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    OpenPayerBilling CodesAnesthesia for Procedures on the Knee and Popliteal AreaCPT cpt-01420-anesthesia-for-knee-including-cast-application-removal-repair
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    CPT 01420: Anesthesia for Application/Removal/Repair of Knee-Including Cast

    Commercial payers pay $80 on average nationally for this procedure.

    CPT code 01420 describes anesthesia services provided for application, removal, or repair of a cast that includes the knee joint, a procedural anesthesia service typically delivered in an ambulatory surgery center, hospital outpatient department, or inpatient surgical setting where regional or general anesthesia may be used to facilitate immobilization procedures involving the knee.

    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

    Across national commercial payers, BUCA’s average commercial rate of $79.70 serves as a midpoint reference against more variable insurer-specific distributions. Blue Cross Blue Shield shows the widest interquartile dispersion (P75 $104.60 minus P25 $60.30 = $44.30), indicating broader negotiated outcomes; Cigna’s IQR is also substantial (P75 $117.80 minus P25 $71.40 = $46.40), and Aetna’s IQR is moderate (P75 $85.30 minus P25 $42.00 = $43.30). UnitedHealth Group has the tightest interquartile spread (P75 $81.00 minus P25 $52.00 = $29.00), suggesting more consistent commercial contract levels.

    Median and mean contrasts further highlight payer positioning: Cigna’s mean $96.10 and median $87.40 sit above BUCA’s average, while Blue Cross Blue Shield’s mean $83.50 and median $78.50 are near BUCA. Aetna’s mean $63.70 and median $48.00 and UnitedHealth Group’s mean $68.20 and median $64.40 are lower than BUCA, framing a market where BUCA’s $79.70 average is mid-to-upper compared with several major commercial payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with progressive right knee pain from unilateral primary osteoarthritis (M17.11) presents for total knee arthroplasty. Intraoperative management requires general endotracheal anesthesia with a peripheral nerve block for postoperative analgesia. The anesthesia provider is billed under 01420 when anesthesia services are performed for application or removal of a cast that includes the knee joint (for example, when a postoperative immobilizing cast or brace that encompasses the knee must be applied, adjusted, or removed in the perioperative period). Typical workflow: preoperative evaluation by the anesthesia team, documentation of medical comorbidities and ASA physical status (e.g., P3), performance of neuraxial or general anesthesia and any peripheral nerve block, coordination with orthopedics for cast application or removal in the operating room or procedure suite, monitoring during the procedure, and immediate postoperative handoff in PACU. Services may occur in an ambulatory surgery center, hospital outpatient department, or inpatient operating room depending on the primary surgical procedure and patient status.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    29881Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)

    Related Modifiers

    9 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…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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
    163W00000X
    2081S0010X
    364SC0200X
    207ZP0101X
    246ZG0701X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M17.9Osteoarthritis of knee, unspecified
    M23.50Chronic instability of knee, unspecified knee
    M25.561Pain in right knee
    M25.562Pain in left knee
    M25.569Pain in unspecified knee
    M76.61Achilles tendinitis, right leg
    M76.62Achilles tendinitis, left leg
    S82.101AUnspecified fracture of upper end of right tibia, initial encounter for closed fracture

    Showing 1–10 of 24

    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-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

    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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    May be the primary orthopedic procedure for which anesthesia is provided; cast application or removal may occur perioperatively.
    29880Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving)Used when more extensive meniscal work is performed; anesthesia services for knee cast care may be billed with 01420 if cast includes knee.
    27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)Major procedure often requiring postoperative immobilization with a cast or brace that includes the knee; anesthesia services for cast application/removal fall under 01420.
    20610Arthrocentesis, aspiration and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint)Diagnostic or therapeutic joint injection may occur in the same episode; anesthesia for cast-related manipulation may be billed separately.
    29877Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)Debridement procedures may be concurrent with cast application or removal; anesthesia services for cast work are reported with 01420.