Summary & Overview

CPT 01220: Anesthesia for Closed Procedures of Upper Femur

CPT code 01220 denotes anesthesia services for closed procedures of the upper two thirds of the femur (thigh bone). As an anesthesia code tied to orthopedic femoral procedures, it captures perioperative anesthesia management for interventions on the proximal and mid femur. Nationwide, accurate use of this code matters for clinical documentation, appropriate facility billing, and aligning anesthesia resource allocation with surgical complexity.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the code, typical sites of service, and the common procedural pairings that prompt use of 01220. The publication also summarizes payer coverage patterns, typical modifiers encountered in practice, relevant provider taxonomies for anesthesia professionals, and commonly associated ICD-10 diagnoses that support medical necessity.

This summary equips billing managers, anesthesia providers, and revenue cycle professionals with a clear understanding of when CPT code 01220 applies, the clinical scenarios that generate it, and the payer landscape relevant to national billing and coding practices.

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Billing Code Overview

CPT code 01220 describes anesthesia services provided for closed procedures of the upper two thirds of the femur (thigh bone). The code applies when the anesthesia provider administers and manages anesthesia care for a patient undergoing any closed procedure involving the proximal or mid femur.

Service Type: General anesthesia services for orthopedic closed procedures of the femur.

Typical Site of Service: Operating room or other procedural suite where closed femoral procedures are performed (inpatient or outpatient surgical setting).

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.

Coding Specifications

Modifier	Description	When to Use
`AA`	Anesthesia services performed personally by an anesthesiologist	Use when the anesthesiologist personally performs the anesthesia.
`AD`	Medical supervision by a physician; more than four concurrent anesthesia procedures	Use when a physician supervises multiple concurrent anesthesia providers (medical direction).
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist as assistant at surgery (note: limited ANES use)	Use when an approved assistant is documented per payor policy; rarely applied to anesthesia billing.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	Use when the anesthesiologist medically directs multiple CRNAs and retains required duties.
`QX`	CRNA service: administered under medical direction by a physician	Use when a CRNA performs the anesthesia under physician direction meeting QX criteria.
`QS`	Monitored anesthesia care (MAC) service	Use when MAC is provided instead of general or regional anesthesia.
`23`	Unusual anesthesia — deep sedation/GA for diagnostic or therapeutic procedures	Use when general anesthesia is required for an otherwise minor or diagnostic procedure due to patient condition.
`50`	Bilateral procedure	Use when bilateral procedures are performed and anesthesia billing rules require modifier `50`.
`62`	Two surgeons — used when two surgeons work together as primary surgeons	Use when two surgeons are documented as co-primary; affects operative reporting that may impact anesthesia documentation.
`78`	Return to the operating room for a related procedure during the postoperative period	Use when the patient returns to OR for a related procedure and additional anesthesia services are provided.
`52`	Reduced services	Use when anesthesia or the surgical procedure is partially reduced or not fully performed.
`53`	Discontinued procedure	Use when the procedure is terminated after initiation; anesthesia time and reason must be documented.
`55`	Postoperative management only	Use when the anesthesiologist provides only postoperative pain management, not intraoperative care.
`62`	(listed above)	(See above)

Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology	Physician anesthesiologists who typically direct or provide anesthesia for orthopedic procedures.
`367500000X`	Certified Registered Nurse Anesthetist	CRNAs who commonly administer anesthesia for knee and proximal femur procedures under supervision or direction.
`207RA0401X`	Anesthesiology Assistant	Anesthesiology assistants who may be part of the anesthesia care team under physician supervision.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M23.50`	Chronic instability of knee, unspecified knee	Documents chronic laxity contributing to recurrent meniscal injury or surgical indication.
`M17.11`	Unilateral primary osteoarthritis, right knee	Common comorbidity influencing surgical approach and anesthetic planning.
`M25.561`	Pain in right knee	Symptom-level diagnosis supporting medical necessity for arthroscopy.
`S83.241A`	Tear of medial meniscus, current injury, right knee, initial encounter	Primary traumatic pathology leading to arthroscopic meniscectomy; directly related to procedure.
`M23.51`	Chronic instability of knee, right knee	Side-specific chronic instability relevant to surgical planning and anesthetic considerations.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29881`	Arthroscopy, 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.
`29880`	Arthroscopy, 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.
`29876`	Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments	Used for extensive synovectomy procedures; may increase anesthesia time and complexity.
`29877`	Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)	Frequently performed alongside meniscectomy; contributes to total anesthetic duration and intraoperative considerations.