Summary & Overview
CPT 01420: Anesthesia for Knee Joint Surgical Procedures
CPT code 01420 covers anesthesia services for open or surgical arthroscopic procedures on the knee joint, when the procedure is not otherwise specified. This code is widely used in the field of anesthesiology to document and bill for anesthesia care during complex knee surgeries, which are commonly performed in outpatient hospital settings. Nationally, the code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for patients undergoing these procedures.
This publication provides a comprehensive overview of CPT 01420, including its clinical context, typical site of service, and relevance in medical billing. Readers will gain insights into payer coverage, common clinical scenarios, and related procedural codes. The analysis also highlights key modifiers and associated taxonomies relevant to anesthesia professionals. Policy updates and benchmarks are discussed to inform stakeholders about current trends and requirements in anesthesia billing for knee surgeries. The information is designed to support healthcare administrators, billing specialists, and clinical teams in understanding the nuances of anesthesia coding for knee procedures.
CPT Code Overview
CPT 01420 is designated for anesthesia services provided during open or surgical arthroscopic procedures on the knee joint that are not otherwise specified. This code is utilized by professionals in the field of anesthesiology to ensure safe and effective pain management during complex knee surgeries. The typical site of service for procedures billed under CPT 01420 is the outpatient hospital setting, specifically place of service code 22. This code is essential for accurately capturing the scope of anesthesia care in knee joint interventions, supporting both clinical documentation and billing processes.
Clinical & Coding Specifications
Clinical Context
A patient presents to an outpatient hospital with chronic knee pain and functional instability. After clinical evaluation and imaging, the patient is diagnosed with either osteoarthritis, meniscal tear, or chronic instability of the knee. The orthopedic surgeon schedules an open or surgical arthroscopic procedure on the knee joint to address the underlying pathology. An anesthesia provider, such as an anesthesiologist, certified registered nurse anesthetist (CRNA), or anesthesiology assistant, administers anesthesia for the procedure. The anesthesia service is coded with 01420 to reflect anesthesia for open or surgical arthroscopic procedures on the knee joint, not otherwise specified. The workflow involves preoperative assessment, induction and maintenance of anesthesia, intraoperative monitoring, and postoperative care in the outpatient hospital setting (Place of Service 22).
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care (MAC) rather than general anesthesia.QX: CRNA service with medical direction by a physician. Used when a certified registered nurse anesthetist (CRNA) provides anesthesia services under the medical direction of a physician.
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207L00000X | Anesthesiology |
367500000X | Certified Registered Nurse Anesthetist |
207RA0401X | Anesthesiology Assistant |
- Specialties Represented:
- Anesthesiology: Physicians specializing in anesthesia care.
- Certified Registered Nurse Anesthetist: Advanced practice nurses trained in anesthesia.
- Anesthesiology Assistant: Non-physician anesthesia providers assisting in anesthesia care.
Related Diagnoses
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M23.50: Chronic instability of knee, unspecified knee- Indicates ongoing instability of the knee joint, often requiring surgical intervention and anesthesia.
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M17.11: Unilateral primary osteoarthritis, right knee- Represents degenerative changes in the right knee, commonly leading to surgical procedures such as arthroscopy or arthroplasty.
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M17.12: Unilateral primary osteoarthritis, left knee- Represents degenerative changes in the left knee, also leading to surgical intervention.
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S83.241A: Other tear of medial meniscus, current injury, right knee, initial encounter- Acute meniscal injury in the right knee, often treated with arthroscopic surgery requiring anesthesia.
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S83.242A: Other tear of medial meniscus, current injury, left knee, initial encounter- Acute meniscal injury in the left knee, similarly treated with surgical intervention and anesthesia.
Each diagnosis is clinically relevant as it represents conditions that commonly necessitate open or arthroscopic knee procedures, for which anesthesia services are coded with 01420.
Related CPT Codes
| CPT Code | Description |
|---|---|
29881 | Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) |
29880 | Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) |
27447 | Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty) |
20610 | Arthrocentesis, aspiration and/or injection into a major joint or bursa (e.g., shoulder, hip, knee joint) |
29877 | Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty) |
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29881and29880are commonly performed arthroscopic procedures for meniscal tears and are often the surgical procedures for which anesthesia is provided and coded with01420. -
27447represents total knee arthroplasty, a major open procedure requiring anesthesia, and is related to01420when anesthesia is provided for this surgery. -
20610is a less invasive procedure (joint aspiration/injection) and may be performed in conjunction with or as an alternative to surgical intervention, but typically does not require the same level of anesthesia as coded by01420. -
29877is an arthroscopic procedure for cartilage debridement, which may be performed alone or with other knee procedures, and anesthesia for this is also coded with01420. -
29881,29880, and29877are commonly used together or as alternatives depending on the intraoperative findings and surgical plan.
National Reimbursement Benchmarks
For CPT code 01420, national mean rates among commercial payers show notable variation. The BUCA (average commercial) mean rate is $101.57, while individual commercial payers range from $65.63 for UnitedHealth Group to $197.79 for Cigna. Blue Cross Blue Shield and Aetna fall in between, at $171.37 and $121.09 respectively. Medicare rates are not available in the input for comparison.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, is widest for Aetna ($168.00) and Cigna ($173.42), indicating greater variability in contracted rates. UnitedHealth Group has the tightest range ($25.25), suggesting more consistent reimbursement levels. Blue Cross Blue Shield and BUCA also show moderate dispersion, at $107.88 and $92.50 respectively.
The table and chart below present the full breakdown of national benchmarks for each payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska shows a significant spread in reimbursement rates for CPT code 01420 across major commercial payers. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($91.47) and BUCA ($93.90), indicating substantial variability in negotiated rates. In contrast, Aetna, Cigna, and UnitedHealth Group display much narrower spreads, with most rates clustering around the lower end of the spectrum.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are considerably higher, while Cigna and UnitedHealth Group are closer to or slightly above their national benchmarks. The table and chart below present the full breakdown of payer-specific rates in Alaska, highlighting these differences and the overall distribution.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 01420 in Alaska, with a mean rate of $219.06.
- UnitedHealth Group offers the lowest mean rate at $74.78.
- 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.