Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Lower AbdomenCPT cpt-00834-infant-lower-abdomen-hernia-anesthesia
    Ask Trek AI about this page

    CPT 00834: Anesthesia for Infant Lower Abdominal Hernia Repair

    Commercial payers pay $75 on average nationally for this procedure.

    CPT code 00834 describes anesthesia services provided for repair of a lower abdominal hernia in an infant younger than one year of age; the service is anesthesia for hernia repair procedures not otherwise specified for this anatomic region, typically delivered in an operating room or surgical suite and documented as intraoperative anesthesia care for pediatric patients.

    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.

    Customize your policy alerts

    Sign up for cpt 00834 policy alerts

    Get alerted when payer policies referencing 00834 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    National Reimbursement Benchmarks

    National commercial reimbursement for CPT 00834 centers around BUCA’s average commercial rate of $75.40, with individual payers showing meaningful variation. Cigna and Aetna sit above BUCA on mean rates at $96.50 and $78.00 respectively, while Blue Cross Blue Shield averages $70.10 and UnitedHealth Group averages $67.40. Cigna’s higher mean is accompanied by a relatively broad upper tail (P90 $159.20), reflecting higher-priced outliers versus other payers.

    Measuring dispersion as P75 minus P25 highlights differences in rate spread: Blue Cross Blue Shield has a spread of $36.90 (from $51.30 to $92.00), UnitedHealth Group is the tightest with a spread of $28.90 (from $52.00 to $80.90), and Aetna’s spread is $52.90 (from $42.00 to $96.09), making it the widest among payers listed. Cigna’s spread is $58.60 (from $68.40 to $125.00), also indicating substantial variability around its higher mean.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools
    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 6-month-old male presents for elective repair of a unilateral inguinal hernia (K40.90). The pediatric surgeon schedules an open inguinal herniorrhaphy under general anesthesia. Preoperative evaluation in the pediatric pre‑op clinic documents a full-term birth, ASA Physical Status P1, normal airway exam, and no significant comorbidities. In the operating room the pediatric anesthesiology team (taxonomy 207LP2900X) performs induction via mask with inhalational agents, secures intravenous access, administers weight‑based antibiotics, and provides endotracheal intubation for airway protection. Intraoperative monitoring includes standard ASA monitors, temperature regulation, and neonatal-sized equipment. Anesthesia time covers induction, maintenance during the lower abdominal/inguinal repair, and emergence until transfer to the post anesthesia care unit (PACU). The anesthesia service is reported with 00834 because the patient is a child younger than 1 year undergoing repair of a lower abdominal hernia not otherwise specified by other anesthesia codes. Typical site of service is an ambulatory surgery center or hospital operating room. Postoperative care includes PACU recovery with monitoring for airway patency, analgesia management, and discharge planning for outpatient follow‑up with the pediatric surgeon.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    10 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…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    P1Modifier P1 indicates an ASA Physical Status I — a normal healthy patient — and is appended to anesthesia CPT codes (00100–01999) based on the anesthesiologist’s clinical assessment. It documents the…- When to apply: Use modifier P1 on anesthesia CPT codes (00100–01999) when the anesthesia provider assigns ASA Physical Status I — a normal healthy patient (non‑smoker, minimal or no alcohol use).…
    P2Modifier P2 denotes an ASA Physical Status II — a patient with mild systemic disease. Per AMA/AAPC, examples include well-controlled hypertension or diabetes, mild obesity (BMI 30–40), current smoker…- When to use: Append modifier -P2 to anesthesia CPT codes (00100–01999) when the anesthesia provider documents the patient has mild systemic disease (ASA Physical Status II) — for example…

    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…
    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…
    207LA0401XAddiction Medicine (Anesthesiology) PhysicianAn anesthesiologist who specializes in the diagnosis and treatment of addictions.
    363LC1500XCommunity Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    207RG0100XGastroenterology PhysicianAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
    376J00000XHomemakerAn individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly respo…
    163WH1000XHospice Registered NurseNursing Service Providers · Registered Nurse
    163WE0900XEnterostomal Therapy Registered NurseNursing Service Providers · Registered Nurse

    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-00800-LOWER-ANTERIOR-ABDOMINAL-WALL-ANESTHESIA

    CPT 00800: Anesthesia for Lower Anterior Abdominal Wall Procedures

    CPT-00802-PANNICULECTOMY-LOWER-ANTERIOR-ABDOMINAL-WALL-ANESTHESIA

    CPT 00802: Anesthesia for Panniculectomy, Lower Anterior Abdominal Wall

    CPT-00811-ANESTHESIA-LOWER-INTESTINAL-ENDOSCOPY

    CPT 00811: Anesthesia for Lower Intestinal Endoscopic Procedure Pre-Duodenal

    CPT-00812-ANESTHESIA-COLONOSCOPY-BELOW-DUODENUM

    CPT 00812: Anesthesia for Colonoscopy Accessing Intestines Below Duodenum

    CPT-00813-ANESTHESIA-COMBINED-UPPER-LOWER-INTESTINAL-ENDOSCOPY

    CPT 00813: Anesthesia for Combined Upper and Lower Intestinal Endoscopy

    CPT-00820-ANESTHESIA-LOWER-POSTERIOR-ABDOMINAL-WALL-PROCEDURES

    CPT 00820: Anesthesia for Lower Posterior Abdominal Wall Procedures

    CPT-00830-LOWER-ABDOMINAL-HERNIA-ANESTHESIA-UNSPECIFIED

    CPT 00830: Anesthesia for Lower Abdominal Hernia Repair, Unspecified

    CPT-00832-ANESTHESIA-LOWER-ABDOMEN-HERNIA-REPAIR

    CPT 00832: Anesthesia for Lower Abdominal Hernia Repair

    CPT-00836-ANESTHESIA-INFANT-LOWER-ABDOMINAL-HERNIA-REPAIR

    CPT 00836: Anesthesia for Infant Lower Abdomen Hernia Repair

    CPT-00840-LOWER-ABDOMEN-INTRAPERITONEAL-ANESTHESIA-LAPAROSCOPY

    CPT 00840: Anesthesia for Lower Abdominal Intraperitoneal Procedures

    Showing 1–10 of 26

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    00830
    Anesthesia for hernia repairs in lower abdomen; not otherwise specified
    Alternative anesthesia code for lower abdominal hernia repairs when patient age/other specifics differ from 00834.
    00832Anesthesia for hernia repairs in lower abdomen; ventral and incisional herniasUse when the hernia is ventral or incisional rather than inguinal; distinguishes procedure type for anesthesia reporting.
    00836Anesthesia for hernia repairs in the lower abdomen not otherwise specified, infants younger than 37 weeks gestational age at birth and younger than 50 weeks gestational age at time of surgeryUse for premature or very young infants meeting gestational age criteria instead of 00834.