CPT 01480: Anesthesia for Open Lower Leg, Ankle, and Foot Bone Procedure
CPT code 01480 denotes anesthesia services rendered for open surgical procedures on the bones of the lower leg, ankle, and foot. This code captures anesthesia complexity associated with orthopedic open procedures involving tibia, fibula, ankle, or foot bones and is important for accurately billing perioperative anesthesia care in these settings. Nationally, correct use of 01480 affects provider reimbursement, resource allocation for surgical anesthesia services, and claims processing consistency for lower-extremity orthopedic surgery.Analyzed payers in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of payer coverage patterns, typical sites of service, and clinical context for use of 01480. The report outlines common clinical scenarios where 01480 applies, related surgical procedures that commonly accompany this anesthesia service, and the typical diagnostic presentations that justify its use.The publication provides actionable benchmarking and coding guidance in the form of coverage snapshots and claim considerations (e.g., procedure pairing and service setting). It also summarizes clinical context to aid coding accuracy for perioperative anesthesia in open lower leg, ankle, and foot surgeries. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 01480 describes anesthesia services provided for an open procedure on the bones of the lower leg, ankle, and foot. The service type is general anesthesia for orthopedic lower extremity open procedures. The typical site of service is an inpatient or outpatient surgical setting (operating room) where open surgical repair of tibia, fibula, ankle, or foot bones is performed.
Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents to the emergency department after a motorcycle crash with severe pain, swelling, and deformity of the right lower leg. Imaging confirms a displaced mid-shaft tibial fracture (S82.201A) and an associated distal fibular fracture. The orthopedic surgeon schedules the patient for open reduction and internal fixation (ORIF) of the tibial shaft and possible fixation of the fibula. The anesthesia team (anesthesiologist or CRNA/AA under supervision) evaluates the patient preoperatively, documents airway assessment, past medical history, medication use (including anticoagulants), allergies, and fasting status, and obtains informed consent for general anesthesia with possible regional block for postoperative analgesia.
On the day of surgery the team provides standardized perioperative care: induction of general anesthesia, endotracheal intubation or laryngeal mask airway as indicated, maintenance of anesthesia, intraoperative monitoring (ECG, pulse oximetry, capnography, blood pressure, temperature), administration of analgesics and muscle relaxants as needed, and potential placement of a femoral or popliteal sciatic nerve block for postoperative pain control. The anesthesiologist documents start and stop times for anesthesia, intraoperative events (significant hypotension, transfusion, or airway complications), and any significant additional work or procedures that affect anesthesia management. Postoperative handoff is given to recovery room nursing with documented emergence and immediate postoperative status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia required substantially greater effort or time due to unusual circumstances documented in the record |
23 | Unusual anesthesia | Use when emergency anesthetic services are provided for a procedure that would ordinarily be elective, if payer accepts modifier for anesthesia codes
50 | Bilateral procedure | Use when identical procedures are performed bilaterally and modifier is appropriate for reporting anesthesia when applicable
52 | Reduced services | Use when the planned surgical procedure is substantially reduced or not completed but anesthesia was partially provided
53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances after anesthesia initiation
62 | Two surgeons | Use when two surgeons work together as primary surgeons and this affects anesthesia complexity
76 | Repeat procedure by same physician | Data not provided for 76 in input — excluded per instructions
77 | Repeat procedure by another physician | Use when a subsequent anesthetic is provided for a repeat operative session by a different physician
78 | Unplanned return to operating/procedure room | Use when patient returns to OR for related procedure during the global period requiring anesthesia
79 | Data not provided for 79 in input — excluded per instructions
AA | Anesthesia services performed personally by anesthesiologist | Use when an MD anesthesiologist personally performs the anesthesia
AD | Medical supervision by a physician: more than four concurrent anesthesia procedures | Use when the physician supervises multiple concurrent anesthesia providers per facility rules
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for anesthesia | Use when an eligible non-physician provides anesthesia services per payer rules
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | Use when the physician medically directs multiple concurrent CRNAs and documentation meets medical direction criteria
QS | Monitored anesthesia care (MAC) service | Use when MAC is provided and reportable for payers that recognize MAC modifiers
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists performing preoperative evaluation, induction, maintenance, and postoperative handoff |
367500000X | Certified Registered Nurse Anesthetist | CRNAs who may deliver anesthesia services under supervision or independently depending on state and payer
207RA0401X | Anesthesiology Assistant | Anesthesiology assistants who provide anesthesia under medical direction of an anesthesiologist
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S82.101A | Fracture of upper end of right tibia, initial encounter for closed fracture | Represents proximal tibial fractures that often require open reduction and fixation under general anesthesia |
S82.102A | Fracture of upper end of left tibia, initial encounter for closed fracture | Same as above for left-sided injury; anesthesia code 01480 can apply when surgery performed
S82.201A | Fracture of shaft of right tibia, initial encounter for closed fracture | Classic indication for open reduction and internal fixation of the tibial shaft under anesthesia
S82.202A | Fracture of shaft of left tibia, initial encounter for closed fracture | Left-sided tibial shaft fracture necessitating operative fixation and anesthesia services
S82.301A | Fracture of lower end of right tibia, initial encounter for closed fracture | Distal tibial fractures that often require ORIF with anesthesia management
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27814 | Open treatment of bimalleolar ankle fracture, includes internal fixation, when performed | May be performed concurrently when ankle fractures require open reduction and internal fixation during the same anesthetic session |
27792 | Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed | May be performed in conjunction with tibial fixation when distal fibula is involved
20680 | Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate) | May be performed in staged or combined procedures under the same or separate anesthesia encounter
27650 | Repair, primary, open or percutaneous, of ruptured Achilles tendon | May occur during the same operative session if concomitant tendon injury is identified and repaired