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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Upper AbdomenCPT cpt-00730-anesthesia-upper-posterior-abdominal-wall
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    CPT 00730: Anesthesia for Upper Posterior Abdominal Wall Procedures

    Commercial payers pay $73 on average nationally for this procedure.

    CPT code 00730 describes anesthesia services provided for procedures on the upper posterior abdominal wall, typically performed as intraoperative anesthesia in an operating room or procedure suite setting for surgical repair or intervention on the upper posterior abdomen.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    National Reimbursement Benchmarks

    National commercial rates for CPT 00730 cluster around the BUCA average commercial rate of $73.40, with individual payers showing meaningful variation. Blue Cross Blue Shield’s interquartile span ($92.00 - $51.60) yields a range of $40.40, Cigna’s IQR ($125.00 - $68.40) is $56.60, Aetna’s IQR ($84.20 - $42.00) is $42.20, and UnitedHealth Group’s IQR ($81.10 - $52.00) is $29.10 — indicating UnitedHealth Group exhibits the tightest middle dispersion while Cigna shows the widest. Across extremes and central tendencies, Cigna posts the highest mean at $96.50 and a high-end P90 of $159.20, while Aetna and UnitedHealth Group present lower medians ($50.00 and $64.00, respectively). Blue Cross Blue Shield and BUCA sit near the middle of the market, with BUCA’s mean at $73.40 reflecting a mid-market commercial benchmark.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 56-year-old male presents for elective repair of a ventral/upper posterior abdominal wall hernia under general anesthesia. Preoperative evaluation in the ambulatory surgery center includes anesthesia assessment documenting American Society of Anesthesiologists (ASA) physical status P2, review of prior abdominal surgeries, and medication reconciliation. On the day of surgery the anesthesia team performs a focused airway and cardiopulmonary evaluation, places standard monitors, induces general endotracheal anesthesia, and provides intraoperative anesthetic management for an open transabdominal repair of the upper posterior abdominal wall hernia. Postoperative handoff is completed to PACU staff with documentation of anesthetic technique, airway management, intraoperative events, estimated blood loss, fluid balance, analgesic regimen, and recovery instructions. Typical sites of service are the hospital main operating room or an ambulatory surgical center depending on patient comorbidity and procedure complexity.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    00740Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to duodenumRelated when endoscopic evaluation of upper abdominal pathology is performed in the same operative episode

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    367H00000XAnesthesiologist AssistantAn individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants …
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    311Z00000XCustodial Care FacilityA facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of …
    390200000XStudent in an Organized Health Care Education/Training ProgramAn individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensur…
    133N00000XNutritionistA specialist in adapting and applying food and nutrient knowledge to the solution of food and nutritional problems, the control of disease, and the pr…
    3747P1801XPersonal Care AttendantAn individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. …
    2080I0007XPediatric Clinical & Laboratory Immunology PhysicianA pediatrician who specializes in clinical and laboratory immunology disease management.

    Related ICD-10-CM Codes

    34 rows

    ICD-10-CM CodeDescription
    A41.9Sepsis, unspecified organism
    C18.9Malignant neoplasm of colon, unspecified
    C19Malignant neoplasm of rectosigmoid junction
    C20Malignant neoplasm of rectum
    D12.6Benign neoplasm of colon, unspecified
    K25.0Acute gastric ulcer with hemorrhage
    K25.2Acute gastric ulcer with both hemorrhage and perforation
    K26.0Acute duodenal ulcer with hemorrhage
    K26.2Acute duodenal ulcer with both hemorrhage and perforation
    K27.0Acute peptic ulcer, site unspecified, with hemorrhage

    Showing 1–10 of 34

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    7 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-00700-ANESTHESIA-UPPER-ANTERIOR-ABDOMINAL-WALL

    CPT 00700: Anesthesia for Upper Anterior Abdominal Wall Procedures

    CPT-00702-ANESTHESIA-UPPER-ANTERIOR-ABDOMINAL-WALL-LIVER-BIOPSY

    CPT 00702: Anesthesia for Upper Anterior Abdominal Wall, Percutaneous Liver Biopsy

    CPT-00731-UPPER-GI-ENDOSCOPY-ANESTHESIA

    CPT 00731: Anesthesia for Upper GI Endoscopy to Proximal Duodenum

    CPT-00732-ERCP-ANESTHESIA-PROXIMAL-DUODENUM

    CPT 00732: Anesthesia for ERCP to Proximal Duodenum

    CPT-00750-ANESTHESIA-UPPER-ABDOMEN-HERNIA-REPAIR

    CPT 00750: Anesthesia for Upper Abdominal Hernia Repair

    CPT-00752-UPPER-ABDOMEN-HERNIA-REPAIR-ANESTHESIA

    CPT 00752: Anesthesia for Upper Abdominal Hernia Repairs

    CPT-00754-ANESTHESIA-OMPHALOCELE-UPPER-ABDOMEN-HERNIA-REPAIR

    CPT 00754: Anesthesia for Upper Abdominal Hernia Repair (Omphalocele)

    CPT-00756-TRANSABDOMINAL-DIAPHRAGMATIC-HERNIA-REPAIR-ANESTHESIA

    CPT 00756: Anesthesia for Transabdominal Diaphragmatic Hernia Repair

    CPT-00770-ANESTHESIA-FOR-MAJOR-ABDOMINAL-VASCULAR-PROCEDURE

    CPT 00770: Anesthesia for Major Abdominal Vascular Procedures

    CPT-00790-ANESTHESIA-UPPER-ABDOMINAL-INTRAPERITONEAL-PROCEDURES

    CPT 00790: Anesthesia for Intraperitoneal Upper Abdominal Procedures

    Showing 1–10 of 14

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    00750
    Anesthesia for hernia repairs in upper abdomen; not otherwise specified
    Alternative or related anesthesia code for certain upper-abdominal hernia repairs when specific anatomic detail differs
    00752Anesthesia for hernia repairs in upper abdomen; lumbar and ventral (incisional) hernias and/or wound dehiscenceRelated for ventral or incisional hernias of the upper abdomen that fall under this subcategory
    00754Anesthesia for hernia repairs in upper abdomen; omphaloceleRelated when the repair is for an omphalocele of the upper abdominal wall
    00756Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic herniaRelated when the procedure specifically involves transabdominal repair of a diaphragmatic hernia
    00770Anesthesia for all procedures on major abdominal blood vesselsRelated if concurrent major abdominal vascular work is performed during the same operation
    00790Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specifiedRelated when intraperitoneal or laparoscopic upper abdominal procedures occur during the same case
    00792Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)Related when hepatic resection or hemorrhage control is performed in addition to or instead of hernia repair