Summary & Overview
CPT 00792: Anesthesia for Partial Hepatectomy or Liver Hemorrhage Procedures
CPT code 00792 represents anesthesia for intraperitoneal procedures in the upper abdomen, including laparoscopy for partial hepatectomy or management of liver hemorrhage, but excluding liver biopsy. This code is significant for hospitals and anesthesia providers nationwide, as it addresses complex surgical cases that require specialized anesthesia expertise. The typical site of service is the outpatient hospital, reflecting the trend toward advanced surgical interventions outside the inpatient setting.
Major payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. The publication provides a comprehensive overview of payer coverage, policy updates, and clinical benchmarks relevant to anesthesia billing for these procedures. Readers will gain insight into the clinical context of the code, common modifiers used in billing, associated provider taxonomies, and related ICD-10 diagnoses. Additionally, the article highlights related CPT codes for similar upper abdominal procedures, offering a broader perspective on anesthesia coding in gastroenterology and hepatology.
This summary equips healthcare professionals, billing specialists, and policy analysts with the latest information on coding practices, payer policies, and clinical applications for anesthesia services in upper abdominal surgery. The content is designed to support accurate billing, compliance, and understanding of national trends in anesthesia reimbursement.
CPT Code Overview
CPT code 00792 is used to report anesthesia services for intraperitoneal procedures in the upper abdomen, specifically for partial hepatectomy or management of liver hemorrhage, excluding liver biopsy. This code applies to procedures performed in an outpatient hospital setting, with anesthesia as the primary service type. The code ensures accurate billing and documentation for complex abdominal surgeries requiring specialized anesthesia care.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital with symptoms such as epigastric pain, nausea, or signs of upper abdominal disease. After clinical evaluation, the patient is diagnosed with a condition requiring a partial hepatectomy or management of liver hemorrhage, excluding liver biopsy. The procedure is performed laparoscopically or via an intraperitoneal approach in the upper abdomen. An anesthesia provider, such as an anesthesiologist or anesthesiology assistant, administers anesthesia services throughout the surgical procedure, ensuring patient safety and comfort. The workflow involves preoperative assessment, intraoperative anesthesia management, and postoperative monitoring in the outpatient hospital setting.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when anesthesia is provided in a manner that allows the patient to remain responsive and breathing independently, typically for procedures where full general anesthesia is not required.P1: A normal healthy patient. Indicates the physical status of the patient as assessed by the anesthesia provider.
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207L00000X | Anesthesiology |
207RA0401X | Anesthesiology Assistant |
207RG0300X | Gastroenterology Physician |
- Specialty Representation:
207L00000X: Physicians specializing in anesthesia care.207RA0401X: Certified anesthesiology assistants.207RG0300X: Physicians specializing in gastroenterology, relevant for upper abdominal procedures.
Related Diagnoses
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K21.9: Gastro-esophageal reflux disease without esophagitis- Relevant for patients presenting with reflux symptoms, which may necessitate upper abdominal procedures.
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K31.9: Disease of stomach and duodenum, unspecified- Indicates unspecified pathology in the stomach or duodenum, potentially requiring surgical intervention.
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R10.13: Epigastric pain- Common presenting symptom for upper abdominal disease, justifying surgical evaluation and intervention.
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R11.0: Nausea- Symptom often associated with upper abdominal pathology, supporting the need for procedural management.
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R11.2: Nausea with vomiting, unspecified- Indicates more severe gastrointestinal symptoms, which may be linked to conditions requiring partial hepatectomy or management of liver hemorrhage.
Related CPT Codes
| CPT Code | Description | Clinical Relationship |
|---|---|---|
00794 | Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, Whipple procedure) | Used for anesthesia during pancreatectomy procedures; similar anatomical region and workflow as 00792. |
00796 | Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient) | Used for anesthesia during liver transplant; shares upper abdominal approach, alternative to 00792. |
00797 | Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity | Used for anesthesia during gastric restrictive procedures; alternative for upper abdominal surgeries. |
- These codes are alternatives to
00792depending on the specific surgical procedure performed. They are not typically billed together but may be selected based on the operative intervention.
National Reimbursement Benchmarks
National mean rates for CPT code 00792 show that Blue Cross Blue Shield and Cigna have the highest average reimbursement, with $711.96 and $698.25 respectively. UnitedHealth Group's mean rate is significantly lower at $65.59, while the BUCA (average commercial) mean rate stands at $342.10. Medicare rates are not available in the input for comparison.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies widely across payers. Blue Cross Blue Shield and Cigna exhibit the widest ranges ($405.25 and $1,026.00 respectively), indicating substantial variability in contracted rates. UnitedHealth Group has the tightest range at $25.51, suggesting more consistent reimbursement levels. Aetna and BUCA also show considerable dispersion, with ranges of $842.50 and $489.64.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a wide rate spread for CPT code 00792, particularly among Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $295.43 ($959.63 minus $664.20). BUCA also shows a substantial spread of $450.62, indicating significant variability in reimbursement rates across payers. In contrast, Aetna, Cigna, and UnitedHealth Group have minimal spreads, with their 25th, 50th, and 75th percentiles clustered closely together, suggesting more uniform payment structures.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are considerably higher, while UnitedHealth Group and Cigna remain below or near national benchmarks. The table and chart below present the full breakdown of payer-specific rates and percentiles for Alaska.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 00792 in Alaska, with a mean rate of $819.33.
- UnitedHealth Group offers the lowest mean rate at $75.12, significantly below both the state and national averages.
- Alaska's mean rates for most payers, especially BCBS and BUCA, are notably higher than their respective national averages, indicating a premium reimbursement environment.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.