Summary & Overview
CPT 00750: Anesthesia for Upper Abdominal Hernia Repair
Headline: CPT 00750: Anesthesia for Upper Abdominal Hernia Repair
Lead: CPT 00750 designates anesthesia services for hernia repairs in the upper abdomen when no more specific code applies. This anesthesia CPT matters because it defines billing and clinical reporting for a common operative category performed in inpatient hospital settings and influences coding consistency across payers nationally.
What this code represents and why it matters: CPT 00750 identifies anesthesia care for upper abdominal hernia repair procedures where the clinical presentation does not match more specific hernia repair anesthesia codes. Accurate use affects claims processing, provider documentation, and payer adjudication and supports consistent capture of anesthesia workload for surgical services.
Key payers covered: The analysis addresses coverage and billing considerations for Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
Overview of reader takeaways: Readers will find a concise summary of the code’s clinical scope and common billing contexts, comparisons to related anesthesia CPTs for upper abdominal procedures, typical site-of-service expectations, and common modifiers used in anesthesia practice. The publication highlights mapping to anesthesia service lines and clinical contexts relevant to perioperative care. Where specific operational or payer policy details are required, the publication directs readers to payer policy references or facility billing departments.
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CPT Code Overview
CPT 00750 describes anesthesia for hernia repairs in the upper abdomen, not otherwise specified. This code is used for anesthesia services provided during surgical repair of upper abdominal hernias. The service type is Anesthesia, and the typical site of service is Inpatient Hospital (POS 21).
Clinical & Coding Specifications
A 62-year-old patient is admitted to the inpatient hospital for repair of an upper abdominal hernia. The patient has a history of cerebrovascular disease with carotid artery stenosis and presents with a symptomatic ventral/epigastric hernia causing pain and bowel obstruction risk. Preoperative evaluation includes anesthesia assessment, review of vascular comorbidities, and perioperative planning for hemodynamic monitoring. In the operating room, an anesthesia team provides general or regional anesthesia appropriate for an upper abdominal hernia repair; documentation of airway management, anesthetic agents, monitoring, and intraoperative events is completed in the anesthesia record. Postoperative handoff to the surgical and inpatient teams includes analgesia plan and monitoring instructions in the PACU and during hospital stay.
Modifiers:
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QS: Monitored anesthesia care service. Use when monitored anesthesia care (MAC) is provided for the procedure and the documentation supports MAC rather than general anesthesia. -
QX: CRNA service with medical direction by a physician. Use when a Certified Registered Nurse Anesthetist provides the anesthesia services under the medical direction of a physician and documentation meets payer criteria for medical direction.
Associated provider taxonomies:
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207L00000X: Anesthesiology — physicians credentialed in anesthesiology who provide anesthesia management and medical direction. -
367H00000X: Anesthesiologist Assistant — advanced practice providers who assist anesthesiologists in the delivery of anesthesia under supervision. -
367500000X: Certified Registered Nurse Anesthetist — CRNAs who deliver anesthesia services and may practice with or without physician direction depending on state law and facility policy.
I65.21 - Occlusion and stenosis of right carotid artery
Clinical relevance: Carotid artery stenosis indicates cerebrovascular disease and increased perioperative stroke risk; anesthesia documentation should note cerebrovascular status and hemodynamic management considerations.
I65.22 - Occlusion and stenosis of left carotid artery
Clinical relevance: Left carotid stenosis similarly informs perioperative risk stratification and monitoring during anesthesia for upper abdominal hernia repair.
I65.23 - Occlusion and stenosis of bilateral carotid arteries
Clinical relevance: Bilateral carotid disease increases cerebrovascular risk and may influence anesthetic technique and intraoperative blood pressure targets.
I65.29 - Occlusion and stenosis of unspecified carotid artery
Clinical relevance: When laterality is not specified, this code denotes carotid artery disease relevant to perioperative risk and anesthesia planning.
I66.9 - Occlusion and stenosis of unspecified cerebral artery
Clinical relevance: Cerebral artery occlusion or stenosis indicates cerebrovascular compromise that affects perioperative management and monitoring during anesthesia for hernia repair.
00752 - Anesthesia for hernia repairs in the upper abdomen, including lumbar and ventral or incisional hernia and/or wound dehiscence.
This code covers similar upper abdominal hernia repairs that explicitly include lumbar, ventral, or incisional hernias; it can be used as an alternative when the procedure documentation specifies those hernia types.
00754 - Anesthesia for hernia repair in the upper abdomen for an omphalocele.
This code applies when the upper abdominal hernia repair specifically involves an omphalocele; it is an alternative when the operative note documents that diagnosis.
00756 - Anesthesia for transabdominal repair of a diaphragmatic hernia.
This code applies when the surgical approach is transabdominal repair of a diaphragmatic hernia; it is used instead of 00750 when the procedure is a diaphragmatic hernia repair. Codes commonly used together or as alternatives: the listed codes represent closely related anesthesia services for different anatomic hernia types or specific surgical approaches; selection depends on the specific hernia type and operative technique documented in the surgical record.
National Reimbursement Benchmarks
National mean commercial rates substantially exceed Medicare's mean when compared to the average commercial benchmark (BUCA). BUCA's mean rate of $139.16 is higher than Medicare's reported mean of $0.00 in the input, while several commercial payers (Cigna, BCBS, Aetna) have mean rates well above BUCA, with Cigna highest at $249.84.
Rate dispersion (P75 − P25) varies across payers. Cigna shows one of the widest dispersions (348.00 − 90.00 = $258.00), indicating broad variability. Aetna also shows wide dispersion (327.50 − 42.00 = $285.50). UnitedHealth Group (UHC) is the tightest (76.00 − 50.33 = $25.67). Blue Cross Blue Shield and BUCA show moderate dispersion at $118.25 and $153.75 respectively. The table and chart below present the full breakdown.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a substantial rate spread for CPT code 00750, with Blue Cross Blue Shield's 75th percentile rate at $300.00 and UnitedHealth Group's 25th percentile at $72.00, resulting in a spread of $228.00. This wide variation highlights significant differences in reimbursement levels among payers within the state. Compared to national averages, Alaska's mean rates for most payers are either above or below the national benchmarks, with Blue Cross Blue Shield notably higher and UnitedHealth Group slightly above its national mean.
The table and chart below present the full breakdown of mean rates and percentile values for Aetna, Blue Cross Blue Shield, Cigna, and UnitedHealth Group in Alaska, providing a clear view of payer-specific reimbursement patterns for CPT code 00750.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 00750 in Alaska, with a mean rate of $269.15.
- UnitedHealth Group offers the lowest mean rate at $75.12, significantly below both the state and national averages.
- The rate spread in Alaska is notably wider than the national average, indicating greater variability in payer reimbursement.
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