CPT 01210: Anesthesia for Open Procedure of Hip Joint
CPT code 01210 designates anesthesia services for an open procedure of the hip joint. This code captures the anesthetic management component of hip surgery and is important for national payment, utilization tracking, and clinical workflow alignment for orthopedic surgical care. It specifically applies to anesthesia professionals providing care during open hip operations, including preoperative, intraoperative, and immediate postoperative management as captured by anesthesia coding conventions.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Coverage and payment practices for 01210 influence hospital and anesthesia group revenue cycles, contracting, and case-level cost accounting in orthopedic service lines.
Readers will find in-depth information on coding context, common clinical scenarios where 01210 applies, related anesthesia CPT codes for hip procedures, and typical sites of service. The publication also outlines benchmarking considerations, payer coverage scope, and operational implications for anesthesia service delivery tied to major hip surgeries. Data not available in the input includes payer-specific reimbursement rates and regional utilization statistics.
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Billing Code Overview
CPT code 01210 describes anesthesia services provided for an open procedure of the hip joint. This service represents perioperative anesthesia care rendered by an anesthesia professional during an open hip operation.
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Service type: Surgical anesthesia for an open hip joint procedure
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Typical site of service: Inpatient or outpatient operating room (surgical suite)
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive right hip pain and severe degenerative changes scheduled for an open hip joint procedure under general anesthesia. The patient has a history of osteoarthritis and reduced ambulation, requiring preoperative assessment by anesthesia for airway, cardiopulmonary status, and optimization of chronic medications. On the day of surgery the anesthesiology team performs pre-induction evaluation in pre-op, documents consent for anesthesia, manages induction and airway, provides intraoperative hemodynamic monitoring and analgesia, and coordinates postoperative pain plan and handoff to recovery unit. The typical perioperative workflow includes preoperative evaluation and risk stratification, induction of anesthesia in the operating room, maintenance of anesthesia throughout the open hip procedure, management of intraoperative events (for example significant blood loss or arrhythmia), and transfer with documented anesthesia record and post-anesthesia instructions to PACU or ICU as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the anesthesia service required substantially greater intensity, time, or technical difficulty than usual and documentation supports increased effort. |
23 | Unusual anesthesia | Use when emergency or unusual circumstances required general anesthesia for a procedure that is normally performed under local/monitored anesthesia care. |
50 | Bilateral procedure | Use when identical procedures are performed on both hips during the same operative session (if applicable to anesthesia billing rules). |
52 | Reduced services | Use when the anesthesia service provided was partially reduced or incomplete compared to the full service. |
53 | Discontinued procedure | Use when the procedure was started but terminated due to extenuating circumstances and anesthesia was provided accordingly. |
54 | Surgical care only | Use when the anesthesiologist provides only intraoperative management and not pre- or post-operative anesthesia services (site-specific billing rules may apply). |
55 | Postoperative management only | Use when the anesthesiologist provides only postoperative pain management and follow-up care. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons and the anesthesia documentation reflects this increased operative complexity. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period | Use when patient returns to OR intra- or postoperatively for a complication related to the initial hip procedure requiring additional anesthesia services. |
AA | Anesthesia services performed personally by anesthesiologist | Use to indicate the anesthesiologist personally provided the anesthesia service. |
AD | Medical supervision by a physician: more than four concurrent anesthesia procedures | Use when the physician supervised more than four concurrent anesthesia procedures. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for anesthesia | Use when anesthesia services were provided by an eligible non-physician practitioner consistent with payer rules. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | Use when the anesthesiologist medically directed multiple concurrent anesthesia cases meeting CMS criteria. |
QS | Monitored anesthesia care service | Use when monitored anesthesia care (MAC) rather than general anesthesia was the service provided and documentation supports MAC. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Board-certified anesthesiologists who typically perform and bill anesthesia for open hip procedures. |
367H00000X | Anesthesiologist Assistant | Clinically qualified anesthesiologist assistants who provide anesthesia care under physician supervision per payer rules. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs who commonly deliver anesthesia for orthopedic open hip procedures, may bill under institution or individual provider rules. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M17.11 | Unilateral primary osteoarthritis, right knee | Degenerative joint disease contributing to pain and mobility impairment; often coexisting lower-extremity osteoarthritis that may impact perioperative positioning and rehabilitation planning for hip surgery. |
M17.12 | Unilateral primary osteoarthritis, left knee | Degenerative knee disease on the left that may influence intraoperative positioning and postoperative mobility needs after hip procedures. |
S83.241A | Sprain of medial collateral ligament of right knee, initial encounter | Acute knee ligament injury that may coexist with hip pathology or be relevant when assessing overall lower-extremity trauma and perioperative immobilization. |
S83.242A | Sprain of medial collateral ligament of left knee, initial encounter | Contralateral or ipsilateral MCL sprain affecting perioperative management and postoperative rehabilitation planning. |
M23.51 | Chronic instability of knee, right knee | Chronic knee instability that can affect gait, fall risk, and postoperative recovery after hip surgery; relevant to anesthesia considerations for positioning and thromboprophylaxis. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01212 | ANESTHESIA OPEN PX HIP JOINT HIP DISARTICULATION | Alternative anesthesia code for open hip joint procedures involving hip disarticulation; used when the surgical procedure is hip disarticulation rather than other open hip operations. |
01214 | ANESTHESIA OPEN PX TOTAL HIP ARTHROPLASTY | Used when the open hip procedure performed is a total hip arthroplasty; represents a closely related anesthesia service for primary joint replacement. |
01215 | ANESTHESIA OPEN PX REVISION TOT HIP ARTHROPLASTY | Used when the surgical procedure is a revision of a prior total hip arthroplasty; reflects potentially increased anesthesia complexity and time compared with primary arthroplasty. |