Summary & Overview

CPT 01464: Anesthesia for Ankle and Foot Arthroscopic Procedures

CPT code 01464 covers anesthesia services for arthroscopic procedures of the ankle and/or foot. This code is used to bill the anesthesia component when a patient undergoes diagnostic or therapeutic arthroscopy in the lower extremity. Nationally, proper use of this code supports accurate reporting of anesthesia resources for ambulatory and inpatient surgical care and informs payment processes tied to perioperative services.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common service settings, and related anesthesia code groupings. The publication summarizes payer coverage considerations, typical sites of service, and the code’s relation to other anesthesia services for the lower leg, ankle, and foot.

The report provides benchmarks and policy-relevant notes for billing and coding teams, clinical leaders, and revenue cycle stakeholders, including comparisons to related anesthesia codes used for open and closed procedures on the lower leg, ankle, and foot. It also outlines typical clinical scenarios in which 01464 is assigned and highlights national implications for anesthesia service reporting and reimbursement alignment.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare01464CPTAnesthesiaAnkle ArthroscopyFoot ArthroscopySurgeryPerioperative CareOperative Reporting

Billing Code Overview

CPT code 01464 describes anesthesia services provided for a patient undergoing an arthroscopic procedure of the ankle and/or foot. The service type is anesthesia for arthroscopic lower extremity procedures, and the typical site of service is an operating room or ambulatory surgery center where ankle or foot arthroscopy is performed. This code covers the anesthesia component associated with diagnostic or therapeutic arthroscopy of the ankle and/or foot.

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient presents with chronic ankle pain and mechanical symptoms after a sports injury; imaging shows a labral tear and osteochondral lesion of the talar dome. The orthopedic surgeon schedules a unilateral ankle arthroscopy for debridement and repair under monitored general anesthesia with peripheral nerve block for postoperative analgesia. Preoperative evaluation by the anesthesia team documents ASA classification P2 for controlled hypertension. The clinical workflow includes preoperative assessment and consent, placement of standard monitors, induction of general anesthesia, ultrasound-guided popliteal sciatic nerve block for intra- and post-operative analgesia, intraoperative management of airway and hemodynamics during the arthroscopic procedure, emergence and transfer to the post-anesthesia care unit (PACU), and postoperative pain control planning and documentation of the anesthetic record and any intraoperative complications.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when anesthesia required substantially greater work due to complexity, extensive time, or unusual events beyond typical ankle arthroscopy anesthesia.
`23`

Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology	Board-certified anesthesiologists who perform and medically direct anesthesia for ankle arthroscopy.
`207LA0401X`	Pain Medicine (Anesthesiology)	Specialists providing perioperative regional analgesia (eg, popliteal sciatic block) and complex pain management.
`367H00000X`	Anesthesiologist Assistant	Clinicians who may provide anesthesia services under the supervision of an anesthesiologist.
`367500000X`	Certified Registered Nurse Anesthetist	CRNAs who provide anesthetic care, often medically directed or supervised depending on facility and payer rules.

ICD-10 Code	Description	Clinical Relevance
`M17.10`	Unilateral primary osteoarthritis, unspecified knee	Osteoarthritis of the knee may coexist with foot/ankle pathology or be relevant in preoperative planning when multiple lower extremity joints are symptomatic.
`M17.11`	Unilateral primary osteoarthritis, right knee	Same clinical relevance as `M17.10`; documents laterality which may affect surgical planning and perioperative mobility considerations.
`M17.12`	Unilateral primary osteoarthritis, left knee	Same clinical relevance as `M17.10`; documents laterality.
`M17.5`	Other unilateral secondary osteoarthritis of knee	Secondary osteoarthritis may reflect prior trauma or joint replacement, affecting rehabilitation and anesthetic risk assessment.
`Z96.651`	Presence of right artificial knee joint	Presence of a prosthetic knee is relevant to positioning, antibiotic prophylaxis considerations, and overall perioperative planning.
`Z96.652`	Presence of left artificial knee joint	Same as `Z96.651` for left-sided prosthetic knee; relevant for mobility and perioperative risk stratification.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`01462`	Anesthesia for all closed procedures on lower leg, ankle, and foot	Applicable for closed/minimally invasive ankle procedures; alternative anesthesia code when specific arthroscopy code not used.
`01470`	Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; not otherwise specified	Used for peripheral nerve or soft tissue procedures of the ankle/foot where arthroscopy code `01464` is not appropriate.
`01472`	Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured Achilles tendon, with or without graft	Relevant when Achilles tendon repair is performed in conjunction with or instead of ankle arthroscopy; indicates different surgical site and anesthetic planning.
`01474`	Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; gastrocnemius recession (eg, Strayer procedure)	Used when gastrocnemius recession is performed during the same operative episode requiring distinct anesthetic considerations.
`01480`	Anesthesia for open procedures on bones of lower leg, ankle, and foot; not otherwise specified	Applicable when conversion to open bone procedures occurs during arthroscopy or when open bone surgery is planned.
`01482`	Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation)	Used for extensive open procedures beyond arthroscopy; may be relevant for staging or unexpected intraoperative findings.
`01484`	Anesthesia for open procedures on bones of lower leg, ankle, and foot; osteotomy or osteoplasty of tibia and/or fibula	Relevant when corrective bony procedures of the tibia/fibula accompany ankle surgery.
`01486`	Anesthesia for open procedures on bones of lower leg, ankle, and foot; total ankle replacement	Applicable when an arthroscopic case converts to or is performed with total ankle arthroplasty requiring a different anesthesia classification.
`01490`	Anesthesia for lower leg cast application, removal, or repair	Relevant to postoperative immobilization procedures requiring anesthesia services in the perioperative period.

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