CPT code 01202: Anesthesia for arthroscopic hip joint procedures

Key takeaways

CPT code 01202 describes anesthesia for arthroscopic procedures of the hip joint, not the knee — the two are commonly confused because the code numbers sit close together.

01202 carries 4.0 base units per the ASA Relative Value Guide; total payment uses the (base units + time units + modifying units) x conversion factor formula.

Anesthesia supervision modifiers (AA, QZ, QX, QK, QY, AD) and physical status modifiers (P1-P6) are required on every 01202 claim.

ICD-10 pairings for 01202 come from the hip and thigh code families, such as M16.x hip osteoarthritis, M24.85x hip derangement, or S70-S79 hip and thigh injury — never a knee diagnosis code.

Pabau’s documentation tools help anesthesia and orthopedic practices capture physical status, modifiers, and anesthesia time accurately before a claim goes out.

CPT code 01202 is the anesthesia code for arthroscopic procedures of the hip joint: minimally invasive, camera-guided surgery inside the hip capsule, covering cases such as labral repair, femoroacetabular impingement (FAI) surgery, loose body removal, and hip synovectomy.

It carries 4.0 base units under the ASA Relative Value Guide, and payment is calculated with the anesthesia base-unit formula rather than the standard Medicare RVU methodology used for most other CPT codes.

The code sits close to the knee arthroscopy anesthesia codes in the CPT Anesthesia section, and as a result they are frequently confused. Specifically, this guide walks through the base-unit calculation, the modifiers and ICD-10 pairings that belong with 01202, and how it differs from the codes it’s most often mixed up with.

CPT code 01202: Definition and clinical description

Anesthesia billing denials often trace back to one root cause: the wrong code was selected before the case even started. CPT 01202 has a precise scope; consequently, using it outside that scope — or confusing it with a similarly-numbered code for a different joint — triggers payer rejection.

The official descriptor, as published by the American Medical Association (AMA), is: Anesthesia for arthroscopic procedures of hip joint. This means the code applies specifically to arthroscopic (minimally invasive, camera-guided) procedures inside the hip joint capsule — such as labral repair, femoroacetabular impingement (FAI) surgery, loose body removal, or hip synovectomy.

In contrast, open hip procedures, closed hip procedures, and any knee procedure require different anesthesia codes entirely.

CPT 01202 falls within the CPT Anesthesia section (range 00100-01999), specifically the Upper Leg (Except Knee) subsection covering anesthesia for procedures on the hip and upper leg.

Orthopedic groups, ambulatory surgery centers, and sports medicine practices billing anesthesia for hip arthroscopy will encounter this code routinely, and the physical therapy practices handling post-operative rehab often work from the same operative report.

It is easy to confuse with the knee arthroscopy anesthesia codes: CPT 01382 for diagnostic knee arthroscopy and CPT 01400 for open or surgical knee arthroscopy not otherwise specified — different joint, different code family, different base units.

Base units and the anesthesia billing formula

CPT 01202 carries 4.0 base units per the American Society of Anesthesiologists (ASA) Relative Value Guide, confirmed against the CMS/VA nationwide anesthesia base-unit table. Notably, base units represent the inherent complexity of providing anesthesia for a given procedure, independent of how long the case runs.

Anesthesia reimbursement is not priced the way most CPT codes are. Instead of the standard work/practice-expense/malpractice RVU methodology used in the Medicare Physician Fee Schedule, anesthesia claims add three components, then multiply by the payer’s conversion factor:

Formula: (B + T + M) x CF = Reimbursement

Worked example: A hip arthroscopy runs 45 minutes. Base units = 4.0. Time units = 45 / 15 = 3.0. Physical status modifier P2 adds 0 units. Modifying units = 0. Total units = 7.0. At the CMS national anesthesia conversion factor for CY2026 ($20.4976 per unit for non-qualifying-participant clinicians), reimbursement = 7.0 x $20.4976 ≈ $143.48.

For a clinician in a qualifying Advanced APM, the CY2026 CF is $20.5998 per unit, yielding ≈ $144.20.

In addition, actual conversion factors are locality-specific and can differ from the national figure. Confirm the exact number for your MAC jurisdiction via the CMS Anesthesiologists Information Center rather than a standard RVU lookup tool.

Modifiers for CPT code 01202

Every anesthesia claim for CPT 01202 requires at least two modifiers: one identifying how the anesthesia was provided (supervision vs. personally performed) and one documenting physical status. Missing either triggers an automatic claim edit.

Anesthesia supervision modifiers

Ultimately, payer contracts govern which modifier combinations are reimbursed and at what percentage. Medicare pays AA and QZ claims at 100% of the allowed amount; medically directed cases (QX/QK) typically reimburse at 50% per claim when both the anesthesiologist and CRNA bill separately. Verify your specific payer contract before assuming these rates apply.

