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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Anesthesia Anesthesia for Procedures on the Upper Leg (Except Knee) |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital |
| Common Modifiers | None AA - Anesthesia by anesthesiologist QX - Qualified nonphysician anesthetist service: With medical direction by a physician |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 01202 |
National average anesthesia conversion factor for CPT 01202 by major payers:

$52.69

$55.71

$56.50

$54.25
Choose a payer to see a sample of rates for CPT 01202.
Faculty Physicians And Surgeons Of Llusm
Anesthesia Service Medical Group, Inc.
Shriners Hospitals For Children
Anesthesia Care Associates Medical Group, Inc.
Cedars-Sinai Medical Care Foundation
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 01202 vs. Other Anesthesia for Procedures on the Upper Leg (Except Knee) Codes
The CPT 01202 code is part of the Anesthesia services used for Anesthesia for Procedures on the Upper Leg (Except Knee). It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 01202 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 01200-CPT | Low | Anesthesia For Joint Procedure, Anesthesia Services For A Noninvasive Procedure Involving A Joint Such As A Scope-Assisted Exam. Common Exam Sites Include Hip Knee Shoulder Wrist Ankle And Elbow. |
| 01202-CPT | Low | Anesthesia For Joint Procedure, Anesthesia Services For A Noninvasive Procedure Involving A Joint Such As A Scope-Assisted Exam. Common Exam Sites Include Hip Knee Shoulder Wrist Ankle And Elbow. |
| 01210-CPT | Moderate | Anesthesia For Joint Surgery, Anesthesia Services For A Surgery Involving A Joint Such As A Scope-Assisted Exam Repair Of A Broken Bone Or Removal Of A Bone. Joint Surgery May Involve The Hip Knee Shoulder Elbow Wrist Or Neck. |
| 01212-CPT | Moderate | Anesthe For Open Procs Invol Hip Joint; Hip Disarticulatio, Anesthesia For Open Procedures Involving Hip Joint; Hip Disarticulatio |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 01202. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 01202 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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