{"id":171314,"date":"2026-08-04T07:38:21","date_gmt":"2026-08-04T07:38:21","guid":{"rendered":"https:\/\/pabau.com\/?p=171314"},"modified":"2026-08-17T11:45:14","modified_gmt":"2026-08-17T11:45:14","slug":"cpt-code-01360","status":"publish","type":"post","link":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/","title":{"rendered":"CPT code 01360: Anesthesia for open distal femur procedures"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT code 01360: Anesthesia for open distal femur procedures\",\"description\":\"CPT code 01360 covers anesthesia for all open procedures on the lower one-third of the femur, such as open reduction and internal fixation of a distal femur fracture. It is the open counterpart to 01340 and carries 5.0 base units. It is not a knee-joint code and not a not-otherwise-specified code.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-01360\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-04\",\"dateModified\":\"2026-08-04\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 01360 covers anesthesia for all open procedures on the lower one-third of the femur, and it carries 5.0 base units.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>It is the open counterpart to 01340, which covers closed procedures on the same segment of femur.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>01360 is not a knee-joint code and not a catch-all, so knee surgery belongs under 01380, 01400, or 01402.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Reimbursement is (base units + time units) x conversion factor, and the 2026 national anesthesia conversion factor is $20.4976.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau helps billing teams track anesthesia claims from submission through payment, so denials surface early.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT code 01360 covers anesthesia for open procedures on the lower one-third of the femur. In practice that means an open reduction and internal fixation (ORIF) of a distal femur fracture, or an open repair just above the knee.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The code sits inside the CPT manual&#8217;s Knee and Popliteal Area range, and that is where the confusion starts. The range name is regional, but the descriptor for 01360 is not. It covers the distal femur only, and it is not a not-otherwise-specified code.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This guide covers the official descriptor, the 5.0 base units, and the surgical procedures that map to it. It also covers modifiers, ICD-10 pairings, the 2026 fee schedule, and the code-selection errors that drive denials.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div>\n<\/figure>\n\n\n\n<h2 id=\"h-cpt-code-01360-definition-and-anatomical-scope\" class=\"wp-block-heading\">CPT code 01360: Definition and anatomical scope<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 01360 has the following official <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">American Medical Association (AMA)<\/a> descriptor: <strong>Anesthesia for all open procedures on lower one-third of femur.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two words in that descriptor do all the work. \u00abOpen\u00bb means the surgeon made an incision at the fracture or bone segment. \u00abLower one-third of femur\u00bb means the distal thigh bone, just above the knee joint.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That region is the supracondylar, transcondylar, and distal shaft territory. Once the surgery moves into the knee joint itself, or up into the upper two-thirds of the femur, a different anesthesia code applies.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">01360<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for all open procedures on lower one-third of femur<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Anesthesia base units<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5.0 (per ASA Relative Value Guide and CMS nationwide base units)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia (01000-01999 series), Knee and Popliteal Area range 01320-01444<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Anatomical scope<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Lower one-third of the femur only &#8211; not the knee joint and not the popliteal area<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Procedure type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open surgical treatment only &#8211; closed treatment of the same segment is 01340<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billable by<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist (MD\/DO) or CRNA, with the matching provider modifier<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Effective status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Active (verify the current year with AMA CPT)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">A common misreading turns 01360 into a broad \u00abupper leg and knee\u00bb catch-all. It isn&#8217;t. The not-otherwise-specified code in this part of the manual is 01400, which covers open or surgical arthroscopic procedures on the knee joint.<\/p>\n\n\n\n<h2 id=\"h-01360-vs-01340-open-versus-closed-on-the-same-bone\" class=\"wp-block-heading\">01360 vs 01340: Open versus closed on the same bone<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">01360 and 01340 describe the same anatomy. The only difference is the surgical approach, and it is worth 1.0 base unit.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>01340<\/strong> &#8211; closed procedures on the lower one-third of the femur, 4.0 base units. Closed reduction, manipulation, or traction, with no incision at the fracture.<\/li>\n\n\n\n<li><strong>01360<\/strong> &#8211; open procedures on the lower one-third of the femur, 5.0 base units. The surgeon opens the site to reduce, plate, nail, graft, or realign the bone.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Read the operative report, not the diagnosis, to tell them apart. A distal femur fracture can be treated either way, so the diagnosis code will not decide this for you.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If the report describes an incision, an implant, hardware, or a bone graft, the case is 01360. If the surgeon reduced the fracture through the skin and immobilized it, the case is 01340.<\/p>\n\n\n\n<h2 id=\"h-procedures-covered-under-01360\" class=\"wp-block-heading\">Procedures covered under 01360<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The surgeon bills the procedure code and the anesthesia provider bills 01360 on a separate claim. The two lines don&#8217;t conflict. The surgical codes below are the ones that most often sit behind an 01360 claim.