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    OpenPayerBilling CodesAnesthesia for Procedures on the Knee and Popliteal AreaCPT cpt-01320-anesthesia-for-knee-popliteal-soft-tissue-procedures
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    CPT 01320: Anesthesia for Procedures on Knee and Popliteal Area

    Commercial payers pay $85 on average nationally for this procedure.

    CPT code 01320 describes anesthesia services provided for procedures on the nerves, muscles, tendons, fascia, and bursae of the knee and/or popliteal area; service type is regional or general anesthesia for knee/popliteal procedures, and the typical site of service is an operating room or procedure suite involving the knee or popliteal region.

    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 reimbursement for CPT 01320 clusters around BUCA’s average commercial benchmark of $85.4, with variation across payers indicating different contracting dynamics. Blue Cross Blue Shield shows moderate dispersion (P25 $52 to P75 $103, range $51), Cigna displays a similar spread (P25 $67.6 to P75 $108.1, range $40.5), and Aetna has the widest interquartile spread (P25 $48 to P75 $163.8, range $115.8). UnitedHealth Group’s reimbursements are the tightest among these payers (P25 $52 to P75 $81.1, range $29.1), suggesting more consistent commercial pricing.

    Looking at central tendency, Cigna ($91.4 mean, median $84.4) and Aetna ($122.4 mean, median $101.6) trend higher than BUCA’s average, while Blue Cross Blue Shield ($76.9 mean, median $67) and UnitedHealth Group ($67.8 mean, median $64) trend lower. Payer-specific max/min values further illustrate upper-end outliers for Aetna ($421.4 max, $30.4 min) and Cigna ($165.3 max, $48 min), reinforcing that Aetna exhibits the broadest full-range variability among the listed commercial payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with progressive unilateral knee pain from primary osteoarthritis (M17.11) is scheduled for arthroscopic debridement and possible repair of medial meniscal and ligamentous structures in the right knee and popliteal region. Preoperative evaluation by the anesthesia team documents ASA class P3 due to controlled hypertension and diabetes. The patient receives regional anesthesia targeting the femoral and popliteal sciatic nerve distribution with monitored sedation. Intraoperative responsibilities include airway management, sedation titration, hemodynamic monitoring, and documentation of regional block performance and effectiveness. Postoperative handoff to PACU includes block efficacy, analgesia plan, and anesthesia record confirming the use of anesthesia services specific to nerves, muscles, tendons, fascia, and bursae of the knee/popliteal area, billed with 01320.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01340Anesthesia for procedures on the knee and popliteal areaOverlapping anesthesia code for knee/popliteal procedures; relates by anatomic coverage and may be selected based on specific operative site and technique.

    Related Modifiers

    7 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…
    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
    367500000X
    207RA0401X
    1835X0200X
    207RN0300X
    261QM2500X
    101Y00000X
    292200000X

    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-01340-ANESTHESIA-CLOSED-PROCEDURE-LOWER-THIRD-FEMUR

    CPT 01340: Anesthesia for Closed Procedure of Lower One-Third of Femur

    CPT-01360-ANESTHESIA-OPEN-PROCEDURE-LOWER-FEMUR

    CPT 01360: Anesthesia for Open Procedure on Lower Femur

    CPT-01380-ANESTHESIA-CLOSED-KNEE-PROCEDURE

    CPT 01380: Anesthesia for Closed Procedure of Knee Joint

    CPT-01382-ANESTHESIA-DIAGNOSTIC-ARTHROSCOPY-KNEE

    CPT 01382: Anesthesia for Diagnostic Arthroscopic Procedure of Knee

    CPT-01390-ANESTHESIA-CLOSED-PROCEDURE-TIBIA-FIBULA-PATELLA

    CPT 01390: Anesthesia for Closed Procedure of Upper Tibia/Fibula/Patella

    CPT-01392-ANESTHESIA-OPEN-PROCEDURE-UPPER-TIBIA-FIBULA-PATELLA

    CPT 01392: Anesthesia for Open Upper Tibia/Fibula/Patella Procedure

    CPT-01400-ANESTHESIA-FOR-KNEE-SURGERY-OPEN-OR-ARTHROSCOPIC

    CPT 01400: Anesthesia for Open or Arthroscopic Knee Procedure

    CPT-01402-ANESTHESIA-TOTAL-KNEE-ARTHROPLASTY

    CPT 01402: Anesthesia for Total Knee Arthroplasty

    CPT-01404-ANESTHESIA-FOR-KNEE-JOINT-SURGERY

    CPT 01404: Anesthesia for Open or Arthroscopic Knee Procedure

    CPT-01420-ANESTHESIA-FOR-KNEE-INCLUDING-CAST-APPLICATION-REMOVAL-REPAIR

    CPT 01420: Anesthesia for Application/Removal/Repair of Knee-Including Cast

    Showing 1–10 of 15

    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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