CPT 01215: Anesthesia for Revision of Total Hip Arthroplasty
CPT code 01215 denotes anesthesia services for a revision of an open total hip arthroplasty, a high-acuity perioperative service tied to complex orthopedic reconstructive surgery. Nationally, this code is used to report the anesthesia component of revision hip arthroplasty cases, reflecting specialized anesthesia management needs including prolonged operative time, blood loss considerations, and coordination with orthopedic surgical teams. The code is relevant to hospital-based anesthesia departments, ambulatory surgical centers that handle complex joint revisions, and payers that cover major joint procedures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for anesthesia in revision total hip arthroplasty, comparisons with related hip anesthesia codes, and a review of common billing considerations. The publication summarizes typical sites of service, associated clinical complexity, and coding relationships that influence claim submission and processing. It also outlines the practical implications for coverage and reimbursement workflows at a national level, including areas where coding specificity affects payment pathways. Data not available in the input are noted where applicable.
Sign up for cpt 01215 policy alerts
Get alerted when payer policies referencing 01215 are released or updated.
Billing Code Overview
CPT code 01215 describes anesthesia services provided for a revision of an open total hip arthroplasty. The service type is anesthesia for a revision total hip arthroplasty, typically performed in an inpatient or hospital operating room setting where open hip revision surgery is carried out. This code captures the anesthesia care associated with the surgical procedure and the perioperative management required for revision of a total hip implant.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a prior total hip arthroplasty presents with progressive hip pain, loosening of the femoral component on radiographs, and mechanical symptoms. The orthopedic surgeon schedules a revision of the open total hip arthroplasty to remove and replace worn or failed components. The anesthesia team evaluates the patient preoperatively, documenting comorbidities (e.g., hypertension, diabetes, obesity), airway assessment, and prior anesthesia history. On the day of surgery the anesthesiologist or CRNA provides general anesthesia with endotracheal intubation, or regional neuraxial anesthesia when appropriate, manages intraoperative hemodynamics, administers multimodal analgesia, and coordinates intraoperative monitoring and postoperative handoff to recovery. Typical workflow includes preoperative evaluation and consent, perioperative medication reconciliation, induction of anesthesia, intraoperative anesthesia management for the revision procedure, immediate postoperative emergence and pain control, and transfer to post-anesthesia care unit (PACU) or inpatient orthopedic ward for monitoring and rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia required substantially greater work due to unusual circumstances beyond typical revision hip arthroplasty (document rationale). |
23 | Unusual anesthesia | Use when general anesthesia is administered for a procedure usually done with local/monitored anesthesia care but only if applicable to specific surgical approach (rare for this code). |
50 | Bilateral procedure | Use when bilateral hip revision procedures are performed during the same operative session. |
52 | Reduced services | Use when scope of anesthetic services is reduced or curtailed (e.g., case aborted early but anesthesia provided). |
53 | Discontinued procedure | Use when the procedure is terminated after induction of anesthesia and anesthesia services were provided for the discontinued operation. |
54 | Surgical care only | Use when the anesthesiologist furnishes only intraoperative care and another provider furnishes pre/postoperative anesthesia services (rare for anesthesia billing). |
55 | Postoperative management only | Use when the anesthesiologist furnishes only postoperative pain management and not intraoperative care. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons for complex revision and this affects anesthesia planning/duration. |
78 | Return to operating room after anesthesia | Use when patient returns to OR for related procedure during the global period and additional anesthesia is provided. |
AA | Anesthesia services by anesthesiologist | Use when an MD or DO anesthesiologist personally performs the anesthesia service. |
AD | Medical supervision by anesthesiologist | Use when an anesthesiologist is medically directing multiple concurrent anesthesia procedures and supervision meets CMS criteria. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist | Use when these non-physician providers deliver anesthesia services where allowed and reported per payer policy. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures by an anesthesiologist | Use when anesthesiologist directs multiple concurrent cases and meets documentation requirements. |
QX | CRNA service with medical direction by a physician | Use when a CRNA furnishes anesthesia with an anesthesiologist providing medical direction. |
QY | Medical direction of one CRNA by an anesthesiologist | Use when anesthesiologist directs a single CRNA for the case per payer rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists who provide preoperative evaluation, intraoperative anesthesia, and postoperative management for revision hip arthroplasty. |
207LA0401X | Pain Medicine (Anesthesiology) | Anesthesiologists with pain subspecialty may manage complex perioperative analgesia or regional blocks for postoperative pain control. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs frequently provide anesthesia services for hip revision procedures, either independently or under medical direction/supervision models. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M17.10 | Unilateral primary osteoarthritis, unspecified knee | Osteoarthritis codes reflect degenerative joint disease; presence of primary osteoarthritis in lower extremity joints can coexist and are relevant to overall joint disease burden and surgical planning. |
M17.11 | Unilateral primary osteoarthritis, right knee | As above; documents laterality of osteoarthritis which may influence rehabilitation and perioperative planning. |
M17.12 | Unilateral primary osteoarthritis, left knee | As above; documents laterality of osteoarthritis which may influence rehabilitation and perioperative planning. |
M17.0 | Bilateral primary osteoarthritis of knee | Indicates bilateral knee osteoarthritis, relevant to functional status and postoperative rehabilitation needs. |
Z96.651 | Presence of right artificial knee joint | Documents existing right knee arthroplasty hardware; relevant for operative history and potential interactions with current hip revision. |
Z96.652 | Presence of left artificial knee joint | Documents existing left knee arthroplasty hardware; relevant for operative history and potential interactions with current hip revision. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01214 | Anesthesia for open procedures involving hip joint; total hip arthroplasty | Related primary procedure code for primary total hip arthroplasty; useful for comparison of anesthesia time and complexity when revision differs from primary arthroplasty. |
01212 | Anesthesia for open procedures involving hip joint; hip disarticulation | Related open hip procedure code representing more extensive surgery; included for clinical context of anesthesia for major open hip surgeries. |