Summary & Overview
CPT 01112: Anesthesia for Bone Marrow Aspiration or Biopsy, Iliac Crest
CPT code 01112 covers anesthesia for bone marrow aspiration and/or biopsy procedures at the iliac crest, including cases where a bone graft is obtained. This code is significant for both clinical and billing purposes, as it ensures proper documentation and reimbursement for anesthesia services provided during these specialized procedures. The code is relevant in hospital and ambulatory surgical settings, reflecting its use in both inpatient and outpatient care.
Major national payers such as Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare recognize and reimburse for CPT code 01112, making it a widely accepted standard for anesthesia billing in bone marrow and graft procedures. The publication provides an overview of payer coverage, common modifiers, associated provider taxonomies, and related clinical diagnoses. Readers will gain insight into policy updates, coding benchmarks, and the clinical context for anesthesia services in bone marrow aspiration and biopsy. The summary also highlights related CPT codes for anesthesia in musculoskeletal and other procedures, offering a comprehensive view of coding practices in anesthesiology.
This article is designed for healthcare professionals, billing specialists, and policy analysts seeking clarity on CPT code 01112, its clinical applications, and payer coverage. It serves as a resource for understanding the nuances of anesthesia coding in bone marrow procedures and the broader landscape of anesthesiology billing.
CPT Code Overview
CPT code 01112 is used to report anesthesia services for bone marrow aspiration and/or biopsy procedures performed at the anterior or posterior iliac crest. This code may also be reported when a bone graft is obtained from the iliac crest. The service type is anesthesiology, and these procedures are typically conducted in a hospital or ambulatory surgical setting, such as an operating room or ambulatory surgery center (ASC).
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient presenting to the hospital or ambulatory surgical center for evaluation of pelvic bone pathology, such as a fracture, neoplastic disease, or osteonecrosis. The patient requires a bone marrow aspiration and/or biopsy from the anterior or posterior iliac crest to aid in diagnosis or treatment planning. An anesthesiology provider administers anesthesia to ensure patient comfort and safety during the procedure, which may also involve obtaining a bone graft from the iliac crest. The clinical workflow includes preoperative assessment, anesthesia induction, monitoring during the procedure, and post-anesthesia care.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care rather than general anesthesia.QX: CRNA service with medical direction by a physician. Used when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia under the medical direction of a physician.
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Provider Taxonomies:
Taxonomy Code Specialty Name 207L00000XAnesthesiology 367500000XCertified Registered Nurse Anesthetist 207RA0401XAnesthesiology Assistant
These taxonomies represent providers qualified to deliver anesthesia services for bone marrow aspiration and/or biopsy procedures.
Related Diagnoses
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S32.9XXA: Fracture of unspecified part of lumbar spine and pelvis, initial encounter- Relevant when bone marrow aspiration or biopsy is performed to assess fracture healing or underlying pathology.
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M84.459A: Pathological fracture in neoplastic disease, pelvis, initial encounter- Indicates a fracture due to neoplastic disease; bone marrow biopsy may be needed for diagnostic purposes.
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M87.051: Idiopathic aseptic necrosis of pelvis- Bone marrow aspiration or biopsy may be performed to evaluate osteonecrosis.
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M80.059A: Age-related osteoporosis with current pathological fracture, pelvis, initial encounter- Relevant for patients with osteoporosis and pelvic fracture; biopsy may help assess bone quality.
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S32.2XXA: Fracture of coccyx, initial encounter- Bone marrow aspiration or biopsy may be performed in the context of coccyx fracture to rule out underlying pathology.
Related CPT Codes
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00912: Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s).- Not typically used with
01112, but may be performed in the same patient if multiple procedures are required.
- Not typically used with
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01173: Anesthesia for open procedures involving upper 2/3 of femur; amputation.- Alternative for procedures involving the femur rather than the iliac crest.
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01200: Anesthesia for procedures on the upper leg (except knee).- Used for upper leg procedures, not directly related to iliac crest biopsy.
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01320: Anesthesia for procedures on the knee and popliteal area.- Used for knee and popliteal area procedures, not typically combined with
01112.
- Used for knee and popliteal area procedures, not typically combined with
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01462: Anesthesia for procedures on the lower leg (below knee).- Used for lower leg procedures, not related to iliac crest.
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01610: Anesthesia for procedures on the shoulder and axilla.- Used for shoulder and axilla procedures, not related to iliac crest.
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01710: Anesthesia for procedures on the upper arm and elbow.- Used for upper arm and elbow procedures, not related to iliac crest.
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01810: Anesthesia for procedures on the forearm, wrist, and hand.- Used for forearm, wrist, and hand procedures, not related to iliac crest.
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01916: Anesthesia for radiological procedures.- May be used if radiological guidance is required during bone marrow aspiration.
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01951: Anesthesia for burn excisions or debridement procedures.- Not typically related to bone marrow aspiration.
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01958: Anesthesia for obstetric procedures.- Not related to bone marrow aspiration.
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01990: Anesthesia for other procedures.- Used for miscellaneous procedures, may be considered if the procedure does not fit other codes.
Most related codes are alternatives for anesthesia in different anatomical regions or types of procedures. 01112 is specific to bone marrow aspiration and/or biopsy from the iliac crest.
National Reimbursement Benchmarks
National mean rates for CPT code 01112 show that Blue Cross Blue Shield and Cigna have the highest average reimbursement, at $266.05 and $299.72 respectively, while UnitedHealth Group is notably lower at $65.62. The BUCA (average commercial) mean rate stands at $155.03, which is significantly higher than UnitedHealth Group but well below Cigna and Blue Cross Blue Shield. Medicare rates are not available in the input for comparison.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies considerably across payers. Blue Cross Blue Shield has the tightest range ($329.50 - $198.60 = $130.90), indicating more consistent rates. Cigna and Aetna display much wider ranges, with Cigna at $344.50 and Aetna at $328.00, reflecting greater variability in reimbursement. UnitedHealth Group and BUCA have moderate dispersion, at $25.33 and $179.81 respectively.
The table and chart below present the full breakdown of national benchmarks for CPT code 01112 across major commercial payers.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska demonstrates a significant rate spread for CPT code 01112, particularly with Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $95.40 ($370.00 minus $274.60). BUCA also shows a wide spread of $159.75, indicating substantial variability in reimbursement rates across payers. In contrast, Aetna, Cigna, and UnitedHealth Group have much narrower spreads, with all percentiles clustered closely together, suggesting more uniform rates for these payers.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are considerably higher, while Cigna and UnitedHealth Group are below their respective national means. The table and chart below present the full breakdown of payer-specific rates in Alaska for CPT code 01112.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 01112 in Alaska, with a mean rate of $327.27.
- UnitedHealth Group offers the lowest mean rate in Alaska at $75.12.
- Alaska's mean rates for most payers are notably higher than national averages, especially for Blue Cross Blue Shield and BUCA.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.