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Open treatment of a supracondylar or transcondylar femoral fracture without intercondylar extension<\/strong> &#8211; CPT 27511, the most frequent pairing with 01360<\/li>\n\n\n\n<li><strong>Open treatment of a supracondylar or transcondylar femoral fracture with intercondylar extension<\/strong> &#8211; CPT 27513<\/li>\n\n\n\n<li><strong>Open treatment of a distal femoral fracture of the medial or lateral condyle<\/strong> &#8211; CPT 27514<\/li>\n\n\n\n<li><strong>Open treatment of a distal femoral epiphyseal separation<\/strong> &#8211; CPT 27519, typical in pediatric growth-plate injuries<\/li>\n\n\n\n<li><strong>Repair of a nonunion or malunion of the femur distal to the head and neck<\/strong> &#8211; CPT 27470 without a graft, CPT 27472 with an autograft<\/li>\n\n\n\n<li><strong>Supracondylar femoral osteotomy<\/strong> &#8211; CPT 27448 without fixation, CPT 27450 with fixation, when the cut is made in the distal third<\/li>\n\n\n\n<li><strong>Open removal of deep hardware from the distal femur<\/strong> &#8211; CPT 20680, when the implant is in the lower one-third of the bone<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Femoral shaft fixation is the case to slow down on. A distal-third shaft fracture repaired open belongs under 01360.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The femur is split by the anesthesia series into an upper two-thirds and a lower one-third. Retrograde nailing through the knee doesn&#8217;t move the case into a knee code, because the treated bone is still the distal femur.<\/p>\n\n\n\n<h2 id=\"h-anesthesia-base-units-for-01360\" class=\"wp-block-heading\">Anesthesia base units for 01360<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 01360 carries <strong>5.0 anesthesia base units<\/strong>. The value comes from the American Society of Anesthesiologists (ASA) Relative Value Guide. CMS publishes the same nationwide figure in its anesthesia base unit file.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Base units represent the complexity and risk of the site and its typical procedures. They don&#8217;t move with case length or patient acuity. The number is fixed per code, and it&#8217;s the starting value in every reimbursement calculation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The 5.0 units put 01360 above closed distal femur work at 4.0 and below open work on the upper two-thirds of the femur at 6.0. Verify the value annually against the current ASA guide, because base units can change.<\/p>\n\n\n\n<h2 id=\"h-how-anesthesia-reimbursement-is-calculated\" class=\"wp-block-heading\">How anesthesia reimbursement is calculated<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Anesthesia doesn&#8217;t use the standard relative value unit system that drives most CPT codes. It uses a unit formula recognized by <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS<\/a> and most commercial payers.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Reimbursement = (Base Units + Time Units) x Conversion Factor<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Some commercial payers add modifying units for physical status or qualifying circumstances. Medicare doesn&#8217;t. Both variations are covered further down the page.<\/p>\n\n\n\n<h3 id=\"h-time-units-and-documentation-requirements\" class=\"wp-block-heading\">Time units and documentation requirements<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Time units come from the documented start and end of anesthesia care. One time unit equals 15 minutes under Medicare rules. Some commercial payers use 10-minute or 12-minute intervals, so confirm the interval before you bill.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Start time<\/strong> &#8211; when the provider begins preparing the patient for anesthesia, including positioning and monitoring setup<\/li>\n\n\n\n<li><strong>End time<\/strong> &#8211; when the patient is handed off to recovery nursing and the provider is no longer in personal attendance<\/li>\n\n\n\n<li><strong>Partial units<\/strong> &#8211; most payers allow rounding to the nearest unit, but the policy varies, so check it<\/li>\n\n\n\n<li><strong>Source record<\/strong> &#8211; the signed anesthesia record, retrievable on audit and consistent with the OR log<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Open distal femur cases run long enough that time units usually outweigh the base units. Practice management software like Pabau keeps timestamped events on the client record, which removes the most common audit trigger on these claims.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-01360\/detailed-client-records-in-pabau.webp\" alt=\"Client record in Pabau showing medical history, medications and appointment activity\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s client records keep the anesthesia note, medications, and timestamps on one timeline, so time units on an 01360 claim are easy to defend.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h3 id=\"h-worked-example-distal-femur-orif-claim\" class=\"wp-block-heading\">Worked example: Distal femur ORIF claim<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">A patient has an open reduction and internal fixation of a supracondylar femur fracture, billed by the surgeon as CPT 27511. The anesthesiologist personally performs the case and documents 120 minutes of anesthesia time.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Calculation<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Value<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Base units (CPT 01360)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fixed per ASA RVG<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5.0<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Time units<\/td>\n<td style=\"padding:12px 16px;color:#374151\">120 minutes \/ 15<\/td>\n<td style=\"padding:12px 16px;color:#374151\">8.0<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total units<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5.0 base + 8.0 time<\/td>\n<td style=\"padding:12px 16px;color:#374151\">13.0<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">2026 conversion factor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">National base rate, locality-adjusted<\/td>\n<td style=\"padding:12px 16px;color:#374151\">$20.4976<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Example reimbursement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">13.0 units x $20.4976<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$266.47<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The figure above is a national estimate before geographic adjustment. Your locality rate will differ, so confirm the current conversion factor for your Medicare Administrative Contractor (MAC) jurisdiction before you rely on it.<\/p>\n\n\n\n<h2 id=\"h-medicare-fee-schedule-and-reimbursement-rates\" class=\"wp-block-heading\">Medicare fee schedule and reimbursement rates<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare doesn&#8217;t publish a flat allowed amount for 01360. It pays the unit formula, and the conversion factor changes by locality and by year. The national anesthesia conversion factor for 2026 is $20.4976.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One change is easy to miss in 2026. CMS now runs two conversion factors, and the anesthesia rate for qualifying participants in an advanced alternative payment model is $20.5998 rather than $20.4976.