CPT 00840 Reimbursement Benchmarks & Policy | OpenPayer

Summary & Overview

CPT 00840: Anesthesia for Intraperitoneal Procedures in Lower Abdomen

CPT code 00840 is a critical billing code for anesthesia services provided during intraperitoneal procedures in the lower abdomen, including laparoscopic surgeries. This code is widely used in outpatient hospital settings to ensure proper documentation and reimbursement for anesthesia care during a range of abdominal interventions. Nationally, the code is recognized by major commercial payers such as Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, reflecting its broad applicability across the healthcare system.

This publication provides a comprehensive overview of CPT code 00840, including its clinical context, typical site of service, and payer coverage. Readers will gain insights into the benchmarks for anesthesia billing, relevant policy updates, and the procedural landscape associated with lower abdominal surgeries. The summary also highlights common modifiers and associated taxonomies, offering clarity on how the code is used in practice. Additionally, the publication outlines related CPT codes and ICD-10 diagnoses frequently encountered with these procedures, supporting a deeper understanding of coding and billing nuances.

Healthcare professionals, administrators, and policy analysts will find this resource valuable for staying informed about anesthesia coding standards, payer requirements, and clinical documentation practices for intraperitoneal procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00840anesthesiaintraperitoneal procedureslaparoscopyoutpatient hospitalmedical billingclinical documentationprocedure codingpolicy updatesabdominal surgery

CPT Code Overview

CPT code 00840 is used to report anesthesia services for intraperitoneal procedures in the lower abdomen, including laparoscopy. This code applies to procedures where anesthesia is administered to facilitate surgical interventions within the peritoneal cavity of the lower abdomen. The service type is anesthesia, and the typical site of service is an outpatient hospital (Place of Service 22). This code is essential for accurately documenting and billing anesthesia care provided during minimally invasive and open abdominal surgeries.

Clinical & Coding Specifications

Clinical Context

A patient presents to the outpatient hospital with symptoms such as acute abdominal pain, suspected appendicitis, or ovarian cyst. After clinical evaluation and imaging, the patient is scheduled for a laparoscopic intraperitoneal procedure in the lower abdomen. An anesthesiologist provides anesthesia services for the surgery, ensuring patient safety and comfort throughout the procedure. The workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative care in the recovery area. The anesthesia service is coded with 00840 for intraperitoneal procedures in the lower abdomen, including laparoscopy.

Coding Specifications

Common Modifiers:

QS - Monitored anesthesia care service
- Used when the anesthesia provider delivers monitored anesthesia care (MAC) during the procedure.
P1 - A normal healthy patient
- Indicates the patient has no systemic disease and is considered healthy for anesthesia risk assessment.

Associated Provider Taxonomies:

Taxonomy Code

National Reimbursement Benchmarks

National mean rates for CPT code 00840 show that Aetna has the highest average reimbursement at $517.03, while UnitedHealth Group is notably lower at $65.59. The BUCA (average commercial) mean rate stands at $251.81, which is significantly higher than typical Medicare rates, though Medicare data is not available in the input for this code.

Rate dispersion varies across payers. Aetna exhibits the widest spread, with a difference of $665.00 between its 75th and 25th percentiles, indicating substantial variability in contracted rates. In contrast, UnitedHealth Group has the tightest range, with only $25.51 separating its 75th and 25th percentiles, suggesting more consistent reimbursement levels. Blue Cross Blue Shield and Cigna fall in between, with moderate dispersion.

The table and chart below present the full breakdown of national benchmarks for each payer.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska exhibits a wide spread in reimbursement rates for CPT code 00840, with Blue Cross Blue Shield showing the largest range between the 25th and 75th percentiles ($198.88), while UnitedHealth Group and Aetna have much narrower spreads ($4.00 and $30.00, respectively). This indicates significant variability in payment levels depending on the payer, with some offering consistently low rates and others much higher. Compared to national averages, Alaska's mean rates for most payers (except Cigna and UnitedHealth Group) are generally higher, particularly for Blue Cross Blue Shield and Aetna, which both exceed their respective national mean rates.

The table and chart below present the full breakdown of mean rates and percentile values for each major payer in Alaska, highlighting the differences in reimbursement levels across the state.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 00840 in Alaska, with a mean rate of $418.03.
UnitedHealth Group offers the lowest mean rate at $75.12, significantly below both state and national averages.
Cigna's mean rate in Alaska ($89.33) is much lower than its national average ($352.10), indicating a substantial deviation.

CPT 00820: Anesthesia for Lower Abdominal Procedures

00846-ANESTHESIA-FOR-INTRAPERITONEAL-PROCEDURES-IN-LOWER-ABDOMEN

CPT 00846: Anesthesia for Lower Abdominal Intraperitoneal Procedures

00864-ANESTH-REMOVAL-OF

CPT 00864: Anesthesia for Bladder Removal Surgery

00802-ANESTHESIA-FOR-PROCEDURES-ON-LOWER-ANTERIOR-ABDOMINAL

CPT 00802: Anesthesia for Lower Anterior Abdominal Wall Procedures

CPT-00812-ANESTHESIA-COLONOSCOPY-BELOW-DUODENUM

CPT 00812: Anesthesia for Screening Colonoscopy Below the Duodenum

00870-ANESTHESIA-FOR-EXTRAPERITONEAL-PROCEDURES-IN-LOWER-ABDOMEN

CPT 00870: Anesthesia for Lower Abdomen Procedures, Cystolithotomy

00860-ANESTHESIA-FOR-EXTRAPERITONEAL-PROCEDURES-IN-LOWER-ABDOMEN

CPT 00860: Anesthesia for Extraperitoneal Lower Abdominal Procedures

00862-ANESTHESIA-SERVICES-FOR-PROCEDURES-IN-THE-LOWER-ABDOMEN

CPT 00862: Anesthesia for Lower Abdomen and Renal Procedures

00865-ANESTHESIA-FOR-EXTRAPERITONEAL-PROCEDURES-IN-LOWER-ABDOMEN

CPT 00865: Anesthesia for Radical Prostatectomy, Lower Abdomen Procedures

00832-ANESTHESIA-FOR-PROCEDURES-IN-LOWER-ABDOMEN-INCLUDING

CPT 00832: Anesthesia for Lower Abdominal Procedures Including Colonoscopy

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Related CPT Codes

CPT Code	Description	Clinical Relationship
`47562`	Laparoscopy, surgical; cholecystectomy	Commonly performed with anesthesia code `00840` for gallbladder removal.
`58661`	Laparoscopy, surgical; with removal of adnexal structures	Used for removal of ovarian or fallopian tube structures, requiring anesthesia `00840`.
`44970`	Laparoscopy, surgical, appendectomy	Appendectomy procedures in the lower abdomen, paired with anesthesia `00840`.
`49320`	Laparoscopy, surgical; with biopsy	Biopsy of intraperitoneal structures, anesthesia provided with `00840`.

These codes represent surgical procedures in the lower abdomen where anesthesia code 00840 is applied.
Codes 47562, 58661, and 44970 are commonly used together with 00840 during respective surgeries.
49320 may be used as an alternative or adjunct procedure requiring anesthesia.

207L00000X	Anesthesiology
207LA0401X	Pain Medicine (Anesthesiology)
207LP2900X	Pediatric Anesthesiology

OpenPayer

Summary & Overview

CPT 00840: Anesthesia for Intraperitoneal Procedures in Lower Abdomen

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes