CPT 01190: Deleted Procedural Code (effective Jan. 1, 2018)

Headline: CPT code 01190 Deleted as of Jan. 1, 2018; code retired from billing use

Lead: CPT code 01190 is a deleted procedural code, removed from the CPT code set effective Jan. 1, 2018. The deletion means the code no longer represents a valid, billable service within the CPT taxonomy and should not be used for current claims submission.

What this code represented and why it matters: Although the specific procedural details are no longer active, the deletion of 01190 has implications for clinical documentation, historical claim review, and mapping to current procedure codes. Nationally, deleted CPT codes affect claim adjudication, retrospective utilization analyses, and the need to map legacy records to active codes for continuity of care and reporting.

Key payers covered: The analysis addresses common national payers, including Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare.

What readers will learn: The publication provides context on the code deletion, guidance on interpreting historical records that reference 01190, and pointers to related active procedures clinicians and billers commonly consider when reconciling past claims. It also summarizes the code’s removal date and outlines the relevance for national payers and retrospective billing workflows.

Note: Specific service details and comparable active replacement codes are not provided in the input and will require reference to current CPT resources.

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Billing Code Overview

CPT code 01190 is a deleted code, with deletion effective Jan. 1, 2018. The original descriptor indicates a service that is no longer billable under this CPT code.

Service type: Deleted/Not applicable

Typical site of service: Data not available in the input.

National Reimbursement Benchmarks

National commercial averages for CPT 01190 center on the BUCA benchmark, with an average rate of $302.30 reflecting the aggregated commercial marketplace. Blue Cross Blue Shield shows wider extremes with a documented minimum of $235 and maximum of $696, while its mean of $302.30 and median of $257.30 sit near the BUCA average, indicating similar central tendency across commercial aggregates.

Dispersion analysis using the interquartile range (P75 − P25) highlights that both payers share the same IQR value of $15.00 (BUCA P75 $265.00 − P25 $250.00; Blue Cross Blue Shield P75 $265.00 − P25 $250.00), so neither payer is tighter or wider by this measure. However, Blue Cross Blue Shield uniquely exhibits a much larger overall spread when considering its documented minimum and maximum rates, creating greater tail risk relative to the BUCA commercial average.

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CPT 01190: Deleted Procedural Code (effective Jan. 1, 2018)

Headline: CPT code 01190 Deleted as of Jan. 1, 2018; code retired from billing use

Key payers covered: The analysis addresses common national payers, including Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare.

Note: Specific service details and comparable active replacement codes are not provided in the input and will require reference to current CPT resources.

Customize your policy alerts

Sign up for cpt 01190 policy alerts

Get alerted when payer policies referencing 01190 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 01190 is a deleted code, with deletion effective Jan. 1, 2018. The original descriptor indicates a service that is no longer billable under this CPT code.

Service type: Deleted/Not applicable

Typical site of service: Data not available in the input.

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 72-year-old female with a history of osteoporosis and metastatic disease to the pelvis presents after a ground‑level fall with acute left hip and pelvic pain. Imaging demonstrates a pathological fracture of the pubis and an unspecified pelvic fracture with concern for collapse of the femoral head. The orthopaedic team schedules operative management that may include open treatment of the proximal femur, hemiarthroplasty, or total hip arthroplasty depending on intraoperative findings. Anesthesia is provided by an anesthesiology physician or certified registered nurse anesthetist in an acute care operating room. Perioperative workflow includes pre‑operative evaluation with review of comorbidities and imaging, intraoperative anesthesia care and monitoring, surgical repair or arthroplasty with possible intraoperative management of musculoskeletal complications, and post‑anesthesia recovery with inpatient postoperative orthopaedic and rehabilitation planning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27130`	Total hip arthroplasty	May be performed if acetabular or femoral head damage necessitates complete joint replacement during management of pelvic or proximal femoral pathological fractures.
`27236`	Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement	Used for fixation or prosthetic replacement of femoral neck fractures encountered during operative management of pelvic/hip fractures.
`27125`	Hemiarthroplasty, hip, partial (e.g., femoral stem prosthesis, bipolar arthroplasty)	Employed when partial hip replacement is appropriate for displaced femoral head fractures or pathological proximal femur fractures.
`27245`	Open treatment of femoral fracture, proximal end, head; with internal fixation	Used when the femoral head is involved and requires open reduction with internal fixation as part of the operative plan.

Related Modifiers

13 rows

Modifier	Description	When to Use
22	Modifier –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…
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
50	Modifier –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…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
52	Modifier ‑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…
53	Modifier 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…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
78	CPT 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…

Showing 1–10 of 13

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
207LC0200X	Critical Care Medicine (Anesthesiology) Physician	An anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
207ZM0300X	Medical Microbiology Physician	A medical microbiologist is expert in the isolation and identification of microbial agents that cause infectious disease. Viruses, bacteria and fungi,…
2080P0207X	Pediatric Hematology & Oncology Physician	A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
207KI0005X	Clinical & Laboratory Immunology (Allergy & Immunology) Physician	An allergy and immunology physician who specializes in clinical and laboratory immunology disease management..
2085U0001X	Diagnostic Ultrasound Physician	A Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound.
2471M1202X	Magnetic Resonance Imaging Radiologic Technologist	A radiologic technologist who specializes in magnetic resonance imaging (MRI) and is appropriately educated and trained, consistent with nationally re…

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27130`	Total hip arthroplasty	May be performed if acetabular or femoral head damage necessitates complete joint replacement during management of pelvic or proximal femoral pathological fractures.
`27236`	Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement	Used for fixation or prosthetic replacement of femoral neck fractures encountered during operative management of pelvic/hip fractures.
`27125`	Hemiarthroplasty, hip, partial (e.g., femoral stem prosthesis, bipolar arthroplasty)	Employed when partial hip replacement is appropriate for displaced femoral head fractures or pathological proximal femur fractures.
`27245`	Open treatment of femoral fracture, proximal end, head; with internal fixation	Used when the femoral head is involved and requires open reduction with internal fixation as part of the operative plan.

Related Modifiers

13 rows

Modifier	Description	When to Use
22	Modifier –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…
25	CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…	- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
50	Modifier –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…
51	Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…	- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
52	Modifier ‑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…
53	Modifier 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…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
78	CPT 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…

Showing 1–10 of 13

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
207LC0200X	Critical Care Medicine (Anesthesiology) Physician	An anesthesiologist, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialis…
207ZM0300X	Medical Microbiology Physician	A medical microbiologist is expert in the isolation and identification of microbial agents that cause infectious disease. Viruses, bacteria and fungi,…
2080P0207X	Pediatric Hematology & Oncology Physician	A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
207KI0005X	Clinical & Laboratory Immunology (Allergy & Immunology) Physician	An allergy and immunology physician who specializes in clinical and laboratory immunology disease management..
2085U0001X	Diagnostic Ultrasound Physician	A Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound.
2471M1202X	Magnetic Resonance Imaging Radiologic Technologist	A radiologic technologist who specializes in magnetic resonance imaging (MRI) and is appropriately educated and trained, consistent with nationally re…

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.