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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Upper AbdomenCPT cpt-00731-upper-gi-endoscopy-anesthesia
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    CPT 00731: Anesthesia for Upper GI Endoscopy to Proximal Duodenum

    CPT code 00731 describes anesthesia services provided when an anesthesia provider manages sedation or general anesthesia for an upper gastrointestinal endoscopic procedure in which an endoscope is introduced to, but not beyond, the proximal (upper) part of the duodenum; the service type is anesthesia for upper GI endoscopy and the typical site of service is an endoscopy suite or ambulatory surgery center where physicians perform diagnostic or therapeutic upper endoscopic procedures.

    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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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 58-year-old with a history of chronic gastroesophageal reflux disease and progressive dysphagia referred for diagnostic upper endoscopy (esophagogastroduodenoscopy) to evaluate for erosive esophagitis, peptic ulcer disease, or obstructing lesions. The gastroenterologist performs sedation and a second provider (anesthesia professional) performs monitored anesthesia care or general anesthesia. The endoscope is advanced through the esophagus, stomach, and into the proximal (first portion) of the duodenum. The anesthesia provider documents pre-anesthesia evaluation, airway assessment, ASA physical status (commonly P2–P4), intra-procedural monitoring and hemodynamic management, sedation agents and doses, and post-anesthesia recovery and handoff. Typical workflow: pre-procedure consent and NPO verification, anesthesia pre-assessment and medication review, induction of sedation or general anesthesia, intra-procedural support while the endoscopist performs the EGD to the proximal duodenum, emergence and recovery in the PACU or endoscopy recovery area, and discharge with written instructions and anesthesia record filed in the medical record.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    00740Anesthesia for diagnostic or therapeutic upper gastrointestinal endoscopic procedures when the endoscope is advanced beyond the duodenum (e.g., endoscopic retrograde cholangiopancreatography)Used for deeper enteric procedures that extend beyond the proximal duodenum; differentiates anesthesia complexity and billing from 00731.
    43235Esophagogastroduodenoscopy, flexible, diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)The endoscopic diagnostic procedure commonly performed alongside anesthesia billed under 00731.
    43239Esophagogastroduodenoscopy with biopsy, single or multipleFrequently performed during the EGD for tissue diagnosis; anesthesiology services reported with 00731 while the gastroenterologist reports the endoscopic CPT.
    43255Esophagogastroduodenoscopy with dilation of esophagus, balloon or push-type (separate procedure)Therapeutic interventions during EGD that may prolong anesthesia time and affect anesthesia complexity and documentation.
    99152Moderate sedation services provided by the same physician or other qualified health care professional performing a diagnostic or therapeutic service, requiring the presence of an independent trained observer to assist in monitoring — initial 15 minutesIn some settings, moderate (conscious) sedation is used instead of anesthesia services; local billing practices determine whether to report anesthesia 00731 or moderate sedation codes.
    99153Each additional 15 minutes of moderate sedation provided by the same physician or other qualified health care professional (list separately in addition to code for primary service)Ancillary code to capture extended monitoring time when moderate sedation rather than general anesthetic is used.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    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…
    99Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…

    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…
    2080P0207XPediatric Hematology & Oncology PhysicianA pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    207LP2900XPain Medicine (Anesthesiology) PhysicianAn anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
    163WP0807XChild & Adolescent Psychiatric/Mental Health Registered NurseNursing Service Providers · Registered Nurse
    163WP2201XAmbulatory Care Registered NurseNursing Service Providers · Registered Nurse
    261QA0900XAmputee Clinic/CenterAn entity, facility, or distinct part of a facility providing counseling, fitting, custom design, prescriptive, and training services related to conge…
    2084N0600XClinical Neurophysiology PhysicianClinical Neurophysiology is a subspecialty with psychiatric or neurologic expertise in the diagnosis and management of central, peripheral, and autono…

    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-00730-ANESTHESIA-UPPER-POSTERIOR-ABDOMINAL-WALL

    CPT 00730: Anesthesia for Upper Posterior Abdominal Wall Procedures

    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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