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    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Lower AbdomenCPT cpt-00836-anesthesia-infant-lower-abdominal-hernia-repair
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    CPT 00836: Anesthesia for Infant Lower Abdomen Hernia Repair

    Commercial payers pay $72 on average nationally for this procedure.

    CPT code 00836 describes anesthesia services for repair of a hernia in the lower abdomen for an infant born at fewer than 37 weeks gestational age and younger than 50 weeks gestational age at the time of surgery, typically representing general anesthesia for neonatal hernia repair procedures performed in an operating room or pediatric surgical suite; this code applies to procedures not otherwise specified by other anesthesia codes and is used when providing intraoperative anesthetic management for lower abdominal hernia repairs in this neonatal population.

    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 00836 center around BUCA’s mean of $71.9, with notable variation among major carriers. Cigna posts the highest mean at $95.3 and a wide upper spread, while Blue Cross Blue Shield (BCBS) and UnitedHealth Group sit closer to BUCA’s level with means of $69.0 and $67.3 respectively. Aetna’s mean of $61.8 is the lowest among these payers but still within the broader commercial range.

    Dispersion (P75 minus P25) highlights differences in contract consistency: Cigna’s dispersion is $56.4 (P75 $123.2 minus P25 $68.0), the widest, indicating greater variability in higher-end reimbursements. Blue Cross Blue Shield’s dispersion is $47.9, BUCA’s is $37.1, UnitedHealth Group’s is $28.8, and Aetna’s is the tightest at $37.2 (P75 $79.2 minus P25 $42.0). These differences reflect where commercial reimbursement is most and least variable.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 6-week-old infant born at 35 weeks gestational age presents for elective repair of a congenital inguinal hernia. The infant is now 6 weeks postnatal age (younger than 50 weeks post-conceptual age) and requires general endotracheal anesthesia for open bilateral inguinal hernia repair. Preoperative evaluation is performed in the pediatric preoperative clinic, including review of neonatal course (apnea of prematurity), current weight, feeding schedule, and medications. The anesthesia team documents preoperative risk classification (e.g., P3 if significant comorbidity), plans airway management with appropriately sized endotracheal tube, and prepares thermoregulation and neonatal monitoring.

    On the day of surgery the patient is transported to the pediatric operating room. Standard monitors (ECG, pulse oximetry, noninvasive blood pressure, end-tidal CO2, temperature) are applied. Intravenous access is obtained; induction is performed with inhalational or intravenous agents per pediatric anesthesiology standards. The anesthesiologist provides intraoperative management including maintenance anesthesia, fluid management, and perioperative analgesia (regional block or local infiltration as appropriate). At procedure end the patient is extubated when criteria are met and transferred to the post-anesthesia care unit (PACU) or neonatal intensive care unit (NICU) depending on stability and prematurity-related needs. Documentation includes anesthesia start and stop times, airway technique, monitored parameters, intraoperative events, and justification for any applicable modifiers (for example 23 for unusual anesthesia circumstances).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    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…
    P3Modifier P3 denotes that the anesthesia patient has severe systemic disease (ASA III). It applies only to anesthesia CPT codes (00100–01999) and must be appended by the anesthesia provider with…- Applies only to anesthesia procedure codes (CPT 00100–01999) and should be appended by the anesthesia provider when the patient meets the definition of "severe systemic disease" (CPT/AAPC P3;…
    P4Modifier P4 indicates the patient is ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life. It is assigned by the anesthesia provider and must be supported…- When to apply: Use modifier P4 only on anesthesia CPT codes (00100–01999) to indicate ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life (examples:…
    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…
    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…
    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…
    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.
    2085N0904XNuclear Radiology PhysicianA radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the admi…
    207SG0202XClinical Biochemical Genetics PhysicianA clinical biochemical geneticist demonstrates competence in performing and interpreting biochemical analyses relevant to the diagnosis and management…
    1041C0700XClinical Social WorkerA social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of p…
    163WX0002XHigh-Risk Obstetric Registered NurseNursing Service Providers · Registered Nurse
    313M00000XNursing Facility/Intermediate Care FacilityAn institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related …

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    K40.00Bilateral inguinal hernia, with obstruction, without gangrene, not specified as recurrent
    K40.10Bilateral inguinal hernia, with gangrene, not specified as recurrent
    K40.20Bilateral inguinal hernia, without obstruction or gangrene, not specified as recurrent
    K40.30Unilateral inguinal hernia, with obstruction, without gangrene, not specified as recurrent
    K40.90Unilateral inguinal hernia, without obstruction or gangrene, not specified as recurrent
    K41.20Bilateral femoral hernia, without obstruction or gangrene, not specified as recurrent
    K41.90Unilateral femoral hernia, without obstruction or gangrene, not specified as recurrent
    K42.9Umbilical hernia without obstruction or gangrene
    K43.2Incisional hernia without obstruction or gangrene
    K43.9Ventral hernia without obstruction or gangrene

    Showing 1–10 of 25

    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-00834-INFANT-LOWER-ABDOMEN-HERNIA-ANESTHESIA

    CPT 00834: Anesthesia for Infant Lower Abdominal 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.
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    00834Anesthesia for hernia repairs in lower abdomen (child younger than 1 year of age)Alternative anesthesia code used specifically for infants under one year undergoing lower abdominal hernia repair; select based on payer and coding guidelines.
    00840Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopyUsed when the hernia repair is performed intraperitoneally or laparoscopically; affects base anesthesia code selection.