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    v1.0.30
    OpenPayerBilling CodesAnesthesia for Procedures on the Pelvis (Except Hip)CPT cpt-01170-anesthesia-open-symphysis-pubis-sacroiliac-joint
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    CPT 01170: Anesthesia for Pubic Symphysis or Sacroiliac Joint Procedures

    Commercial payers pay $68 on average nationally for this procedure.

    CPT code 01170 describes anesthesia services provided for open surgical procedures involving the pubic symphysis or the sacroiliac joint; service type: regional or general anesthesia for orthopedic pelvic procedures; typical site of service: inpatient or outpatient operating room for open pelvic or sacroiliac surgery.

    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

    Commercial rates for CPT 01170 center around BUCA’s average commercial rate of $68.10, which serves as a mid-market reference point among major national payers. Cigna shows the highest central tendency with a median of $85.70 and a mean of $93.70, while Aetna and Blue Cross Blue Shield display lower medians at $48.00 and $52.70 respectively. UnitedHealth Group’s median sits at $64.00, closer to BUCA’s average, indicating that many contracts fall near the market midpoint rather than at extremes.

    Dispersion (P75 minus P25) highlights variation in contract spread: Cigna’s dispersion is $53.30 (P75 $120.00 minus P25 $67.90), the widest of the group, signaling broader variability in negotiated rates. Blue Cross Blue Shield’s dispersion is $30.40 (P75 $76.70 minus P25 $42.30), Aetna’s is $38.00 (P75 $82.00 minus P25 $42.00), BUCA’s is $40.40 (P75 $85.50 minus P25 $48.10), and UnitedHealth Group is the tightest at $29.00 (P75 $80.80 minus P25 $52.00). These spreads indicate where commercial rate variability is most and least concentrated.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 56-year-old patient presents for elective open surgical stabilization of the pubic symphysis after a pelvic ring injury sustained in a motor vehicle collision. The orthopedic team plans an open reduction and internal fixation of the symphysis pubis with possible sacroiliac joint fixation. Pre‑operative evaluation is completed by the anesthesia team, including medical history, airway assessment, and review of comorbidities. On the day of surgery the anesthesiology provider administers general endotracheal anesthesia with intraoperative hemodynamic management, invasive monitoring as needed, and postoperative anesthetic care in the recovery area until the patient meets discharge criteria from the post‑anesthesia care unit. The anesthesia service documented includes preoperative evaluation, induction, maintenance, and emergence care for an open procedure involving the symphysis pubis and/or sacroiliac joint as described by 01170.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20610Arthrocentesis, aspiration and/or injection; major joint or bursaMay be performed preoperatively or postoperatively for diagnostic aspiration or intraoperative joint management unrelated to open fixation but billed when performed.

    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
    207L00000X
    207LA0401X
    207LP2900X
    347E00000X
    152W00000X
    163WN0003X
    287300000X
    2083P0500X

    Related ICD-10-CM Codes

    20 rows

    ICD-10-CM CodeDescription
    M16.9Osteoarthritis of hip, unspecified
    M17.11Unilateral primary osteoarthritis, right knee
    M25.521Pain in right elbow
    M25.522Pain in left elbow
    M27.0Developmental disorders of jaws
    M51.26Other intervertebral disc displacement, lumbar region
    M53.2X1Spinal instabilities, occipito-atlanto-axial region
    M67.40Ganglion, unspecified site
    M75.121Complete rotator cuff tear or rupture of right shoulder, not specified as traumatic
    M75.122Complete rotator cuff tear or rupture of left shoulder, not specified as traumatic

    Showing 1–10 of 20

    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-01112-ANESTHESIA-BONE-MARROW-ASPIRATION-BIOPSY-ILIAC-CREST

    CPT 01112: Anesthesia for Iliac Crest Bone Marrow Aspiration/Biopsy

    CPT-01120-ANESTHESIA-FOR-PELVIC-BONY-PROCEDURES

    CPT 01120: Anesthesia for Procedures on the Bony Pelvis

    CPT-01130-ANESTHESIA-BODY-CAST-APPLICATION-REVISION

    CPT 01130: Anesthesia for Body Cast Application or Revision

    CPT-01140-INTERPELVIABDOMINAL-AMPUTATION-ANESTHESIA

    CPT 01140: Anesthesia for Interpelviabdominal (Hindquarter) Amputation

    CPT-01150-ANESTHESIA-RADICAL-PELVIC-TUMOR-PROCEDURE

    CPT 01150: Anesthesia for Radical Pelvic Tumor Procedures

    CPT-01160-ANESTHESIA-CLOSED-SYMPHYSIS-PUBIS-SACROILIAC-PROCEDURE

    CPT 01160: Anesthesia for Closed Pelvic Procedures (Symphysis/Sacroiliac)

    CPT-01173-ANESTHESIA-OPEN-PELVIC-ACETABULAR-FRACTURE-REPAIR

    CPT 01173: Anesthesia for Open Repair of Pelvic/Acetabular Fracture

    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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    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.

    24357
    Tendon repair, elbow
    Not directly related to pelvic procedures; listed as related in the dataset but typically used for upper‑extremity tendon repair procedures performed by orthopedics.
    24359Tendon transfer, elbowNot directly related to pelvic/sacroiliac surgery; included as a related orthopedic elbow procedure in the dataset.
    24360Repair of ruptured tendon, elbowNot directly related to 01170; represents additional orthopedic procedures that may appear in provider panels but are unrelated to open symphysis pubis/sacroiliac anesthesia services.