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That difference is about half a percent per unit. On a 13-unit case it is worth roughly $1.33, which sounds trivial until you multiply it across a year of orthopedic trauma volume.<\/p>\n\n\n\n<h3 id=\"h-fee-schedule-by-payer-type\" class=\"wp-block-heading\">Fee schedule by payer type<\/h3>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Payer type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Rate structure<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicare<\/td>\n<td style=\"padding:12px 16px;color:#374151\">(5.0 + time units) x $20.4976 (2026 national base)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Locality-adjusted; $20.5998 for advanced APM participants<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicaid<\/td>\n<td style=\"padding:12px 16px;color:#374151\">State-specific conversion factor, often below Medicare<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Check your state Medicaid fee schedule<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Commercial (in-network)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Contracted conversion factor per agreement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Often above Medicare; may add physical status units<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Commercial (out-of-network)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Billed charges or a negotiated rate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subject to No Surprises Act rules<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Workers&#8217; compensation<\/td>\n<td style=\"padding:12px 16px;color:#374151\">State fee schedule<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Varies widely by state; common on trauma cases<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">To find your own figure, enter 01360 in the CMS Physician Fee Schedule lookup and select your MAC jurisdiction. The Medicare rate is a useful floor for contract negotiation rather than a prediction of what commercial payers will pay.<\/p>\n\n\n\n<h2 id=\"h-modifiers-used-with-01360\" class=\"wp-block-heading\">Modifiers used with 01360<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Every anesthesia claim needs a provider modifier that says who delivered the care and under what supervision arrangement. A missing or mismatched modifier is one of the fastest routes to a denial on an 01360 claim.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Who uses it<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Meaning<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Medicare payment<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist (MD\/DO)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia personally performed by the anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100% of the allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QZ<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA service without medical direction<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100% of the allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QK<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist (MD\/DO)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical direction of two to four concurrent cases<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50%, paired with QX<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QX<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA service under physician medical direction<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50%, paired with QK or QY<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QY<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist (MD\/DO)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical direction of one CRNA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50%, paired with QX<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AD<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist (MD\/DO)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical supervision of more than four concurrent procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Capped units; pays less than medical direction<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Billing AA when the anesthesiologist directed a CRNA rather than performing the case is a compliance problem. CMS treats it as a false claim under the medical direction rules.<\/p>\n\n\n\n<h3 id=\"h-physical-status-modifiers-p1-p6\" class=\"wp-block-heading\">Physical status modifiers (P1-P6)<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Physical status modifiers describe how sick the patient was at the time of anesthesia. They are appended after the provider modifier. <strong>Medicare pays no additional amount for P1 through P6.<\/strong> Some commercial payers do add units.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Patient status<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Medicare adder<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Typical commercial adder<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P1<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Normal healthy patient<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mild systemic disease<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Severe systemic disease<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<td style=\"padding:12px 16px;color:#374151\">+1 unit (payer-specific)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Severe systemic disease that is a constant threat to life<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<td style=\"padding:12px 16px;color:#374151\">+2 units (payer-specific)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Moribund patient not expected to survive without surgery<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<td style=\"padding:12px 16px;color:#374151\">+3 units (payer-specific)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P6<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Brain-dead patient for organ donation<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<td style=\"padding:12px 16px;color:#374151\">None<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Open distal femur cases skew toward older trauma patients, so P3 and P4 are common. Append the modifier that matches the anesthesia record, and check the payer contract before you count those units as revenue.<\/p>\n\n\n\n<h2 id=\"h-qualifying-circumstances-add-on-codes\" class=\"wp-block-heading\">Qualifying circumstances add-on codes (99100-99140)<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Qualifying circumstances codes report conditions that made the anesthesia significantly harder. They are add-on codes, billed alongside 01360 and never alone. Medicare doesn&#8217;t pay extra for them, while many commercial payers do.