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    OpenPayerBilling CodesAnesthesia for Procedures on the Knee and Popliteal AreaCPT cpt-01392-anesthesia-open-procedure-upper-tibia-fibula-patella
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    CPT 01392: Anesthesia for Open Upper Tibia/Fibula/Patella Procedure

    Commercial payers pay $97 on average nationally for this procedure.

    CPT code 01392 describes anesthesia services provided for patients undergoing any open surgical procedure involving the upper ends of the tibia, fibula, and/or patella; service type: anesthesia for open orthopedic surgery of the proximal lower leg/knee region; typical site of service: hospital operating room or ambulatory surgery center where open knee/upper tibia procedures are performed.

    For related coverage guidance, see recent payer policy updates: Surgical Site of Care - Hospital Outpatient, Dental Anesthesia Services, Dental Anesthesia Services.

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    National Reimbursement Benchmarks

    For CPT 01392, BUCA’s average commercial rate sits at $96.50 and serves as a national benchmark for commercial reimbursement. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $47.70, Cigna’s spread is $41.50, UnitedHealth Group’s spread is $29.10, and Aetna shows the widest spread at $175.80. These spreads indicate that Aetna’s commercial payments are far more variable across markets, while UnitedHealth Group displays the tightest clustering of rates around its midrange.

    Across the five payers, payer-specific medians and means vary substantially around BUCA’s mean. Blue Cross Blue Shield and Cigna cluster relatively close to BUCA’s average, while Aetna’s high maximum and wide spread drive larger upside variation. UnitedHealth Group’s narrower spread suggests more consistent commercial pricing nationally compared with the others.

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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 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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01360Anesthesia for procedures on knee area (other than intra-articular); not otherwise specifiedAlternative anesthesia code for certain knee-area open surgical procedures; used when is not the most specific descriptor.

    Related Modifiers

    8 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…
    P3Modifier P3 denotes that the anesthesia patient has severe systemic disease (ASA III). It applies only to anesthesia CPT codes (00100–01999) and must be appended by the anesthesia provider with…- Applies only to anesthesia procedure codes (CPT 00100–01999) and should be appended by the anesthesia provider when the patient meets the definition of "severe systemic disease" (CPT/AAPC P3;…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    207LA0401X
    367500000X
    102L00000X
    261QE0700X
    2084N0402X
    103TH0004X
    207WX0200X

    Related ICD-10-CM Codes

    33 rows

    ICD-10-CM CodeDescription
    M17.10Unilateral primary osteoarthritis, unspecified knee
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M17.5Other unilateral secondary osteoarthritis of knee
    M23.261Derangement of other lateral meniscus due to old tear or injury, right knee
    M84.471APathological fracture, right ankle, initial encounter for fracture
    M84.472APathological fracture, left ankle, initial encounter for fracture
    M84.473APathological fracture, unspecified ankle, initial encounter for fracture
    M84.474APathological fracture, right foot, initial encounter for fracture
    M84.475APathological fracture, left foot, initial encounter for fracture

    Showing 1–10 of 33

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Surgical Site of Care - Hospital Outpatientregence2026-11-01
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    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

    Related Codes

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

    CPT 01320: Anesthesia for Procedures on Knee and Popliteal Area

    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-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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    01392
    01380Anesthesia for intra-articular procedures of the knee jointUsed when the primary procedure is an intra-articular knee joint operation rather than open proximal tibial/fibular/patellar surgery.
    01382Anesthesia for arthroscopic procedures of the kneeUsed when the procedure is arthroscopic rather than open; may be reported instead of 01392 for arthroscopy.
    01390Anesthesia for knee area procedures, other than specifiedGeneral category code for knee-area anesthesia; may represent related or less-specific anesthesia services compared to 01392.