Summary & Overview
CPT 01442: Anesthesia for Knee and Popliteal Area Procedures
CPT code 01442 represents anesthesia services for procedures involving the knee and popliteal area, a critical component in surgical care for orthopedic interventions. This code is widely recognized across major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for patients undergoing knee surgeries in inpatient hospital settings.
The publication provides a comprehensive overview of 01442, detailing its clinical context, typical use cases, and associated billing practices. Readers will gain insight into relevant modifiers such as QS for monitored anesthesia care and QX for certified registered nurse anesthetist services with physician direction. The article also highlights associated taxonomies, including anesthesiology and orthopaedic surgery, and outlines common ICD-10 diagnoses linked to knee procedures, such as primary osteoarthritis and the presence of artificial knee joints.
Additionally, the summary includes related CPT codes for surgical procedures on the knee, offering a broader perspective on how anesthesia services integrate with orthopedic care. The publication is designed to inform healthcare professionals, billing specialists, and policy analysts about current benchmarks, policy updates, and clinical considerations for anesthesia billing in knee and popliteal procedures.
CPT Code Overview
CPT code 01442 is used to report anesthesia services for procedures performed on the knee and popliteal area. This code applies specifically to anesthesia administered during surgical interventions targeting these anatomical regions. The service type is anesthesia, and the typical site of service is an inpatient hospital setting (Place of Service 21). This code is essential for accurately documenting and billing anesthesia care provided during knee and popliteal procedures.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult admitted to an inpatient hospital for surgical intervention on the knee due to conditions such as unilateral primary osteoarthritis or the presence of an artificial knee joint. The patient may require procedures like total knee arthroplasty, arthroscopy, or aspiration/injection into the knee joint. Anesthesia services are provided to ensure patient comfort and safety during these procedures, with the anesthesia team coordinating care before, during, and after the operation.
Coding Specifications
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Modifiers:
Modifier Code Description When Used QSMonitored anesthesia care service Used when anesthesia is provided as monitored anesthesia care rather than general anesthesia. QXCRNA service with medical direction by a physician Used when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia under the medical direction of a physician. -
Provider Taxonomies:
Taxonomy Code Specialty 207L00000XAnesthesiology 367500000XCertified Registered Nurse Anesthetist 207X00000XOrthopaedic Surgery
Related Diagnoses
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M17.10- Unilateral primary osteoarthritis, unspecified knee- Indicates osteoarthritis affecting one knee, relevant for patients undergoing knee procedures requiring anesthesia.
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M17.11- Unilateral primary osteoarthritis, right knee- Specifies osteoarthritis in the right knee, often leading to surgical intervention and anesthesia.
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M17.12- Unilateral primary osteoarthritis, left knee- Specifies osteoarthritis in the left knee, relevant for left-sided knee procedures.
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Z96.651- Presence of right artificial knee joint- Indicates a patient with a right knee prosthesis, possibly requiring anesthesia for revision or related procedures.
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Z96.652- Presence of left artificial knee joint- Indicates a patient with a left knee prosthesis, relevant for anesthesia during procedures involving the artificial joint.
Related CPT Codes
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27447- Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)- Commonly performed for severe osteoarthritis or joint degeneration. Anesthesia services (
01442) are required during this procedure.
- Commonly performed for severe osteoarthritis or joint degeneration. Anesthesia services (
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20610- Arthrocentesis, aspiration and/or injection into a major joint or bursa- May be performed for diagnostic or therapeutic purposes in patients with knee pain or swelling. Anesthesia may be provided for patient comfort.
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29881- Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving)- Used for surgical treatment of meniscal tears. Anesthesia is necessary for this minimally invasive procedure.
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29888- Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction- Performed for ACL injuries. Anesthesia services are integral to the surgical workflow.
These codes represent procedures that may require anesthesia services as described by 01442. They are commonly used together in the clinical workflow, depending on the patient's diagnosis and surgical plan.
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 01442 among BUCA (average commercial) payers is $172.40, which is substantially higher than the UnitedHealth Group mean rate of $65.54. Blue Cross Blue Shield and Cigna report the highest mean rates at $380.95 and $452.96, respectively, while Aetna's mean rate is $228.40.
Rate dispersion varies significantly across payers. Cigna exhibits the widest spread, with a difference of $604.00 between its 75th and 25th percentiles, indicating substantial variability in contracted rates. In contrast, UnitedHealth Group has the tightest range, with only $25.18 separating its 75th and 25th percentiles, suggesting more consistent reimbursement levels. The table and chart below present the full breakdown of national benchmarks for each payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a wide spread in reimbursement rates for CPT code 01442, with Blue Cross Blue Shield offering the highest mean rate at $509.99 and UnitedHealth Group the lowest at $74.78. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($163.15) and BUCA ($259.05), indicating significant variability in payment levels across payers. In contrast, Aetna, Cigna, and UnitedHealth Group show minimal spread, with their 25th, 50th, and 75th percentiles nearly identical, suggesting consistent but lower reimbursement rates.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are substantially higher, while Cigna and UnitedHealth Group remain below their national benchmarks. The table and chart below present the full breakdown of payer-specific rates and percentiles for Alaska, highlighting the state's unique reimbursement landscape for this procedure.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 01442, with a mean rate of $509.99.
- UnitedHealth Group offers the lowest mean rate at $74.78, significantly below both the state and national averages.
- Alaska's mean rates for most payers, especially Blue Cross Blue Shield and BUCA, are notably higher than their respective national averages, indicating a premium reimbursement environment.
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.