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Units<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Distal femur example<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">99100<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Patient under 1 year or over 70<\/td>\n<td style=\"padding:12px 16px;color:#374151\">1<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ORIF of a supracondylar fracture in an 82-year-old<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">99116<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use of total body hypothermia<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Rare in distal femur work; documented cooling only<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">99135<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use of controlled hypotension<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Deliberate hypotension to limit blood loss in a long fixation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">99140<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Emergency conditions<\/td>\n<td style=\"padding:12px 16px;color:#374151\">2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unplanned open fixation of an unstable distal femur fracture<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">99100 comes up often on this code, because distal femur fractures cluster in older patients. Payers audit these add-ons, so the record has to describe how the condition changed anesthesia management. Noting the patient&#8217;s age isn&#8217;t enough.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Before an 01360 claim goes out, read one line of the operative report: the approach. Open, incision, plate, nail, or graft confirms 01360. Closed reduction or manipulation moves the claim to 01340, and any work inside the joint moves it to 01380, 01400, or 01402. That single check catches the most expensive coding error on this code.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-crna-and-medical-direction-billing\" class=\"wp-block-heading\">CRNA and medical direction billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Both anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs) bill 01360. A CRNA working without physician medical direction appends modifier QZ and receives 100% of the Medicare allowable.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Independent CRNA billing depends on state law and on whether the state has opted out of the federal physician supervision requirement. Verify the current position for your state before you assume it applies.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When an anesthesiologist directs a CRNA, both submit their own claim. The physician bills QK for two to four concurrent cases, or QY for a single CRNA, and the CRNA bills QX. Each side receives 50%.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medical direction also carries seven CMS requirements during the case. These include the pre-anesthesia evaluation, presence at induction and emergence, monitoring at critical moments, and remaining immediately available throughout.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Miss the documentation for any one of them and the claim drops from medical direction to medical supervision under modifier AD, which pays materially less. Long trauma cases with staggered start times are where this usually slips.<\/p>\n\n\n\n<h2 id=\"h-icd-10-diagnosis-codes-that-support-the-claim\" class=\"wp-block-heading\">ICD-10 diagnosis codes that support the claim<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Every 01360 claim needs an ICD-10-CM code that establishes medical necessity. The anesthesia claim should carry the same primary diagnosis the surgeon reported.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Typical procedure context<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S72.401A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified fracture of lower end of right femur, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">ORIF of a distal femur fracture, pattern not specified<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S72.402A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified fracture of lower end of left femur, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The same repair on the left side<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S72.451A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Displaced supracondylar fracture without intracondylar extension of lower end of right femur, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment with a plate or retrograde nail (CPT 27511)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S72.421A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Displaced fracture of lateral condyle of right femur, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of a condylar fracture (CPT 27514)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S72.401K<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified fracture of lower end of right femur, subsequent encounter for closed fracture with nonunion<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open repair of a nonunion, with or without graft (CPT 27470, 27472)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S79.121A<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Salter-Harris Type II physeal fracture of lower end of right femur, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of a distal femoral epiphyseal separation (CPT 27519)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The ICD-10 seventh character describes the fracture, not the surgery. That is why \u00abclosed fracture\u00bb and open surgical treatment often sit on the same claim. Later visits in the same episode move on to D.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Use character A for an initial encounter with an intact skin envelope, and B or C when the fracture itself was open. Choosing B because the surgeon operated is a documentation error waiting to be found on audit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Knee diagnoses are the other warning sign. A meniscal derangement or knee osteoarthritis code paired with 01360 signals the wrong anesthesia code, because those conditions point to 01380, 01400, or 01402. Laterality also has to match the operative report.<\/p>\n\n\n\n<h2 id=\"h-related-cpt-codes-in-the-anesthesia-series\" class=\"wp-block-heading\">Related CPT codes in the anesthesia series<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">01360 sits in the Knee and Popliteal Area range, 01320 to 01444. Its neighbors cover very different scopes: knee soft tissue, the knee joint, and the same femur segment treated a different way.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Official descriptor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Base units<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key distinction from 01360<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01230<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for open procedures involving upper two-thirds of femur; not otherwise specified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">6.