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    v1.0.30
    OpenPayerBilling CodesAnesthesia for Procedures on the Upper Leg (Except Knee)CPT cpt-01220-anesthesia-closed-procedure-upper-femur
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    CPT 01220: Anesthesia for Closed Procedure of Upper Two-Thirds of Femur

    Commercial payers pay $78 on average nationally for this procedure.

    CPT code 01220 describes anesthesia services provided for a patient undergoing a closed procedure of the upper two thirds of the femur (thigh bone); service type: anesthesia for orthopedic surgical procedure; typical site of service: operating room or ambulatory surgical center for femoral/thigh closed procedures.

    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

    BUCA’s average commercial rate for CPT 01220 sits at $77.90 and provides a useful mid-market benchmark against the major national commercial carriers. Cigna posts a higher mean at $91.40 while Aetna ($80.80), Blue Cross Blue Shield ($75.70), and UnitedHealth Group ($67.90) cluster near BUCA; note Cigna’s higher median ($84.40) compared with others, indicating its central tendency is above the BUCA average.

    Examining dispersion (P75 minus P25) highlights variability in contracted rates: Blue Cross Blue Shield’s interquartile range is $49.00 (P75 $100.20 minus P25 $51.80), Aetna’s is $62.30 (P75 $104.40 minus P25 $42.10), Cigna’s is $41.60 (P75 $108.20 minus P25 $67.60), BUCA’s is $41.20 (P75 $99.00 minus P25 $52.80), and UnitedHealth Group’s is $30.90 (P75 $81.10 minus P25 $52.00). UnitedHealth Group shows the tightest spread while Aetna shows the widest.

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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 ambulatory woman with progressive right knee pain and mechanical symptoms presents for arthroscopic knee surgery. Preoperative evaluation documents unilateral primary osteoarthritis of the right knee (M17.11), intermittent pain (M25.561), and a recent MRI showing a medial meniscal tear consistent with a current injury (S83.241A) and signs of chronic instability (M23.51). The orthopedic surgeon schedules an arthroscopic meniscectomy and chondroplasty. The anesthesia team (anesthesiologist or CRNA) provides neuraxial or general anesthesia for the closed procedure of the upper two thirds of the femur/thigh region when required by positioning or comorbidities, using CPT 01220 to report anesthesia services for procedures involving the proximal femur/thigh region when these arise during the planned knee arthroscopy or related closed procedures.

    Perioperative workflow: preoperative assessment and documentation of ASA status, informed consent for anesthesia, medication reconciliation, intraoperative monitoring and anesthetic management (regional block or general anesthesia as appropriate), immediate postoperative handoff to PACU with anesthesia record documenting time in/out, anesthetic agents, and any intraoperative complications relevant to modifier reporting (for example, 23 for unusual postoperative services or 78 for an unplanned return to the OR). Typical payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    367500000X
    207RA0401X
    207ZC0500X
    171000000X
    133VN1201X
    213EP1101X
    2251G0304X

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

    CPT 01215: Anesthesia for Revision of Open Total Hip Arthroplasty

    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.

    CPT CodeDescriptionRelationship to This Procedure
    29881Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)Common primary surgical procedure for a torn meniscus; anesthesia reported with CPT 01220 if anesthesia covers proximal femur/thigh closed procedures arising during care.
    29880Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)Used when both medial and lateral meniscectomies are performed; anesthesia services billed per intraoperative time and complexity.
    29876Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartmentsUsed for extensive synovectomy procedures; may increase anesthesia time and complexity.
    29877Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)Frequently performed alongside meniscectomy; contributes to total anesthetic duration and intraoperative considerations.