case half of the procedures will go over.

Are the other providers also paid by the minute? I wonder if there's a surgeon going, "Well, that was easy. Let's just hang out here for a few minutes before closing up."