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open surgery higher up the same bone, above the distal third<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01320<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for all procedures on nerves, muscles, tendons, fascia, and bursae of knee and\/or popliteal area<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Soft tissue around the knee, not bone or joint<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01340<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for all closed procedures on lower one-third of femur<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same anatomy as 01360, treated without an incision<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\"><strong>01360<\/strong><\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for all open procedures on lower one-third of femur<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The code on this page<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01380<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for all closed procedures on knee joint<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Closed treatment of the joint itself, not the femur<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01400<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for open or surgical arthroscopic procedures on knee joint; not otherwise specified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The not-otherwise-specified code for knee joint surgery<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">01402<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty<\/td>\n<td style=\"padding:12px 16px;color:#374151\">7.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Dedicated total knee replacement code, the highest here<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Base units for these codes come from the ASA Relative Value Guide and the CMS nationwide base unit file. Check the current descriptors with <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC&#8217;s CPT code lookup<\/a> before you submit.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Total knee arthroplasty is the clearest example of what 01360 is not. That case is 01402 at 7.0 base units, so billing 01360 instead undercodes the claim by two units and misstates the anatomy.<\/p>\n\n\n\n<h2 id=\"h-documentation-and-medical-necessity-requirements\" class=\"wp-block-heading\">Documentation and medical necessity requirements<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The anesthesia record has to support both the code choice and the units billed. On 01360 that means the record proves an open approach in the lower one-third of the femur, and proves the time.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Anesthesia start and stop times<\/strong> &#8211; exact clock times rather than an estimated total, consistent with the OR log<\/li>\n\n\n\n<li><strong>Surgical procedure and site<\/strong> &#8211; the surgeon&#8217;s CPT code and the femur segment treated, so the anesthesia code can be defended<\/li>\n\n\n\n<li><strong>Approach<\/strong> &#8211; open or closed, stated plainly, because this is the line between 01360 and 01340<\/li>\n\n\n\n<li><strong>Provider role<\/strong> &#8211; MD\/DO, CRNA, or anesthesiologist assistant, plus the supervision arrangement billed<\/li>\n\n\n\n<li><strong>Pre-anesthesia evaluation<\/strong> &#8211; history, physical, ASA physical status, and the anesthesia plan<\/li>\n\n\n\n<li><strong>Intraoperative record<\/strong> &#8211; vital signs, airway management, and drugs administered<\/li>\n\n\n\n<li><strong>Medical direction checklist<\/strong> &#8211; all seven CMS criteria, each time-stamped, whenever QK or QY is billed<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Digital intake and pre-anesthesia forms help here, because a template captures the same fields every case. That consistency is what makes a record easy to defend two years later.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-01360\/digital-forms.webp\" alt=\"Pabau medical forms builder with a library of clinical form templates\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s digital forms let you build a pre-anesthesia template once, so ASA status and the anesthesia plan get captured the same way on every case.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Rounding time to a habitual block, such as always billing 120 minutes for a distal femur fixation, is a recoupment risk. Anesthesia time is documented continuously, from preparation for induction until the provider is no longer in attendance.<\/p>\n\n\n\n<h2 id=\"h-common-billing-errors-and-denial-reasons\" class=\"wp-block-heading\">Common billing errors and denial reasons<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Denials on this code cluster around a short list, and most of them are preventable with a pre-submission check.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Confusing 01360 with 01340<\/strong> &#8211; the two codes share an anatomy and differ only on approach. Bill 01360 for open treatment and 01340 for closed treatment of the same segment.<\/li>\n\n\n\n<li><strong>Reaching for 01360 on knee joint surgery<\/strong> &#8211; arthroscopy, ligament reconstruction, and knee replacement are not distal femur procedures. Those belong under 01380, 01400, or 01402.<\/li>\n\n\n\n<li><strong>Treating 01360 as a catch-all<\/strong> &#8211; it has no not-otherwise-specified language. Nothing lands here by default just because the case involved the leg.<\/li>\n\n\n\n<li><strong>Crossing the femur boundary<\/strong> &#8211; open fixation above the distal third is 01230, not 01360. Check where the fracture sits before choosing.<\/li>\n\n\n\n<li><strong>Missing start or end time<\/strong> &#8211; the record needs exact clock times. An elapsed total with no anchor is the single most common denial trigger.<\/li>\n\n\n\n<li><strong>Wrong provider modifier<\/strong> &#8211; billing AA for a directed case, or QK and QX without the seven documented criteria, which downcodes the claim to AD.<\/li>\n\n\n\n<li><strong>ICD-10 laterality mismatch<\/strong> &#8211; a right femur procedure with a left femur diagnosis. It is a data entry slip that still costs 30 to 60 days.<\/li>\n\n\n\n<li><strong>Expecting Medicare to pay add-ons<\/strong> &#8211; physical status and qualifying circumstances units are commercial-payer territory, not Medicare revenue.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Review denial patterns on this code quarterly. Code-selection errors repeat across a whole team, while arithmetic slips tend to be isolated, and the fix for each is different. Coding resources are available on the <a href=\"https:\/\/www.cms.gov\/medicare\/coding-billing\/icd-10-codes\" target=\"_blank\" rel=\"nofollow noopener\">CMS ICD-10 codes page<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related CPT codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00940\/\">CPT code 00940 \u2014 Anesthesia for vaginal procedures<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-01382\/\">CPT code 01382 \u2014 Anesthesia for diagnostic knee arthroscopy<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-01390\/\">CPT code 01390 \u2014 Anesthesia for closed tibia, fibula, and patella<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-01392\/\">CPT code 01392 \u2014 Anesthesia for open tibia and fibula surgery<\/a><\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-how-pabau-supports-anesthesia-claim-accuracy\" class=\"wp-block-heading\">How Pabau supports anesthesia claim accuracy<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most 01360 denials start in the record long before anyone picks a code. Start and end times get handed over verbally. The approach is buried three paragraphs into the operative note. The modifier decision happens in the OR and never reaches the claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau closes that distance. <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">Claims management<\/a> keeps the documentation and the claim in one system. The times, the approach, and the modifier travel together instead of being reassembled at billing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Your team chases fewer denials, and the ones that do arrive are easier to answer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Those record habits pay off outside the operating room too. The same one-system setup supports osteopathy practices and the regenerative medicine teams that see these patients after a slow-healing fracture.