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    v1.0.30
    OpenPayerBilling CodesAnesthesia for Procedures on the Upper Leg (Except Knee)CPT cpt-01215-anesthesia-revision-total-hip-arthroplasty
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    CPT 01215: Anesthesia for Revision of Open Total Hip Arthroplasty

    Commercial payers pay $70 on average nationally for this procedure.

    CPT code 01215 describes anesthesia services provided for a patient undergoing a revision of an open total hip arthroplasty, representing perioperative management for a major orthopedic reconstructive procedure; service type: general/regional anesthesia for revision total hip arthroplasty; typical site of service: inpatient or ambulatory surgical center during an open hip revision operation.

    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

    Across national commercial contracts for CPT 01215, BUCA’s average commercial rate of $69.80 provides a useful midpoint reference against individual payer patterns. Cigna and Aetna sit above BUCA on mean rates at $93.10 and $80.40 respectively, while Blue Cross Blue Shield ($59.20) and UnitedHealth Group ($67.50) are at or below that average. Cigna and Aetna also show higher medians ($85.70 and $57.20) relative to BUCA’s median of $59.90, reflecting payer-specific positioning around the midmarket.

    Rate dispersion (P75 minus P25) highlights variability: Aetna’s interquartile spread is $62.50, BCBS is $33.0, BUCA is $39.80, Cigna is $52.30, and UnitedHealth Group is $29.0. UnitedHealth Group and Blue Cross Blue Shield have the tightest IQRs ($29.00 and $33.00), indicating more concentrated contract rates, while Aetna and Cigna show the widest spreads ($62.50 and $52.30), signalling greater variability in negotiated commercial rates.

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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 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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01214Anesthesia for open procedures involving hip joint; total hip arthroplastyRelated primary procedure code for primary total hip arthroplasty; useful for comparison of anesthesia time and complexity when revision differs from primary arthroplasty.

    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
    207LA0401X
    367500000X
    364SH1100X
    363LW0102X
    282N00000X
    2082S0099X
    332000000X

    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-01210-ANESTHESIA-OPEN-PROCEDURE-HIP-JOINT

    CPT 01210: Anesthesia for Open Procedure of Hip Joint

    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-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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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    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.