CPT 01200: Anesthesia for Closed Hip Joint Procedures
CPT code 01200 designates anesthesia services provided during closed procedures of the hip joint. These services cover anesthetic management for interventions that do not require open surgical exposure of the joint, including arthroscopic or percutaneous procedures and closed reductions. Nationally, anesthesia coding for regional and procedural services like this supports accurate billing, resource allocation, and quality measurement in perioperative care.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise review of the code’s clinical context, typical sites of service, and related service distinctions. The publication also outlines common modifiers and associated provider taxonomies relevant to anesthesia billing, lists typical ICD-10 diagnoses that may justify use of the code, and references closely related CPT anesthesia codes for hip and upper leg procedures.
This summary equips billing managers, anesthesiology departments, and policy analysts with a practical, national-level snapshot of CPT code 01200, highlighting where it sits in anesthesia service coding and what to expect in clinical documentation and payer interactions. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 01200 describes administration of anesthesia services for a patient undergoing any closed procedure involving the hip joint. "Closed" indicates procedures that do not require an open surgical entry into the joint, such as certain closed reductions, joint injections, or arthroscopic interventions.
Service Type: Anesthesia services for closed hip procedures
Typical Site of Service: Operating room or procedure suite (inpatient or outpatient surgical settings)
Clinical & Coding Specifications
Clinical Context
A 58-year-old ambulatory patient presents with chronic right hip pain refractory to conservative care and is scheduled for a closed hip joint procedure under anesthesia, such as an intra-articular hip injection, closed reduction of a hip dislocation, or arthrography. The patient has a history of osteoarthritis of the hip with episodic mechanical symptoms and intermittent instability. Preoperative evaluation by the anesthesiology team includes review of comorbidities, airway assessment, fasting status, medication reconciliation (including anticoagulants), and informed consent for monitored anesthesia care (MAC) or general anesthesia as appropriate.
On the day of service the patient arrives to an ambulatory surgery center or hospital outpatient department. Standard ASA monitors are applied, intravenous access obtained, and regional techniques (e.g., lumbar plexus block or fascia iliaca block) may be considered in coordination with the proceduralist. The anesthesiologist documents the start and stop times of anesthesia services, intraoperative hemodynamic management, any emergence events, and post-anesthesia recovery instructions before transfer to PACU. Billing uses 01200 for anesthesia services provided for any closed procedure involving the hip joint.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual Anesthesia | Use when medically necessary general anesthesia is provided for a procedure that would not ordinarily require general anesthesia. |
50 | Bilateral Procedure | Use when anesthesia is provided for bilateral hip procedures performed during the same anesthetic. |
52 | Reduced Services | Use when anesthesia services are partially reduced or not completed as planned. |
53 | Discontinued Procedure | Use when the procedure and anesthesia are terminated before completion for patient-related or intraoperative reasons. |
54 | Surgical Care Only | Use when the anesthesiologist is not providing postoperative anesthesia management (e.g., only intraoperative care billed by another clinician). |
55 | Postoperative Management Only | Use when billing only the postoperative anesthesia portion separate from intraoperative services. |
62 | Two Surgeons | Use when two surgeons work together as primary surgeons for a complex case requiring concurrent expertise; may affect anesthesia documentation but is primarily a surgical modifier. |
78 | Return to OR for Related Procedure During Global Period | Use when the patient returns to the operating room for a related procedure requiring additional anesthesia during the global period. |
AA | Anesthesia by Anesthesiologist | Use to indicate the anesthesiology service was personally performed by a physician-anesthesiologist. |
QK | Medical Direction of Two, Three, or Four Anesthesia Providers | Use when the physician medically directs multiple CRNA providers during the anesthetic. |
QS | Monitored Anesthesia Care (MAC) Service | Use when MAC services are provided and reported per payer rules. |
QX | CRNA Service with Medical Direction by Physician | Use when a CRNA performs the anesthesia under physician direction meeting CMS criteria. |
QY | Medical Direction of One CRNA by One Physician | Use when the physician medically directs one CRNA and meets CMS documentation requirements. |
QZ | CRNA Service Without Medical Direction by a Physician | Use when a CRNA provides anesthesia without physician medical direction. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Primary specialty for physician anesthesiologists providing 01200 services. |
207LA0401X | Pain Medicine (Anesthesiology) | Relevant when procedural pain management or injections of the hip joint are performed under anesthesia. |
207LP2900X | Pediatric Anesthesiology | Applicable when 01200 services are provided to pediatric patients requiring specialized pediatric anesthesia care. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M75.100 | Unspecified rotator cuff tear or rupture of unspecified shoulder | Included in input; not directly hip-related but may indicate concurrent shoulder pathology in the patient’s problem list. |
S43.401A | Sprain of unspecified acromioclavicular joint, initial encounter | Included in input; represents shoulder girdle injury appearing in the patient record though not directly related to a hip closed procedure. |
M19.011 | Primary osteoarthritis, right shoulder | Included in input; documents degenerative joint disease in the shoulder, may be a comorbidity. |
M19.012 | Primary osteoarthritis, left shoulder | Included in input; documents degenerative shoulder disease as a comorbidity. |
S42.001A | Fracture of unspecified part of right clavicle, initial encounter | Included in input; represents recent shoulder/upper chest trauma present in the record but not the hip procedure indication. |
Note: The provided ICD-10 list includes upper-extremity and shoulder diagnoses present in the patient record; for 01200 typical primary hip indications would include hip osteoarthritis, hip fracture, intra-articular pathology, or hip dislocation when documented as the operative indication.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01202 | Under Anesthesia for Procedures on the Upper Leg (Except Knee) – arthroscopic procedure of the hip joint | Alternative anesthesia code used for arthroscopic hip procedures; used when the specific arthroscopic procedure falls under that descriptor. |
01250 | Under Anesthesia for Procedures on the Upper Leg (Except Knee) – procedure on nerves, muscles, tendons, fascia, and bursae of the upper leg | Related when soft-tissue interventions around the hip or upper leg are performed under anesthesia during the same encounter. |