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-01360\/automate-claims-through-healthcode.webp\" alt=\"Pabau checkout screen alongside a completed insurer invoice\"\/><figcaption class=\"wp-element-caption\"><em>Pabau links each invoice to the payer and the treatment record, so an 01360 claim leaves the practice with its times and modifiers attached.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Keep anesthesia claims clean from OR to payment                <\/h3>\n\n                <p class=\"description\">\n                    Pabau gives anesthesia and surgical teams one place to capture times, approach, and modifiers, then track every claim through to payment. Fewer denials to chase, and faster answers when one lands.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">01360 is a narrow code wearing a broad label. It lives in the Knee and Popliteal Area range, but it pays for open surgery on the lower one-third of the femur and nothing else.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What decides the claim is the operative report. Read it for two facts, the approach and the femur segment, before anything reaches the claim form. Get those two right and 5.0 base units plus accurate time follow easily.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The trade-off worth remembering is a small one. Skipping that check saves a minute now and costs far more in rework later. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau keeps anesthesia documentation and claims in one place for orthopedic and surgical practices.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Is the fracture higher up the femur?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-01230\/\">CPT code 01230<\/a> covers open procedures on the upper two-thirds of the femur at 6.0 base units.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding the surgery side of a growth-plate case?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20150\/\">CPT code 20150<\/a> covers excision of an epiphyseal bar and the documentation payers expect.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing anesthesia for another open orthopedic case?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20251\/\">CPT code 20251<\/a> covers open vertebral body biopsy and how to document it.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding a nerve injury from the same trauma?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s345xxa\/\">ICD-10 code S34.5XXA<\/a> covers injury of the lumbar, sacral, and pelvic sympathetic nerves.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Following the patient once the femur heals?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/star-excursion-balance-test\/\">Star excursion balance test<\/a> sets out a scored protocol for lower-limb function.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1785753227245\"><h3 class=\"schema-faq-question\">What is CPT code 01360 used for?<\/h3> <p class=\"schema-faq-answer\">CPT code 01360 covers anesthesia for all open procedures on the lower one-third of the femur. That is the distal thigh bone, just above the knee joint. Typical cases include open reduction and internal fixation of a supracondylar or condylar fracture, open repair of a distal femur nonunion, and supracondylar osteotomy. It does not cover the knee joint, and it is not a catch-all code for the leg.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785753227246\"><h3 class=\"schema-faq-question\">What is the difference between CPT 01360 and CPT 01340?<\/h3> <p class=\"schema-faq-answer\">Both codes describe the lower one-third of the femur, and the difference is the surgical approach. CPT 01340 covers closed procedures, such as closed reduction or manipulation with no incision at the fracture, and carries 4.0 base units. CPT 01360 covers open procedures, where the surgeon opens the site to reduce, plate, nail, or graft the bone, and carries 5.0 base units. Read the operative report to decide, because the diagnosis code is the same either way.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785753227246b\"><h3 class=\"schema-faq-question\">How many base units does CPT 01360 have?<\/h3> <p class=\"schema-faq-answer\">CPT code 01360 carries 5.0 anesthesia base units per the ASA Relative Value Guide, and CMS publishes the same nationwide figure. That sits above closed distal femur work at 4.0 units and below open work on the upper two-thirds of the femur at 6.0 units. Base units are fixed per code, so verify the value annually against the current ASA guide.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785753227247\"><h3 class=\"schema-faq-question\">Can CPT 01360 be used for a total knee replacement?<\/h3> <p class=\"schema-faq-answer\">No. Total knee arthroplasty is billed with CPT 01402, which carries 7.0 base units. CPT 01360 covers the femur, not the knee joint, so using it for a knee replacement both undercodes the claim and misstates the anatomy. Other knee joint procedures fall under 01380 for closed treatment and 01400 for open or surgical arthroscopic work.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785753227248\"><h3 class=\"schema-faq-question\">How is reimbursement calculated for CPT code 01360?<\/h3> <p class=\"schema-faq-answer\">Reimbursement equals base units plus time units, multiplied by the conversion factor. For a 120-minute open distal femur fixation under Medicare, that is 5.0 base units plus 8.0 time units, or 13.0 units. At the 2026 national anesthesia conversion factor of $20.4976 the claim comes to roughly $266 before geographic adjustment. Commercial payers use their own contracted conversion factors.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785753227249\"><h3 class=\"schema-faq-question\">What modifiers are required with CPT code 01360?<\/h3> <p class=\"schema-faq-answer\">Every claim needs a provider modifier. Use AA when the anesthesiologist personally performs the case, and QZ for a CRNA working without medical direction. Use QK when a physician directs two to four cases, or QY when a physician directs one CRNA, and QX for that CRNA. Physical status modifiers P1 to P6 may also be appended. Medicare pays no extra for physical status, though some commercial payers add units for P3 and above.