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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Upper AbdomenCPT cpt-00756-transabdominal-diaphragmatic-hernia-repair-anesthesia
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    CPT 00756: Anesthesia for Transabdominal Diaphragmatic Hernia Repair

    Commercial payers pay $71 on average nationally for this procedure.

    CPT code 00756 describes anesthesia services provided for a patient undergoing transabdominal repair of a diaphragmatic hernia, a surgical procedure to repair a defect in the respiratory diaphragm and return protruding abdominal contents to the abdominal cavity; service type: anesthesia for transabdominal diaphragmatic hernia repair; typical site of service: inpatient or outpatient operating room depending on surgical setting.

    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 national rates for CPT 00756 cluster around BUCA’s average commercial benchmark of $71.3, with notable payer-level differences. Blue Cross Blue Shield shows a relatively wide middle spread (P75 $88.5 minus P25 $48.9 = $39.6), and Cigna displays the largest dispersion (P75 $122.3 minus P25 $68.0 = $54.3), indicating broader variability in negotiated prices. UnitedHealth Group and Aetna are tighter by comparison: UnitedHealth Group’s interquartile range is $29.0 (P75 $81.0 − P25 $52.0) and Aetna’s is $33.0 (P75 $74.3 − P25 $42.0).

    Price ceilings also diverge across payers, with Blue Cross Blue Shield peaking at $195.4 and Cigna at $152.6, while UnitedHealth Group and Aetna have lower maximums of $122.7 and $147.0 respectively. Median and mean positions place Cigna and BUCA above the group average, suggesting higher typical reimbursements, while Aetna and UnitedHealth Group sit nearer or below BUCA’s average commercial benchmark of $71.3.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 52-year-old female presents with progressive epigastric pain, postprandial fullness, and intermittent shortness of breath. Imaging (CT abdomen/pelvis) demonstrates a large left-sided diaphragmatic hernia with omental and small-bowel herniation into the thoracic cavity and partial bowel obstruction. Preoperative assessment identifies ASA physical status P3 due to hypertension and chronic obstructive pulmonary disease. The surgical team plans a transabdominal diaphragmatic hernia repair under general endotracheal anesthesia via an open abdominal approach to reduce herniated contents, repair the diaphragmatic defect, and place mesh as indicated.

    Perioperative workflow: the patient undergoes preoperative evaluation by the anesthesiology team, airway assessment, and optimization of pulmonary status. In the operating room, standard ASA monitors are applied, rapid sequence induction is considered if gastric distention is present, and invasive monitoring (arterial line) is placed based on comorbidities. The anesthetic plan includes general anesthesia with endotracheal intubation, controlled ventilation with attention to peak airway pressures after reduction of intrathoracic contents, and hemodynamic management during potential tension physiology. Postoperative disposition is decided with the surgeon; many patients recover in a postanesthesia care unit (PACU) then to a surgical ward or intensive care unit if respiratory compromise or hemodynamic instability is anticipated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    00754

    Related Modifiers

    9 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…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    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…
    207RA0401XAddiction Medicine (Internal Medicine) PhysicianAn internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified b…
    111NP0017XPediatric ChiropractorThe Pediatric Chiropractor is a chiropractor with specialized, advanced training and certification in the evaluation, care and management of health an…
    224ZF0002XFeeding, Eating & Swallowing Occupational Therapy AssistantOccupational therapy assistants provide environmental modifications under the supervision of an occupational therapist. OTAs develop and implement an…
    246ZI1000XMedical IllustratorNone
    208U00000XClinical Pharmacology PhysicianClinical pharmacology encompasses the spectrum of activities related to the discovery, development, regulation, and utilization of safe and effective …
    2278C0205XCritical Care Certified Respiratory TherapistRespiratory emergencies are commonplace in the treatment of critical care patients. Included in the assessment measurements conducted by the respirat…

    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-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-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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    Anesthesia for procedures on the upper abdomen
    Alternative or adjacent anesthesia code for procedures involving the upper abdominal cavity; may be used for upper abdominal components of the operation depending on exact surgical site.
    00752Anesthesia for procedures on the upper abdomenRelated upper abdominal anesthesia code; selection depends on exact operative field and coding guidelines.
    00770Anesthesia for procedures on the upper abdomenAnother upper abdominal anesthesia code used for procedures involving the diaphragm and upper abdominal organs; used per anesthesia coding conventions based on surgical documentation.