Summary & Overview

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

CPT code 01392 denotes anesthesia services for patients undergoing any open procedure involving the upper ends of the tibia, fibula, and/or the patella. This anesthesia code is relevant nationally for facility and professional billing when open knee-area orthopedic surgeries are performed, covering perioperative anesthesia management for procedures that include proximal tibial, fibular, or patellar approaches. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare.

Readers will find a concise overview of where CPT code 01392 fits in anesthesia billing for knee-area open procedures, including typical sites of service and clinical context tied to lower-extremity orthopedic surgery. The publication outlines payer coverage considerations and compares this code to closely related knee anesthesia codes to clarify coding selection for open procedures versus arthroscopy or other knee-area services. The material also highlights common clinical indications that align with this anesthesia service and flags related billing complexities relevant to national payers and facility billing workflows.

Data not available in the input for some operational benchmarks and payer-specific reimbursement rates.

AetnaBlue Cross Blue ShieldCigna HealthUnited HealthcareMedicare01392CPTanesthesiaorthopedic surgeryknee surgeryperioperative careoperating roomambulatory surgery center

Billing Code Overview

CPT code 01392 describes anesthesia services provided for any open surgical procedure involving the upper ends of the tibia, fibula, and/or the patella. The service type is anesthesia for open lower-extremity orthopedic procedures. The typical site of service is an inpatient or outpatient surgical setting where open knee-area orthopedic surgery is performed, such as hospital operating rooms or ambulatory surgery centers.

Clinical & Coding Specifications

Clinical Context

A 68-year-old patient with progressive unilateral knee pain due to primary osteoarthritis (M17.11) presents for an open proximal tibial osteotomy and debridement involving the upper tibia and patella. Preoperative evaluation includes anesthetic assessment by an anesthesiologist or Certified Registered Nurse Anesthetist (CRNA), review of comorbidities (cardiac, pulmonary), medication reconciliation, and informed consent for general or regional anesthesia. On the day of surgery the patient undergoes induction of general endotracheal anesthesia with peripheral nerve block adjunct for postoperative analgesia. Intraoperative management includes airway control, hemodynamic monitoring, fluid management, and administration of anesthetic agents; postoperative handoff to PACU staff outlines analgesic plan and any complications. Typical settings are an inpatient hospital operating room or ambulatory surgical center for complex knee-area open procedures, with anesthesia services reported under 01392 for open procedures of the upper tibia, fibula, and/or patella.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when anesthesia services required substantially greater effort or complexity than typical for `01392` and documentation supports increased work.
`23`	Unusual anesthesia	Use when emergency anesthesia is required due to acute physiological conditions that prevent standard preoperative evaluation.
`50`	Bilateral procedure	Use when identical open procedures are performed on both lower extremities during the same operative session.
`52`	Reduced services	Use when the anesthesia service is partially reduced or service elements are omitted.
`53`	Discontinued procedure	Use when the anesthesia was initiated but the procedure was aborted prior to completion for valid clinical reasons.
`62`	Two surgeons	Use when two surgeons of different specialties work together as primary surgeons for the operative procedure, affecting anesthesia complexity.
`78`	Unplanned return to OR following initial procedure	Use when the patient returns to the operating room for a related procedure during the global period, increasing anesthesia services.
`AA`	Anesthesia by an anesthesiologist	Use to indicate the service was personally performed by a physician anesthesiologist, when required by payer.
`QK`	Medical direction of two, three, or four CRNAs	Use when an anesthesiologist medically directs multiple CRNAs during the anesthetic for `01392`.
`QS`	Monitored anesthesia care service	Use when monitored anesthesia care rather than general/regional anesthesia is provided for the procedure.
`QX`	CRNA service with medical direction by anesthesiologist	Use when a CRNA performs the anesthesia under an anesthesiologist's medical direction.
`QY`	Medical direction of one CRNA by anesthesiologist	Use when an anesthesiologist directs one CRNA during the anesthesia.
`LT`	Left side	Use to indicate the anesthesia relates to a left-sided procedure when laterality reporting is required.
`P3`	Patient status, severe systemic disease	Use to document higher ASA physical status when the patient has severe systemic disease impacting anesthetic risk.

Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology	Physician specialty commonly billing for anesthesia services for open knee-area procedures.
`207LA0401X`	Pain Medicine (Anesthesiology)	Anesthesiologists with pain subspecialty may provide regional blocks or perioperative pain management.
`367500000X`	Certified Registered Nurse Anesthetist	CRNAs frequently provide anesthesia services in hospital and ambulatory settings for `01392`.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M17.10`	Unilateral primary osteoarthritis, unspecified knee	Indicates degenerative joint disease of a single knee often requiring open procedures of the proximal tibia/patella for deformity correction or debridement.
`M17.11`	Unilateral primary osteoarthritis, right knee	Specifies right-sided primary osteoarthritis; correlates with laterality for procedure and anesthesia reporting (e.g., `LT`/`RT` modifiers where applicable).
`M17.12`	Unilateral primary osteoarthritis, left knee	Specifies left-sided primary osteoarthritis; used for left-sided operative anesthesia billing.
`M17.5`	Other unilateral secondary osteoarthritis of knee	Secondary osteoarthritis from prior trauma or underlying conditions that may necessitate open reconstructive procedures of the upper tibia/fibula/patella.
`Z96.651`	Presence of right artificial knee joint	Indicates prior right total knee arthroplasty; relevant when planning anesthesia for revision or adjacent-site open procedures.
`Z96.652`	Presence of left artificial knee joint	Indicates prior left total knee arthroplasty; relevant for anesthesia planning for subsequent open procedures near the prosthesis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`01360`	Anesthesia for procedures on knee area (other than intra-articular); not otherwise specified	Alternative anesthesia code for certain knee-area open surgical procedures; used when `01392` is not the most specific descriptor.
`01380`	Anesthesia for intra-articular procedures of the knee joint	Used when the primary procedure is an intra-articular knee joint operation rather than open proximal tibial/fibular/patellar surgery.
`01382`	Anesthesia for arthroscopic procedures of the knee	Used when the procedure is arthroscopic rather than open; may be reported instead of `01392` for arthroscopy.
`01390`	Anesthesia for knee area procedures, other than specified	General category code for knee-area anesthesia; may represent related or less-specific anesthesia services compared to `01392`.