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    OpenPayerBilling CodesAnesthesia for Procedures on the Knee and Popliteal AreaCPT cpt-01340-anesthesia-closed-procedure-lower-third-femur
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    CPT 01340: Anesthesia for Closed Procedure of Lower One-Third of Femur

    Commercial payers pay $76 on average nationally for this procedure.

    CPT code 01340 describes anesthesia services provided for a patient undergoing any closed procedure of the lower one-third of the femur (thigh bone); service type: anesthesia for closed femoral procedures; typical site of service: hospital operating room or ambulatory surgical center where lower femur closed procedures are performed.

    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

    National commercial pricing for CPT 01340 clusters near the BUCA average commercial rate of $75.70, with notable variation among individual payers. UnitedHealth Group and Aetna exhibit tighter interquartile spreads of $30.00 and $44.00 respectively, indicating more concentrated commercial pricing around their medians. Blue Cross Blue Shield and Cigna show wider dispersion — BCBS has an IQR of $49.50 and Cigna an IQR of $40.50 — reflecting greater variability in contractual rates and potential market negotiation differences.

    Blue Cross Blue Shield posts the highest maximum at $208.40 while UnitedHealth Group’s $122.70 cap and Aetna’s $178.20 cap frame the upper end of the range; BUCA’s average of $75.70 sits near the middle of payer distributions. Median levels place Cigna and Blue Cross Blue Shield above the BUCA average, suggesting higher mid-market commercial reimbursements for those carriers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 56-year-old male with a history of progressive right knee pain from unilateral primary osteoarthritis (M17.11) presents for operative management after failed conservative care. Preoperative evaluation documents intermittent mechanical catching and instability consistent with a medial meniscus tear (S83.241A) and prior episodes suggestive of chronic knee instability (M23.50). The orthopedic surgeon schedules a closed intramedullary fixation of a distal femur fracture (lower one-third of the femur) under general endotracheal anesthesia with possible regional adjunct. The anesthesia team (Anesthesiology or Certified Registered Nurse Anesthetist) performs a pre-op assessment, documents ASA physical status (P2 or P3 as appropriate), obtains informed consent for anesthesia, places standard monitors, induces general anesthesia, and provides intraoperative maintenance including endotracheal intubation, ventilation, hemodynamic management, and appropriate analgesia. A femoral nerve or adductor canal block may be provided pre- or post-induction for postoperative pain control. The case concludes with emergence, transfer to the post-anesthesia care unit (PACU), and documentation of anesthesia time and any intraoperative complications. Typical site of service is an ambulatory surgery center or hospital operating room for closed procedures on the lower one-third of the femur. Common presenting indications include distal femur fracture fixation in the setting of acute injury (S83.241A, S83.511A) or operative treatment related to degenerative and instability conditions (M17.11, M23.50, M25.561).

    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
    207X00000X
    261QU0200X
    2088P0231X
    2085N0700X
    207RH0002X
    261QP1100X

    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-01320-ANESTHESIA-FOR-KNEE-POPLITEAL-SOFT-TISSUE-PROCEDURES

    CPT 01320: Anesthesia for Procedures on Knee and Popliteal Area

    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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    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01360Anesthesia for all open procedures on lower one‑third of femurRelated anesthesia code for open procedures of the same anatomic region; use when the surgical approach is open rather than closed.