Physical status modifiers (P1-P6)

Similarly, physical status modifiers document the patient’s health classification and may add base units to the claim. Per ASA guidance, P3 and above carry additional unit values, though payer reimbursement for these additions varies.

P3-P5 add-on units are payer-specific. However, many commercial payers do not reimburse the additional base units even when the modifier is correctly applied. Check individual payer contracts before relying on add-on unit reimbursement.

Qualifying circumstances codes

Qualifying circumstance codes may be reported alongside CPT 01202 when the clinical situation genuinely warrants them, though coverage varies significantly by payer.

CPT code 01202 reimbursement and Medicare rates

Medicare reimbursement for CPT 01202 is locality-based. CMS sets an anesthesia conversion factor (CF) for each Medicare Administrative Contractor (MAC) jurisdiction, published annually in the Physician Fee Schedule Final Rule (Addenda D and E).

The national anesthesia CF was $20.3178 per unit for 2025; for CY2026 it is $20.4976 per unit for non-qualifying-participant clinicians, or $20.5998 per unit for clinicians in a qualifying Advanced APM. Actual MAC-locality figures can differ from the national number, so confirm the exact rate for your jurisdiction via the CMS Anesthesiologists Information Center.

For a typical 45-minute hip arthroscopy with a P1 patient billed under modifier AA, the calculation runs: (4.0 base units + 3.0 time units + 0 modifying units) x CF. As a result, at the CY2026 national CF of $20.4976, that yields approximately $143.48 from Medicare.

Commercial payers use their own contracted conversion factors, which may be higher or lower, so compare rates across procedure code fee schedules when negotiating payer contracts.

Because anesthesia is priced on base units and a conversion factor rather than the standard work/practice-expense/malpractice RVU split, a general Medicare Physician Fee Schedule RVU lookup tool will not produce an accurate anesthesia figure. Use the ASA Relative Value Guide for base units and the CMS anesthesia conversion factor files for the dollar value instead.

How to bill CPT code 01202: Step-by-step

Anesthesia billing for CPT 01202 requires more documentation steps than a standard surgical CPT claim. Specifically, each step below corresponds to a payer edit that can trigger a denial if skipped.

Verify the procedure and assign base units

1. Confirm procedure scope and joint. Verify the operative report describes an arthroscopic procedure of the hip joint — not the knee, and not an open or closed hip procedure. If the surgeon converted to an open procedure mid-case, CPT 01202 no longer applies.
2. Assign base units. Apply 4.0 base units per the ASA Relative Value Guide. Document this in the anesthesia billing record.

Calculate units and apply required modifiers

3. Calculate time units. Record anesthesia start and stop times. Divide total minutes by 15 and round per payer rules. Most payers round to the nearest whole unit; some round down.
4. Select physical status modifier. Document the ASA physical status classification in the pre-anesthesia assessment. Apply the corresponding P1-P6 modifier to the claim. This is a required field, not optional.
5. Add supervision modifier. Apply AA, QZ, QX, QK, QY, or AD based on who provided the anesthesia and whether medical direction occurred. This modifier determines the payment percentage.

Confirm diagnosis coding and submit

6. Review qualifying circumstances. Confirm whether 99100, 99116, 99135, or 99140 applies. Only add if documented in the anesthesia record, and confirm the payer’s rules on separate payment.
7. Submit with matching ICD-10 codes. The diagnostic code must support hip pathology. Common pairings include M16.x (primary osteoarthritis of the hip), M24.85x (other specific joint derangement of the hip, including labral pathology), and S70-S79 codes for hip and thigh trauma (for example, S73.19- hip sprain, the convention often used for labral tears). A knee diagnosis code — M17.x gonarthrosis or M23.x internal derangement of the knee — should never accompany a 01202 claim; that combination is a body-part mismatch payers flag immediately. Always confirm medical necessity alignment with the payer’s LCD.
8. Verify payer-specific rules. Some payers require prior authorization for elective hip arthroscopy. Others apply anesthesia billing policies that differ from Medicare — confirm the specific requirements for procedure and modifier combinations before submission.

Finally, HIPAA-compliant electronic claims submission under the ASC X12 837P format is required for Medicare and most commercial payers. Review your practice’s HIPAA-compliant claims submission workflow to ensure anesthesia records and billing data are handled correctly.

Common billing errors with CPT code 01202

Most 01202 denials fall into five patterns. Moreover, identifying which error category applies makes appeals faster and prevents the same mistake on the next claim.

