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    v1.0.30
    OpenPayerBilling CodesAnesthesia for Procedures on the Upper Leg (Except Knee)CPT cpt-01210-anesthesia-open-procedure-hip-joint
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    CPT 01210: Anesthesia for Open Procedure of Hip Joint

    Commercial payers pay $80 on average nationally for this procedure.

    CPT code 01210 describes anesthesia services provided for an open surgical procedure of the hip joint; the service is anesthesia delivery for an open hip operation and is typically performed in an operating room or surgical suite as part of inpatient or outpatient orthopedic surgical care.

    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 rate levels for CPT 01210 cluster around BUCA’s average commercial benchmark of $80.00, with individual payer means spanning lower to higher bands: Aetna ($126.30), Cigna ($95.30), UnitedHealth Group ($67.30), Blue Cross Blue Shield ($63.70), and BUCA ($80.00). Median values indicate Cigna and Aetna skew higher (Cigna median $86.00, Aetna median $91.30) while Blue Cross Blue Shield and UnitedHealth Group medians sit near the BUCA average (BCBS median $54.60, UnitedHealth median $64.00). Min and max rates are available for some payers and reflect broader outliers for Aetna (min $30.30, max $452.80) and Cigna (min $46.00, max $154.70).

    Examining dispersion via the interquartile range (P75 minus P25) highlights variability: Aetna’s spread is $121.70 (P75 $165.80 minus P25 $45.10), Cigna’s is $56.40 (P75 $123.20 minus P25 $68.00), Blue Cross Blue Shield’s is $35.80 (P75 $79.50 minus P25 $43.70), UnitedHealth Group’s is $28.80 (P75 $80.80 minus P25 $52.00), and BUCA’s is $49.60 (P75 $101.40 minus P25 $49.40). Aetna displays the widest IQR, while UnitedHealth Group is the tightest.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01212ANESTHESIA OPEN PX HIP JOINT HIP DISARTICULATIONAlternative 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

    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
    367H00000X
    367500000X
    1835P1300X
    163WD1100X
    224P00000X
    207P00000X
    347E00000X

    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-01200-ANESTHESIA-CLOSED-HIP-PROCEDURE

    CPT 01200: Anesthesia for Closed Procedure on Hip Joint

    CPT-01202-ARTHROSCOPIC-HIP-ANESTHESIA

    CPT 01202: Anesthesia for Hip Arthroscopy

    CPT-01212-HIP-DISARTICULATION-ANESTHESIA

    CPT 01212: Anesthesia for Open Disarticulation of Hip

    CPT-01214-ANESTHESIA-OPEN-TOTAL-HIP-ARTHROPLASTY

    CPT 01214: Anesthesia for Open Total Hip Arthroplasty

    CPT-01215-ANESTHESIA-REVISION-TOTAL-HIP-ARTHROPLASTY

    CPT 01215: Anesthesia for Revision of Open Total Hip Arthroplasty

    CPT-01220-ANESTHESIA-CLOSED-PROCEDURE-UPPER-FEMUR

    CPT 01220: Anesthesia for Closed Procedure of Upper Two-Thirds of Femur

    CPT-01230-ANESTHESIA-OPEN-UPPER-TWO-THIRDS-FEMUR

    CPT 01230: Anesthesia for Open Procedure of Upper Two-Thirds of Femur

    CPT-01232-ANESTHESIA-AMPUTATION-UPPER-THIGH-FEMUR

    CPT 01232: Anesthesia for Amputation of Upper Femur

    CPT-01234-ANESTHESIA-RADICAL-RESECTION-UPPER-FEMUR

    CPT 01234: Anesthesia for Radical Resection of Upper Two-Thirds of Femur

    CPT-01250-ANESTHESIA-UPPER-LEG-SOFT-TISSUE-PROCEDURES

    CPT 01250: Anesthesia for Upper Leg Soft-Tissue Procedures

    Showing 1–10 of 14

    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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    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.
    01215ANESTHESIA OPEN PX REVISION TOT HIP ARTHROPLASTYUsed when the surgical procedure is a revision of a prior total hip arthroplasty; reflects potentially increased anesthesia complexity and time compared with primary arthroplasty.