Summary & Overview
CPT 01190: Anesthesia Services in Inpatient Hospital (Deleted Code)
CPT code 01190, previously used for anesthesia services in inpatient hospital settings, was deleted effective January 1, 2018. This code played a significant role in the billing and documentation of anesthesia care for complex surgical procedures, particularly those involving the pelvis and hip. The removal of CPT 01190 from the code set underscores the continual evolution of medical billing practices and the need for providers and payers to stay current with coding updates.
Blue Cross Blue Shield is the primary payer referenced in this analysis. Readers will gain insight into the historical context of CPT 01190, including its clinical applications, typical site of service, and associated modifiers such as QS for monitored anesthesia care and QX for CRNA services with physician direction. The publication also highlights related ICD-10 diagnoses and CPT codes, providing a comprehensive overview of the clinical scenarios where this code was previously utilized. Policy updates, benchmarks, and the impact of code deletion on billing practices are discussed, offering valuable information for healthcare professionals, administrators, and policy analysts.
CPT Code Overview
CPT 01190 was an anesthesia code used for services provided in an inpatient hospital setting. The code was officially deleted effective January 1, 2018, and is no longer in use for current billing or clinical documentation. As an anesthesia service, it was typically associated with procedures requiring specialized care and monitoring during surgery or other interventions. The deletion of this code reflects ongoing updates to medical billing standards and the evolution of clinical practice. Data not available in the input regarding the specific procedures previously associated with this code.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult admitted to an inpatient hospital for surgical treatment of a pelvic or hip fracture. The patient may present with a fracture of the pelvis, pubis, or femoral neck, possibly due to trauma or underlying neoplastic disease. An anesthesiology physician or certified registered nurse anesthetist (CRNA) provides anesthesia services during procedures such as total hip arthroplasty or open treatment of femoral fractures. The clinical workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and post-anesthesia care. The service is performed in an inpatient hospital setting, with anesthesia tailored to the patient's medical condition and surgical requirements.
Coding Specifications
-
Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care (MAC) during the procedure.QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia under the medical direction of an anesthesiology physician.
-
Provider Taxonomies:
Taxonomy Code Specialty Name 207L00000XAnesthesiology Physician 367500000XCertified Registered Nurse Anesthetist (CRNA) 207LC0200XCritical Care Medicine (Anesthesiology)
These taxonomies represent providers qualified to deliver anesthesia services for orthopedic surgical procedures in the inpatient hospital setting.
Related Diagnoses
-
S32.9XXA: Fracture of unspecified part of lumbar spine and pelvis, initial encounter- Relevant for patients presenting with pelvic or lumbar fractures requiring surgical intervention and anesthesia.
-
M84.459A: Pathological fracture in neoplastic disease, pelvis, initial encounter- Indicates a fracture due to underlying neoplastic disease, often necessitating surgical repair and anesthesia.
-
M96.89: Other intraoperative and postprocedural complications and disorders of musculoskeletal system- Used for complications arising during or after musculoskeletal surgery, which may require additional anesthesia services.
-
M87.051: Idiopathic aseptic necrosis of pelvis- Represents non-traumatic necrosis of pelvic bone, potentially leading to surgical intervention and anesthesia.
-
S32.5XXA: Fracture of pubis, initial encounter for closed fracture- Pertains to patients with pubic bone fractures, often managed surgically with anesthesia support.
Each diagnosis is clinically relevant to the orthopedic procedures associated with the deleted anesthesia code 01190, as they represent conditions requiring surgical and anesthesia care in the inpatient hospital setting.
Related CPT Codes
-
27130: Total hip arthroplasty- Used for surgical replacement of the hip joint. Commonly performed for fractures or degenerative conditions. Anesthesia services are required during this procedure.
-
27236: Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement- Involves surgical repair of femoral neck fractures, often with internal fixation or prosthetic replacement. Anesthesia is necessary for this operation.
-
27125: Hemiarthroplasty, hip, partial (e.g., femoral stem prosthesis, bipolar arthroplasty)- Partial hip replacement procedure, typically for certain types of femoral fractures. Anesthesia services are provided during surgery.
-
27245: Open treatment of femoral fracture, proximal end, head; with internal fixation- Surgical fixation of femoral head fractures. Anesthesia is required for the procedure.
These codes are related to the deleted anesthesia code 01190 as they represent the orthopedic surgical procedures for which anesthesia services would have been provided. They are commonly used together in clinical workflows, with anesthesia codes reported alongside the surgical procedure codes.
National Reimbursement Benchmarks
For CPT code 01190, the national mean rate for Blue Cross Blue Shield and BUCA (average commercial) is $277.22. Medicare rates are not available in the input, so a direct comparison cannot be made. The commercial mean rates are consistent across both Blue Cross Blue Shield and BUCA.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, is $15.00 for both Blue Cross Blue Shield and BUCA, indicating a relatively tight range of reimbursement rates nationally for these payers. No other payer data is available for comparison.
The table and chart below present the full breakdown of national benchmarks for CPT code 01190 by payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska's reimbursement rates for CPT code 01190 are highly uniform, with Blue Cross Blue Shield and BUCA both reporting a mean rate of $82.29 and all percentile values at $80.00. This results in a rate spread of $0.00, indicating no variation in payment rates among providers for this code within the state. Such uniformity is uncommon and suggests a standardized approach to reimbursement for this procedure.
Compared to national averages, Alaska's rates are substantially lower. National mean rates for Blue Cross Blue Shield and BUCA are $277.22, with percentile values ranging from $250.00 to $265.00. The table and chart below present the full payer breakdown for Alaska, highlighting the stark difference between state and national reimbursement levels.
Key Insights for Alaska
- Blue Cross Blue Shield and BUCA are tied as the highest and lowest paying payers in Alaska for CPT 01190, both with a mean rate of $82.29.
- All percentile values (25th, 50th, 75th) are identical at $80.00, indicating no rate spread among providers in Alaska.
- Alaska's mean rates are significantly lower than national averages, with a gap of nearly $195.00 compared to national BCBS and BUCA rates.
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.