• Confusing 01202 with a knee arthroscopy code. CPT 01202 is anesthesia for the hip joint. Knee arthroscopy anesthesia uses an entirely different code family — CPT 01382 (diagnostic knee arthroscopy) or CPT 01400 (open or surgical knee arthroscopy, NOS). The joint named in the operative report must match the code’s own descriptor, not just its position in the CPT Anesthesia range.
• Using 01202 for non-arthroscopic hip procedures. If the hip procedure was open or closed rather than arthroscopic, a different anesthesia code applies (01200 for closed, 01210 for open NOS, 01214 for total hip arthroplasty). Submitting 01202 for a non-arthroscopic procedure is a descriptor mismatch that payers catch at the code-edit level.
• Incorrect time unit calculation. Rounding errors are common when anesthesia time spans a half-unit interval. Some payers round down; others use an “8-minute rule” similar to E/M time. Know your payer’s specific rounding policy before calculating time units.
• Missing physical status modifier. A claim without a P1-P6 modifier is technically incomplete. Many clearinghouses will pass the claim, but payers often deny or reduce payment without documentation of patient status.
• Wrong modifier combination for the service model. Billing AA when medical direction actually occurred, or QX when the CRNA worked independently, triggers compliance risk and potential overpayment recovery. The modifier must reflect what actually happened during the case.

For instance, billing teams who also handle related anesthesia codes can cross-reference CPT 01210 and CPT 01214 in the table below to see how base units and documentation requirements shift as the surgical approach changes.

Related anesthesia CPT codes

CPT 01202 is part of the hip and upper leg anesthesia code family (01200-01274). Selecting the correct adjacent code matters when the surgical approach changes or when the site differs from the hip joint.

Notably, the distinction between 01200 (closed procedures) and 01202 (arthroscopic procedures) is surgical approach, not anatomy. Both codes apply to the hip joint. Both carry 4.0 base units per the ASA RVG. Use the operative report to determine which code matches the actual approach.

Note the separate lower-leg family: CPT 01250’s descriptor covers the upper leg, not the lower leg, ankle, and foot — that descriptor and its 3.0 base units belong to CPT 01470.

Indeed, the anesthesia section spans far more than hip and knee cases. CPT 00550 covers sternal debridement, and CPT 00402 applies to reconstructive breast procedures — both illustrate how the base-unit value shifts with anatomical complexity rather than surgical technique.

CPT 00174, the code for intraoral procedures, shows the same pattern at the opposite end of the body. The base-unit-plus-time formula applies across the whole Anesthesia section, but the base-unit value itself is never interchangeable between codes.

How Pabau supports anesthesia billing documentation

Anesthesia and orthopedic practices managing a steady volume of hip arthroscopy cases need documentation workflows that capture the right joint, modifier selections, time stamps, and physical status classifications without manual re-entry — and without relying on memory to tell 01202 apart from a similarly-numbered knee code.

For example, practice management software like Pabau helps by attaching modifier and documentation requirements directly to procedure types in digital forms, so a physical status modifier or supervision code is never missing from the anesthesia record.

In addition, pre-anesthesia assessment data captured through digital intake forms flows straight into the same patient record used for billing documentation, keeping pre-operative notes aligned with what eventually goes on the claim.

In particular, this matters for practices that also code hip and knee cases side by side: keeping treatment notes, operative reports, and anesthesia time logs in one system reduces the chance that a hip arthroscopy case gets billed with a knee-family code, or vice versa.

Pabau’s role here is documentation and workflow support, not claims submission. The anesthesia record it helps you build is what your billing team or clearinghouse uses to submit an accurate claim.

Keep hip anesthesia documentation accurate

Pabau's digital forms and treatment notes help anesthesia and orthopedic practices capture physical status, modifier selections, and anesthesia start/stop times in one record, reducing the missing documentation that leads to denials.

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Conclusion

CPT 01202 is narrow by design: anesthesia for arthroscopic procedures of the hip joint, 4.0 base units, nothing broader and nothing borrowed from the knee arthroscopy code family. The costliest mistake on this code isn’t a modifier or a rounding error — it’s picking up the wrong joint before the claim is even built.

Once the joint, base units, time calculation, and modifier pair are locked in, the rest of the claim follows a predictable pattern. Practices that document consistently — same fields, same modifier logic, same ICD-10 cross-check — see fewer denials on this code than practices reconstructing the details claim by claim.

Overall, for practices processing a high volume of anesthesia claims, keeping that documentation organized is where most of the work lives. Book a demo to see how Pabau helps surgical and anesthesia teams document hip and knee anesthesia cases accurately from the first entry.

Continue your research

Billing anesthesia for an open hip procedure instead? CPT code 01210 covers open hip joint procedures and carries a different base-unit value than the arthroscopic code.

Coding a total hip replacement case? CPT code 01214 is the anesthesia code for open total hip arthroplasty, distinct from arthroscopic hip work.

Double-checking that this isn’t a knee case? CPT code 01382 is the anesthesia code for diagnostic knee arthroscopy — a different joint and a different code family from 01202.

Frequently asked questions