CPT 01173: Anesthesia for Open Pelvic/Acetabular Fracture Repair
CPT code 01173 represents anesthesia care for open repair of pelvic fractures or column fractures involving the acetabulum. This anesthesia-specific code captures perioperative anesthetic management for complex, high-acuity orthopedic procedures on the pelvis and acetabulum, services that are resource-intensive and commonly performed in hospital operating rooms. Nationally, accurate coding of these procedures affects payment, quality measurement, and care coordination for trauma and orthopedic surgery programs. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise explanation of the code's clinical intent and service setting, a summary of commonly associated modifiers and clinical taxonomies, and links to closely related surgical and procedural codes used in pelvic and lower-extremity orthopedic care. The publication also highlights typical diagnostic pairings and related surgical CPT codes to aid clinical documentation and billing alignment. Data not available in the input for payer-specific reimbursement rates or utilization benchmarks is not included.
Sign up for cpt 01173 policy alerts
Get alerted when payer policies referencing 01173 are released or updated.
Billing Code Overview
CPT code 01173 describes anesthesia services provided for a patient undergoing open repair of fracture disruption of the pelvis or of column fracture involving the acetabulum. The service type is anesthesia for major orthopedic pelvic/acetabular fracture repair. The typical site of service is an inpatient or hospital-based operating room where open orthopedic pelvic or acetabular fracture reconstruction is performed.
Clinical & Coding Specifications
Clinical Context
A 62-year-old male presents with a displaced pelvic fracture involving the acetabulum after a motor vehicle collision. He is scheduled for an open reduction and internal fixation (ORIF) of the pelvic ring and acetabular column under general anesthesia. Preoperative evaluation in the preoperative clinic documents a history of right knee osteoarthritis with a prior right total knee arthroplasty (Z96.651), well-controlled hypertension, and ASA physical status P3. The anesthesia team (anesthesiologist or Certified Registered Nurse Anesthetist) conducts a focused airway assessment, reviews imaging and baseline labs, obtains informed consent for anesthesia risks, and plans for arterial line placement and possible central venous access due to anticipated blood loss and potential prolonged case duration.
Intraoperative workflow includes induction of general endotracheal anesthesia, placement of invasive monitoring, standardized multimodal analgesia including regional nerve block or neuraxial adjunct if indicated, active warming, fluid and blood product management, and coordination with the surgical team for timed additional procedures. Postoperatively the patient is transferred to the post-anesthesia care unit (PACU) with orders for pain control, thromboprophylaxis, and monitoring for hemorrhage or hemodynamic instability. If extended postoperative anesthesia care is needed (e.g., return to OR for revision), appropriate anesthesia modifiers and documentation are applied.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia care is substantially greater in complexity or time than typical for open pelvic/acetabular repair and documentation supports increased work. |
23 | Unusual anesthesia | Use when general anesthesia is medically necessary for a minor procedure—rare for this code; applicable if unexpected circumstances change the anesthesia plan. |
50 | Bilateral procedure | Use if simultaneous bilateral pelvic/acetabular procedures are performed and payer requires bilateral modifier on related surgical/ancillary claims. |
52 | Reduced services | Use when the planned anesthesia service is partially reduced or not completed as documented (e.g., aborted procedure). |
53 | Discontinued procedure | Use when anesthesia is provided for a procedure that is terminated due to patient instability or other intraoperative event. |
62 | Two surgeons | Use when two surgeons simultaneously perform distinct surgical procedures on the pelvis/acetabulum requiring separate surgical teams; may affect anesthesia reporting in some payers. |
78 | Unplanned return to OR | Use when the patient returns to the operating room for related procedure during the global period requiring additional anesthesia services. |
AA | Anesthesia by physician | Use to indicate anesthesia services personally performed by a physician anesthesiologist. |
QK | Medical direction of two or three anesthetists | Use when the physician medically directs multiple anesthetists (CRNAs) for this case according to payer rules. |
QS | Monitored anesthesia care service | Use when MAC is provided instead of general anesthesia, and documentation supports MAC billing. |
QX | CRNA service furnished under supervision of a physician | Use when a CRNA performs the anesthesia service under appropriate physician supervision and payer requires this modifier. |
QY | Medical direction of one CRNA by an anesthesiologist | Use when the anesthesiologist medically directs one CRNA for the case. |
FX | Primary anesthesiologist | Use in complex cases to identify the primary anesthesiologist when multiple anesthesia providers are listed (payer-specific). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists perform preoperative evaluation, intraoperative management, and postoperative anesthesia care for open pelvic/acetabular repair. |
207LA0401X | Pain Medicine (Anesthesiology) | Consult for complex perioperative pain management, regional techniques, or multimodal analgesia planning. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs commonly provide anesthesia services either independently or under medical direction/supervision for this procedure. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M17.10 | Unilateral primary osteoarthritis, unspecified knee | Documents degenerative knee disease that may affect mobility and perioperative risk assessment for pelvic/acetabular repair. |
M17.11 | Unilateral primary osteoarthritis, right knee | Side-specific osteoarthritis may influence positioning, preexisting prosthesis status, and postoperative rehabilitation planning. |
M17.12 | Unilateral primary osteoarthritis, left knee | Side-specific osteoarthritis may influence positioning, preexisting prosthesis status, and postoperative rehabilitation planning. |
M17.5 | Other unilateral secondary osteoarthritis of knee | Indicates secondary degenerative changes (post-traumatic, inflammatory) that may affect pain control strategies and functional baseline. |
Z96.651 | Presence of right artificial knee joint | Prior right knee arthroplasty is relevant for perioperative antibiotic prophylaxis, positioning, and thromboembolism risk assessment. |
Z96.652 | Presence of left artificial knee joint | Prior left knee arthroplasty is relevant for perioperative antibiotic prophylaxis, positioning, and thromboembolism risk assessment. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27447 | Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) | May be a separate orthopedic procedure during the same hospitalization; relevant for perioperative planning and comorbidity management but not performed concurrently with pelvic ORIF typically. |
20610 | Arthrocentesis, aspiration and/or injection into a major joint or bursa | May be performed preoperatively for diagnostic or therapeutic relief of knee symptoms; relevant if concurrent knee joint aspiration is required. |
29881 | Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) | Represents possible prior or staged knee interventions influencing perioperative mobility and anesthesia planning. |
29888 | Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction | Related to knee procedures in the patient history that may affect positioning, rehabilitation, or anesthetic considerations. |
99221 | Initial hospital care, per day, for the evaluation and management of a patient | Used by the admitting physician for initial inpatient evaluation; coordinates with anesthetic perioperative assessment and inpatient management. |