Summary & Overview
CPT 01610: Anesthesia for Knee Joint Procedures, Unspecified
Headline: Anesthesia Code CPT 01610 Defined for Knee Joint Procedures
Lead: CPT 01610 denotes anesthesia services for knee joint procedures not otherwise specified, an important procedural anesthesia code used across outpatient hospital settings. It provides a billing descriptor for anesthesiologists and anesthesia teams when no more specific knee anesthesia code applies.
What the code represents and why it matters: CPT 01610 identifies anesthesia care associated with knee joint procedures that lack a dedicated anesthesia code. Nationally, clear use of this code supports appropriate billing classification for perioperative anesthesia services and helps align clinical documentation with payer requirements for outpatient surgical care.
Key payers covered: This overview addresses coverage and billing contexts relevant to Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
What readers will learn: The publication provides a concise reference on clinical context for CPT 01610, common procedural pairings, and the outpatient hospital setting in which it is most often applied. Readers will find information useful for coding accuracy and payer alignment, including related procedural contexts and typical clinical diagnoses associated with knee procedures. Where input was incomplete, the publication notes missing metadata and clarifies that some service-line specifics are not available.
CPT Code Overview
CPT 01610 describes anesthesia services provided for procedures on the knee joint when not otherwise specified. This code falls under the Anesthesiology service type and is typically used when anesthesia is administered for knee joint procedures that do not have a more specific anesthesia code. The usual site of service for CPT 01610 is an Outpatient Hospital (POS 22).
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with progressive right knee pain from M17.11 (unilateral primary osteoarthritis, right knee) presents for outpatient surgical management. The planned procedure is a knee joint operation requiring anesthesia in an outpatient hospital (POS 22), such as arthroscopy or arthroplasty. Preoperative evaluation by the anesthesia team documents medical history, airway assessment, and consent for anesthesia. On the day of surgery the anesthesia provider administers anesthesia appropriate for the knee procedure, monitors vital signs intraoperatively, and provides emergence and handoff in the PACU. The anesthesia service is billed using 01610 for anesthesia for procedures on the knee joint; not otherwise specified.
Coding Specifications
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Modifiers
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QS: Monitored anesthesia care service — Indicates monitored anesthesia care (MAC) was provided for the procedure when appropriate. -
QX: CRNA service with medical direction by a physician — Indicates the service was performed by a Certified Registered Nurse Anesthetist under the medical direction of a physician. -
Provider Taxonomies
| Taxonomy Code | Specialty |
|---|---|
207L00000X | Anesthesiology |
367500000X | Certified Registered Nurse Anesthetist |
207RA0401X | Anesthesiology Assistant |
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Notes on usage
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Use
QSwhen the documented service meets the criteria for monitored anesthesia care rather than general or regional anesthesia. -
Use
QXwhen a CRNA provides the anesthesia service and medical direction by a physician is documented according to payer rules.
Related Diagnoses
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M17.11— Unilateral primary osteoarthritis, right kneeRelevance: Degenerative joint disease of the right knee commonly leads to surgical interventions requiring anesthesia, such as arthroscopy or arthroplasty.
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M17.12— Unilateral primary osteoarthritis, left kneeRelevance: Degenerative changes of the left knee that may necessitate operative procedures under anesthesia billed with
01610. -
S83.241A— Sprain of medial collateral ligament of right knee, initial encounterRelevance: Acute ligamentous injury to the right knee that can require operative repair or arthroscopic evaluation under anesthesia.
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S83.242A— Sprain of medial collateral ligament of left knee, initial encounterRelevance: Acute medial collateral ligament sprain on the left side potentially requiring surgical management with anesthesia.
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M23.50— Chronic instability of knee, unspecified kneeRelevance: Chronic knee instability may lead to reconstructive procedures or arthroscopy for which anesthesia
01610is reported.
Related CPT Codes
| CPT Code | Description | Clinical Relationship |
|---|---|---|
29881 | Arthroscopy, knee, surgical; with meniscectomy | May be the principal orthopedic procedure for which anesthesia 01610 is reported; commonly performed in the same encounter when arthroscopic meniscectomy is indicated. |
29880 | Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral) | Alternative arthroscopic meniscectomy procedure; anesthesia 01610 may be billed for the anesthesia service during this procedure. |
27447 | Total knee arthroplasty | Major knee joint replacement procedure; anesthesia 01610 applies when anesthesia is provided for knee joint surgery, such as total knee arthroplasty. |
20610 | Arthrocentesis, aspiration and/or injection into a joint or bursa | Diagnostic or therapeutic joint aspiration/injection that may occur in the same episode of care; anesthesia 01610 could be used when the anesthesia service covers intraoperative anesthesia for procedures on the knee joint. |
- Common pairings:
01610is frequently reported with arthroscopic codes29881or29880and with major reconstructive codes such as27447.20610may be reported in related diagnostic or minor therapeutic encounters.
National Reimbursement Benchmarks
National commercial mean rates sit well above Medicare for CPT 01610 when comparing the average commercial benchmark (BUCA) to Medicare; BUCA’s mean of $185.12 is materially higher than Medicare’s value as provided (Medicare value not present in the input, shown as $0.00 in the table). Aetna, Cigna, and BCBS report the highest mean commercial rates among the listed payers, while UnitedHealth Group reports the lowest mean.
Rate dispersion, measured as the difference between the 75th and 25th percentiles, is widest for Aetna (477.00 - 45.00 = $432.00) and Cigna (433.00 - 89.00 = $344.00), indicating broader variability in allowed rates. The tightest distributions are observed for UnitedHealth Group (75.33 - 50.33 = $25.00) and BCBS (316.50 - 204.50 = $112.00), reflecting more consistent allowed rates. The table and chart below present the full percentile and mean-rate breakdown.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska demonstrates a wide spread in reimbursement rates for CPT code 01610, with Blue Cross Blue Shield showing the largest rate spread between the 25th and 75th percentiles ($370.00 minus $274.60 = $95.40), while Aetna, Cigna, and UnitedHealth Group have much narrower spreads, all under $10.00. This indicates significant variability in payment levels depending on the payer, with some offering consistently low rates and others providing a broader range.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are substantially higher, while Cigna and UnitedHealth Group are below their national benchmarks. The table and chart below present the full breakdown of payer-specific rates in Alaska for CPT code 01610.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 01610, with a mean rate of $327.69.
- 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.