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785753227250\"><h3 class=\"schema-faq-question\">Can a CRNA bill CPT code 01360?<\/h3> <p class=\"schema-faq-answer\">Yes. A CRNA working without physician medical direction bills CPT 01360 with modifier QZ and receives 100% of the Medicare allowable. Under physician medical direction the CRNA appends QX and receives 50%, with the directing anesthesiologist billing QK or QY for the other 50%. Independent billing depends on state law and on whether the state has opted out of the federal supervision requirement.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785753227251\"><h3 class=\"schema-faq-question\">Which ICD-10 codes support a CPT 01360 claim?<\/h3> <p class=\"schema-faq-answer\">Most 01360 claims are supported by S72 distal femur fracture codes. Examples include S72.401A for an unspecified fracture of the lower end of the right femur. S72.451A covers a displaced supracondylar fracture, and S72.421A a lateral condyle fracture. Nonunion repairs use a subsequent-encounter character, for example S72.401K, and pediatric growth-plate cases use S79.121A. Note that the seventh character describes the fracture, not the surgery, so an open repair of a closed fracture still takes character A.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>CPT code 01360 covers anesthesia for open procedures on the lower one-third of the femur. In practice that means an open reduction and internal fixation (ORIF) of a distal femur fracture, or an open repair just above the knee. The code sits inside the CPT manual&#8217;s Knee and Popliteal Area range, and that is where [&hellip;]<\/p>\n","protected":false},"author":81,"featured_media":171310,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"","_yoast_wpseo_content_score":"","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[4162,1602,4164,1236],"class_list":["post-171314","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-anesthesia-billing","tag-cpt-modifiers","tag-crna","tag-medicare-reimbursement"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT code 01360: Base units, modifiers, and 2026 rates<\/title>\n<meta name=\"description\" content=\"CPT code 01360 covers anesthesia for open procedures on the lower one-third of the femur, at 5.0 base units. It is not a knee code.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT code 01360: Base units, modifiers, and 2026 rates\" \/>\n<meta property=\"og:description\" content=\"CPT code 01360 covers anesthesia for open procedures on the lower one-third of the femur, at 5.0 base units. It is not a knee code.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-04T07:38:21+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-17T11:45:14+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-01360.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Aleksandar Kochovski\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Aleksandar Kochovski\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data2\" content=\"19 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/\"},\"author\":{\"name\":\"Aleksandar Kochovski\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/#\\\/schema\\\/person\\\/73b672a49e20bfba8161e3c17ee3dda2\"},\"headline\":\"CPT code 01360: Anesthesia for open distal femur procedures\",\"datePublished\":\"2026-08-04T07:38:21+00:00\",\"dateModified\":\"2026-08-17T11:45:14+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/\"},\"wordCount\":3837,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-01360.webp\",\"keywords\":[\"Anesthesia Billing\",\"Cpt Modifiers\",\"CRNA\",\"Medicare reimbursement\"],\"articleSection\":[\"Billing Codes\",\"CPT Codes\"],\"inLanguage\":\"es\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/\",\"name\":\"CPT code 01360: Base units, modifiers, and 2026 rates\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-01360.webp\",\"datePublished\":\"2026-08-04T07:38:21+00:00\",\"dateModified\":\"2026-08-17T11:45:14+00:00\",\"description\":\"CPT code 01360 covers anesthesia for open procedures on the lower one-third of the femur, at 5.0 base units. 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It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/#\\\/schema\\\/person\\\/73b672a49e20bfba8161e3c17ee3dda2\",\"name\":\"Aleksandar Kochovski\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"caption\":\"Aleksandar Kochovski\"},\"description\":\"Aleksandar is a content strategist and editor working in tech publishing, with a background in higher education. He specializes in topics around compliance in software solutions. When he's not writing at Pabau, you can find him tending to his bonsai collection or hitting the gym.\",\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/blog\\\/author\\\/aleksandar-kochovski\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227245\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227245\",\"name\":\"What is CPT code 01360 used for?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT code 01360 covers anesthesia for all open procedures on the lower one-third of the femur. That is the distal thigh bone, just above the knee joint. Typical cases include open reduction and internal fixation of a supracondylar or condylar fracture, open repair of a distal femur nonunion, and supracondylar osteotomy. It does not cover the knee joint, and it is not a catch-all code for the leg.\",\"inLanguage\":\"es\"},\"inLanguage\":\"es\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227246\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227246\",\"name\":\"What is the difference between CPT 01360 and CPT 01340?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Both codes describe the lower one-third of the femur, and the difference is the surgical approach. CPT 01340 covers closed procedures, such as closed reduction or manipulation with no incision at the fracture, and carries 4.0 base units. CPT 01360 covers open procedures, where the surgeon opens the site to reduce, plate, nail, or graft the bone, and carries 5.0 base units. Read the operative report to decide, because the diagnosis code is the same either way.\",\"inLanguage\":\"es\"},\"inLanguage\":\"es\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227246b\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227246b\",\"name\":\"How many base units does CPT 01360 have?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT code 01360 carries 5.0 anesthesia base units per the ASA Relative Value Guide, and CMS publishes the same nationwide figure. That sits above closed distal femur work at 4.0 units and below open work on the upper two-thirds of the femur at 6.0 units. Base units are fixed per code, so verify the value annually against the current ASA guide.\",\"inLanguage\":\"es\"},\"inLanguage\":\"es\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227247\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227247\",\"name\":\"Can CPT 01360 be used for a total knee replacement?