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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Upper AbdomenCPT cpt-00752-upper-abdomen-hernia-repair-anesthesia
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    CPT 00752: Anesthesia for Upper Abdominal Hernia Repairs

    Commercial payers pay $83 on average nationally for this procedure.

    CPT code 00752 describes anesthesia services for hernia repairs in the upper abdomen, including lumbar, ventral, incisional hernias, and wound dehiscence; the service is anesthesia care provided in an inpatient or outpatient surgical setting for operative management of upper abdominal wall hernias and related wound complications.

    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

    Commercial rates for CPT 00752 center on a BUCA average of $83.50, with individual payers showing meaningful variation around that benchmark. Blue Cross Blue Shield has a relatively narrow interquartile spread ($91.00 − $51.30 = $39.70), and UnitedHealth Group is similarly tight ($81.00 − $52.00 = $29.00), indicating more consistent commercial payments. Cigna and BUCA display moderate dispersion (Cigna IQR $103.30 − $65.50 = $37.80; BUCA IQR $105.00 − $56.30 = $48.70), while Aetna shows the widest IQR ($173.80 − $66.50 = $107.30), signaling substantial variability in negotiated commercial rates.

    Maximum and minimum endpoints further emphasize spread differences: Aetna’s max of $388 contrasts with its $30.20 minimum, whereas UnitedHealth Group’s narrower top-to-bottom band ($122.70 max, $34.90 min) reinforces its tighter distribution. Blue Cross Blue Shield and Cigna occupy midrange positions by both central tendency and dispersion, framing BUCA’s average as a useful market midpoint among these commercial payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old male presents with progressive upper abdominal pain and a symptomatic ventral/incisional hernia after prior laparotomy. He reports intermittent dysphagia (R13.10) and throat pain (R07.0) but the primary surgical indication is a painful, enlarging incisional hernia with localized bowel entrapment suspected on exam and imaging. The surgical team plans an open repair of an upper abdominal ventral/incisional hernia under general anesthesia with endotracheal intubation. The anesthesiology team evaluates the patient in preoperative holding, documents airway assessment, ASA physical status (P3), relevant comorbidities, and perioperative risks related to possible esophageal disease (K22.2, K22.8). Intraoperative care includes induction, airway management, hemodynamic monitoring, maintenance of anesthesia, analgesia, and emergence. Postoperative handoff to PACU addresses airway concerns, pain control, nausea/vomiting prophylaxis, and instructions for wound monitoring given the repair and potential for wound dehiscence. If intraoperative complexity increases (extensive adhesiolysis or unplanned visceral repair), a modifier such as 22 may be applied to reflect increased procedural service intensity.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    8 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…
    47Modifier -47 (“Anesthesia by Surgeon”) is appended to a surgical or procedural CPT code when the surgeon personally provides regional or general anesthesia for the procedure. Use of -47 indicates the…- Use modifier -47 when the surgeon personally provides regional or general anesthesia during the surgical procedure (i.e., the surgeon administers the anesthesia in addition to performing the…
    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…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    207RA0000XAdolescent Medicine (Internal Medicine) PhysicianAn internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and so…
    173F00000XSleep Specialist (PhD)Sleep medicine is a clinical specialty with a focus on clinical problems that require accurate diagnosis and treatment. The knowledge base of sleep me…
    103K00000XBehavior AnalystA behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential …
    226300000XKinesiotherapistA provider trained and educated in the applied science of medically prescribed therapeutic exercise, education and adapted physical activities designe…
    225XR0403XDriving and Community Mobility Occupational TherapistOccupational therapists can optimize and prolong an older driver's ability to drive safely and ease the transition to other forms of transportation if…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    K22.2Esophageal obstruction
    K22.8
    K22.9Disease of esophagus, unspecified
    K42.0Umbilical hernia with obstruction, without gangrene
    K42.9Umbilical hernia without obstruction or gangrene
    K43.0Incisional hernia with obstruction, without gangrene
    K43.1Incisional hernia with gangrene
    K43.2Incisional hernia without obstruction or gangrene
    K43.3Parastomal hernia with obstruction, without gangrene
    K43.4Parastomal hernia with gangrene

    Showing 1–10 of 26

    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-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-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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    00750Anesthesia for hernia repairs in upper abdomen; not otherwise specifiedAlternative primary anesthesia code for upper abdominal hernia repairs when specific subtype of 00752 is not applicable.
    00754Anesthesia for hernia repairs in upper abdomen; omphaloceleUse when the hernia repair is for an omphalocele rather than a lumbar/ventral/incisional hernia.
    00756Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic herniaUse when the repair involves a transabdominal diaphragmatic hernia rather than the lumbar/ventral/incisional hernias described by 00752.