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    OpenPayerBilling CodesAnesthesia for Procedures on the Forearm, Wrist, and HandCPT cpt-01820-anesthesia-closed-radius-ulna-wrist-hand-procedure
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    CPT 01820: Anesthesia for Closed Procedure on Radius/Ulna/Wrist/Hand

    CPT code 01820 describes anesthesia services provided for a patient undergoing a closed procedure on the radius, ulna, wrist, or hand bones; this represents an anesthesia service for operative care, typically provided in an outpatient surgical center or hospital operating room and billed as intraoperative anesthesia for upper extremity closed reduction or fixation procedures.

    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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    Clinical & Coding Specifications

    Clinical Context

    A 48-year-old right-hand–dominant patient presents to the ambulatory surgery center after an acute distal radius fracture sustained during a fall. The orthopedic surgeon plans a closed reduction and percutaneous pinning of the distal radius under regional or general anesthesia. The patient undergoes preoperative evaluation by the anesthesia team, which documents medical history, airway assessment, and ASA physical status P2. On the day of surgery the anesthesia provider establishes monitoring, obtains informed consent, and performs either a supraclavicular or axillary brachial plexus block for surgical anesthesia; alternatively, general endotracheal or laryngeal mask airway anesthesia may be used if block is contraindicated or conversion is required.

    The anesthesia service described by 01820 covers anesthesia for closed procedures on the radius, ulna, wrist, or hand bones. Typical workflow includes pre‑op evaluation, intraoperative management (sedation, airway, hemodynamic control), block performance if used, documentation of estimated blood loss and fluids, and post‑anesthesia recovery handoff to PACU staff. Common scenarios include closed reduction and percutaneous pinning, irrigation and drainage for certain traumatic injuries, or closed treatment of carpal bone fractures where open exposure is not required. Communication with the surgical team regarding potential conversion to open procedure or intraoperative complications (requiring modifier use such as 62 or 78) is documented by the anesthesia provider.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20600Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, elbow, hip, knee)May be performed preoperatively for diagnostic or therapeutic aspiration when effusion complicates wrist/forearm injuries; not typically billed with 01820 but can be part of perioperative care.
    25600Closed treatment of distal radial metaphyseal fracture; without manipulation, with or without castingRelated closed fracture care; anesthesia may be provided for manipulation or reduction of distal radius fractures billed under 01820 when anesthesia services are required.
    25605Closed treatment of distal radial metaphyseal fracture; with manipulationCommonly performed with anesthesia services coded to 01820 when closed reduction with manipulation is required.
    29075Closed treatment of carpal bone dislocation or fracture; without manipulationAllied procedures on carpal bones that may occur in the same operative setting; anesthesia coded separately with 01820 for closed bone procedures of wrist/hand.
    64415

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    207K00000X
    207P00000X
    363A00000X
    208D00000X
    207YS0123X
    2278P3900X
    1223S0112X

    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-01810-ANESTHESIA-FOREARM-WRIST-HAND-PROCEDURES

    CPT 01810: Anesthesia for Forearm, Wrist, and Hand Procedures

    CPT-01829-WRIST-ARTHROSCOPY-ANESTHESIA-DIAGNOSTIC

    CPT 01829: Anesthesia for Diagnostic Arthroscopy of the Wrist

    CPT-01830-ANESTHESIA-DISTAL-RADIUS-WRIST-HAND-PROCEDURES

    CPT 01830: Anesthesia for Distal Radius/Ulna, Wrist, or Hand Procedures

    CPT-01832-TOTAL-WRIST-REPLACEMENT-ANESTHESIA

    CPT 01832: Anesthesia for Total Wrist Replacement

    CPT-01840-FOREARM-WRIST-HAND-ARTERIAL-ANESTHESIA

    CPT 01840: Anesthesia for Forearm, Wrist, and Hand Arterial Procedures

    CPT-01842-UPPER-EXTREMITY-ARTERIAL-EMBOLECTOMY-ANESTHESIA

    CPT 01842: Anesthesia for Forearm/Wrist/Hand Arterial Embolectomy

    CPT-01844-VASCULAR-SHUNT-ANESTHESIA-SERVICES

    CPT 01844: Anesthesia for Vascular Shunt or Shunt Revision

    CPT-01850-ANESTHESIA-VEINS-FOREARM-WRIST-HAND

    CPT 01850: Anesthesia for Vein Procedures of Forearm, Wrist, Hand

    CPT-01852-ANESTHESIA-FOR-PHLEBORRHAPHY-FOREARM-WRIST-HAND

    CPT 01852: Anesthesia for Phleborrhaphy of Forearm, Wrist, and Hand

    CPT-01860-FOREARM-WRIST-HAND-CAST-ANESTHESIA

    CPT 01860: Anesthesia for Forearm, Wrist, or Hand Cast Application or Revision

    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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    Injection, anesthetic agent; brachial plexus, single injection
    Regional nerve block that may be performed by the anesthesia or pain team as the primary anesthetic technique supporting the procedure billed with 01820.
    31500Intubation, endotracheal, emergency or electiveAirway management code that may be performed as part of general anesthesia for cases where general anesthesia is used instead of regional techniques for procedures covered by 01820.