CPT 01484: Anesthesia for Tibia/Fibula Osteotomy or Osteoplasty
CPT code 01484 represents anesthesia services furnished during osteotomy or osteoplasty of the tibia and/or fibula. This code captures intraoperative anesthesia for reconstructive or reshaping procedures of the lower leg bones and is relevant to anesthesiologists and surgical teams involved in orthopedic lower-extremity care. Nationally, accurate assignment of this CPT code is important for clinical documentation, perioperative billing, and interoperability across payers.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The summary addresses common billing patterns, allowed service locations, and clinical context tied to tibial and fibular osteotomy/osteoplasty procedures. Readers will find a concise explanation of the code’s clinical scope, typical sites of service, commonly associated diagnoses and related anesthesia codes, and a comparison to nearby anesthesia codes for lower-leg open procedures.
This publication provides clinicians, coding professionals, and policy analysts with benchmarks and policy-relevant context to support correct code use, documentation alignment, and payer discussions. It highlights the code’s place within anesthesia coding for orthopedic lower-extremity surgery and outlines the clinical scenarios in which 01484 is the appropriate anesthesia code for intraoperative services.
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Billing Code Overview
CPT code 01484 describes anesthesia services provided for osteotomy or osteoplasty of the tibia and/or fibula. The service type is intraoperative anesthesia for lower leg bone reconstruction or reshaping procedures. The typical site of service is an operating room or other procedural suite where orthopedic lower-extremity surgical procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with chronic, progressive medial compartment knee pain due to unilateral primary osteoarthritis presents for surgical correction. After failed conservative management including physical therapy, NSAIDs, and intra-articular injections, the orthopaedic surgeon plans a proximal tibial osteotomy (osteotomy of the tibia) to realign the mechanical axis and offload the affected compartment. The preoperative evaluation by the anesthesia team documents ASA physical status P2 for well-controlled hypertension. In the operating room the patient receives general endotracheal anesthesia with monitored hemodynamics; regional anesthesia (adductor canal block) may be performed preoperatively by the anesthesiologist or a Certified Registered Nurse Anesthetist for postoperative analgesia. The procedure includes exposure of the proximal tibia, performance of the osteotomy and fixation with plate and screws. Typical intraoperative events that affect anesthesia coding include significant blood loss requiring transfusion, prolonged surgical time, or an unplanned second anesthetist for a team approach. Recovery occurs in the PACU with standard post-anesthesia monitoring and discharge plan to inpatient orthopedic service or same-day discharge depending on institutional practice and patient status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia services are substantially greater in scope, time, or intensity than usual for 01484 due to complexity or complications. |
23 | Unusual anesthesia | Use when general anesthesia is administered for a procedure that is normally performed under local/monitored anesthesia, if clinically applicable. |
50 | Bilateral procedure | Use when identical osteotomies are performed on both lower extremities during the same operative session. |
52 | Reduced services | Use when the planned osteotomy is partially performed or limited, resulting in reduced anesthesia services. |
53 | Discontinued procedure | Use when the procedure is terminated after induction of anesthesia prior to completion for documented medical reasons. |
54 | Surgical care only | Use when the anesthesiologist provides only intraoperative anesthesia and postoperative management is transferred to another qualified provider. |
55 | Postoperative management only | Use when the anesthesiologist provides ONLY postoperative anesthesia care after another provider performed intraoperative anesthesia. |
56 | Preoperative management only | Use when the anesthesiologist provides only preoperative evaluation and preparation and does not participate intraoperatively. |
62 | Two surgeons/Team approach | Use when a surgeon qualifies for the team or co-surgeon billing; applies when anesthesia services support a complex, team-based surgical approach. |
78 | Unplanned return to the operating room following anesthesia | Use when the patient returns to the OR for a related procedure requiring additional anesthesia in the immediate postoperative period. |
AA | Anesthesia services performed personally by anesthesiologist | Use to indicate the anesthesiologist personally performed the anesthesia. |
AD | Medical supervision by anesthesiologist; more than four concurrent anesthesia procedures | Use when supervising multiple concurrent anesthesia cases as defined by payer rules. |
QK | Medical direction of two or more CRNAs by an anesthesiologist | Use when the anesthesiologist medically directs multiple CRNAs for this case. |
QS | Monitored anesthesia care (MAC) service | Use when monitored anesthesia care is provided instead of general or regional anesthesia for this procedure. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physicians providing anesthesia services for lower extremity osteotomy; documents ASA status and anesthesia plan. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs who may provide or assist with anesthesia delivery under supervision or direction. |
207X00000X | Orthopaedic Surgery | Surgeons performing the osteotomy/osteoplasty of the tibia and/or fibula and responsible for operative indications and technique. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M17.10 | Unilateral primary osteoarthritis, unspecified knee | Indicates degenerative joint disease of the knee that may necessitate realignment osteotomy to relieve unicompartmental loading. |
M17.11 | Unilateral primary osteoarthritis, right knee | Specifies right-sided knee arthropathy when planning a right proximal tibial osteotomy. |
M17.12 | Unilateral primary osteoarthritis, left knee | Specifies left-sided knee arthropathy when planning a left proximal tibial osteotomy. |
M17.5 | Other unilateral secondary osteoarthritis of knee | Represents secondary osteoarthritis (post-traumatic, inflammatory) that may be treated with osteotomy for symptom control or joint preservation. |
Z96.651 | Presence of right artificial knee joint | Indicates prior right knee arthroplasty; relevant for planning osteotomy or osteoplasty in the contralateral or ipsilateral limb with altered anatomy. |
Z96.652 | Presence of left artificial knee joint | Indicates prior left knee arthroplasty; relevant for surgical planning and anesthesia considerations due to prior implants. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01480 | Anesthesia for open procedures on bones of lower leg, ankle, and foot; (open procedure) of lower leg, ankle, and foot | Alternative anesthesia code used when the surgical procedure is an open procedure of the lower leg/ankle/foot rather than specifically an osteotomy of tibia/fibula; used when documentation supports that descriptor. |
01482 | Anesthesia for open procedures on bones of lower leg, ankle, and foot; radical resection (including below knee amputation) | Related when a more extensive radical resection or amputation is performed instead of osteotomy; indicates a different anesthesia complexity and coding pathway. |