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. Total knee arthroplasty is billed with CPT 01402, which carries 7.0 base units. CPT 01360 covers the femur, not the knee joint, so using it for a knee replacement both undercodes the claim and misstates the anatomy. Other knee joint procedures fall under 01380 for closed treatment and 01400 for open or surgical arthroscopic work.\",\"inLanguage\":\"es\"},\"inLanguage\":\"es\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227248\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-01360\\\/#faq-question-1785753227248\",\"name\":\"How is reimbursement calculated for CPT code 01360?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Reimbursement equals base units plus time units, multiplied by the conversion factor. For a 120-minute open distal femur fixation under Medicare, that is 5.0 base units plus 8.0 time units, or 13.0 units. At the 2026 national anesthesia conversion factor of $20.4976 the claim comes to roughly $266 before geographic adjustment. 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It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.","foundingDate":"2011-10-20","numberOfEmployees":{"@type":"QuantitativeValue","minValue":"201","maxValue":"500"}},{"@type":"Person","@id":"https:\/\/pabau.com\/es\/#\/schema\/person\/73b672a49e20bfba8161e3c17ee3dda2","name":"Aleksandar Kochovski","image":{"@type":"ImageObject","inLanguage":"es","@id":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/06\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg","url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/06\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/06\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg","caption":"Aleksandar Kochovski"},"description":"Aleksandar is a content strategist and editor working in tech publishing, with a background in higher education. He specializes in topics around compliance in software solutions. When he's not writing at Pabau, you can find him tending to his bonsai collection or hitting the gym.","url":"https:\/\/pabau.com\/es\/blog\/author\/aleksandar-kochovski\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227245","position":1,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227245","name":"What is CPT code 01360 used for?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT code 01360 covers anesthesia for all open procedures on the lower one-third of the femur. That is the distal thigh bone, just above the knee joint. Typical cases include open reduction and internal fixation of a supracondylar or condylar fracture, open repair of a distal femur nonunion, and supracondylar osteotomy. It does not cover the knee joint, and it is not a catch-all code for the leg.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227246","position":2,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227246","name":"What is the difference between CPT 01360 and CPT 01340?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Both codes describe the lower one-third of the femur, and the difference is the surgical approach. CPT 01340 covers closed procedures, such as closed reduction or manipulation with no incision at the fracture, and carries 4.0 base units. CPT 01360 covers open procedures, where the surgeon opens the site to reduce, plate, nail, or graft the bone, and carries 5.0 base units. Read the operative report to decide, because the diagnosis code is the same either way.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227246b","position":3,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227246b","name":"How many base units does CPT 01360 have?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT code 01360 carries 5.0 anesthesia base units per the ASA Relative Value Guide, and CMS publishes the same nationwide figure. That sits above closed distal femur work at 4.0 units and below open work on the upper two-thirds of the femur at 6.0 units. Base units are fixed per code, so verify the value annually against the current ASA guide.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227247","position":4,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227247","name":"Can CPT 01360 be used for a total knee replacement?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. Total knee arthroplasty is billed with CPT 01402, which carries 7.0 base units. CPT 01360 covers the femur, not the knee joint, so using it for a knee replacement both undercodes the claim and misstates the anatomy. Other knee joint procedures fall under 01380 for closed treatment and 01400 for open or surgical arthroscopic work.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227248","position":5,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227248","name":"How is reimbursement calculated for CPT code 01360?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Reimbursement equals base units plus time units, multiplied by the conversion factor. For a 120-minute open distal femur fixation under Medicare, that is 5.0 base units plus 8.0 time units, or 13.0 units. At the 2026 national anesthesia conversion factor of $20.4976 the claim comes to roughly $266 before geographic adjustment. Commercial payers use their own contracted conversion factors.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227249","position":6,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227249","name":"What modifiers are required with CPT code 01360?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Every claim needs a provider modifier. Use AA when the anesthesiologist personally performs the case, and QZ for a CRNA working without medical direction. Use QK when a physician directs two to four cases, or QY when a physician directs one CRNA, and QX for that CRNA. Physical status modifiers P1 to P6 may also be appended. Medicare pays no extra for physical status, though some commercial payers add units for P3 and above.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227250","position":7,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227250","name":"Can a CRNA bill CPT code 01360?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes. A CRNA working without physician medical direction bills CPT 01360 with modifier QZ and receives 100% of the Medicare allowable. Under physician medical direction the CRNA appends QX and receives 50%, with the directing anesthesiologist billing QK or QY for the other 50%. Independent billing depends on state law and on whether the state has opted out of the federal supervision requirement.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227251","position":8,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-01360\/#faq-question-1785753227251","name":"Which ICD-10 codes support a CPT 01360 claim?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Most 01360 claims are supported by S72 distal femur fracture codes. Examples include S72.401A for an unspecified fracture of the lower end of the right femur. S72.451A covers a displaced supracondylar fracture, and S72.421A a lateral condyle fracture. Nonunion repairs use a subsequent-encounter character, for example S72.401K, and pediatric growth-plate cases use S79.121A. 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