Summary & Overview
CPT 01173: Anesthesia for Pelvic Procedures (Except Hip)
CPT code 01173 covers anesthesia services for procedures performed on the pelvis, excluding the hip. This code is widely used in inpatient hospital settings to ensure proper billing and documentation for anesthesia care during pelvic surgeries. Nationally, the code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, making it relevant for providers and facilities across the country.
This publication provides a comprehensive overview of CPT 01173, including payer coverage, clinical context, and related billing practices. Readers will gain insight into the typical use of this code, associated modifiers, and relevant taxonomies for anesthesia professionals. The summary also highlights common ICD-10 diagnoses linked to pelvic procedures, as well as related CPT codes for surgical and hospital care. Policy updates and benchmarks are discussed to help stakeholders understand the evolving landscape of anesthesia billing for pelvic surgeries.
By reviewing this information, healthcare professionals, administrators, and policy analysts will be equipped with the latest knowledge on coding, payer requirements, and clinical context for anesthesia services in pelvic procedures. The publication serves as a resource for understanding national trends and ensuring compliance with payer policies.
CPT Code Overview
CPT 01173 is designated for anesthesia services provided during procedures on the pelvis (except hip). This code is used to report the professional work of anesthesia care for pelvic surgeries, excluding those involving the hip. The service type is anesthesia, and the typical site of service is an inpatient hospital setting (POS 21). This code is essential for accurately documenting and billing anesthesia care in complex pelvic procedures, ensuring proper reimbursement and compliance with national standards.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult admitted to an inpatient hospital for a surgical procedure on the pelvis (excluding the hip), such as pelvic fracture repair or gynecologic surgery. The patient may have underlying conditions like osteoarthritis or a history of joint replacement, as indicated by the associated ICD-10 codes. An anesthesiologist or certified registered nurse anesthetist (CRNA) provides anesthesia services to ensure the patient is safely sedated and pain-free during the procedure. The clinical workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative care in the hospital setting.
Coding Specifications
| Modifier Code | Description | When Used |
|---|---|---|
AA | Anesthesia services performed personally by anesthesiologist | When the anesthesiologist provides the service directly |
QK | Medical direction of two, three, or four concurrent anesthesia procedures | When an anesthesiologist supervises multiple procedures |
QX | CRNA service with medical direction by a physician | When a CRNA provides anesthesia under physician direction |
QZ | CRNA service without medical direction by a physician | When a CRNA provides anesthesia independently |
Associated Provider Taxonomies:
207L00000X- Anesthesiology (Physicians specializing in anesthesia care)207LA0401X- Pain Medicine (Anesthesiology) (Physicians specializing in pain management within anesthesiology)367500000X- Certified Registered Nurse Anesthetist (CRNA) (Nurse specialists in anesthesia care)
Related Diagnoses
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M17.10- Unilateral primary osteoarthritis, unspecified knee- Indicates degenerative changes in one knee, relevant for patients undergoing pelvic or lower extremity procedures.
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M17.11- Unilateral primary osteoarthritis, right knee- Specifies osteoarthritis in the right knee, which may necessitate surgical intervention and anesthesia.
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M17.12- Unilateral primary osteoarthritis, left knee- Specifies osteoarthritis in the left knee, relevant for surgical planning and anesthesia.
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M17.5- Other unilateral secondary osteoarthritis of knee- Refers to secondary osteoarthritis, possibly due to trauma or other conditions, requiring surgical management.
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Z96.651- Presence of right artificial knee joint- Indicates a history of knee replacement, which may impact anesthesia planning for pelvic procedures.
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Z96.652- Presence of left artificial knee joint- Indicates a history of left knee replacement, relevant for perioperative assessment and anesthesia care.
Related CPT Codes
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27447- Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)- Often performed in conjunction with anesthesia services for knee replacement procedures.
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20610- Arthrocentesis, aspiration and/or injection into a major joint or bursa- May require anesthesia for pain management during joint aspiration or injection.
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29881- Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)- Anesthesia is necessary for surgical arthroscopy procedures.
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29888- Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction- Anesthesia services are provided during ACL repair or reconstruction.
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99221- Initial hospital care, per day, for the evaluation and management of a patient- Used for initial hospital admission and evaluation, often preceding surgical procedures requiring anesthesia.
These codes are commonly used together in surgical workflows, with anesthesia (01173) supporting the primary surgical procedure. Some codes may be alternatives depending on the specific intervention performed.
National Reimbursement Benchmarks
National mean rates for CPT code 01173 show that commercial payers generally reimburse at higher levels than Medicare. The average commercial rate (BUCA) is $259.74, while UnitedHealth Group, representing Medicare in this context, has a mean rate of $65.62.
Rate dispersion varies significantly across payers. Blue Cross Blue Shield has the tightest range between the 25th and 75th percentiles ($248.50), indicating more consistent reimbursement. In contrast, Cigna exhibits the widest spread ($948.00), reflecting substantial variability in rates. Aetna also shows a broad range ($680.00), while BUCA and UnitedHealth Group have narrower dispersions ($378.50 and $25.33, respectively).
The table and chart below present the full breakdown of national benchmarks for CPT code 01173 by payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska exhibits a wide rate spread for CPT code 01173, particularly among Blue Cross Blue Shield and BUCA, where the difference between the 75th and 25th percentiles exceeds $400 and $488, respectively. In contrast, Aetna, Cigna, and UnitedHealth Group show minimal rate variation, with all percentiles clustered closely together, indicating limited negotiation or variation in reimbursement for these payers.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are substantially higher, while Cigna and UnitedHealth Group are below their respective national means. The table and chart below present the full breakdown of payer-specific reimbursement rates in Alaska for CPT code 01173.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 01173, with a mean rate of $809.14.
- UnitedHealth Group offers the lowest mean rate at $75.12.
- Alaska's mean rates for most payers, especially Blue Cross Blue Shield and BUCA, are significantly higher than national averages, while Cigna and UnitedHealth Group are below national means.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.