Summary & Overview
CPT 00794: Anesthesia for Partial or Total Pancreatectomy
CPT 00794 represents anesthesia services provided for major upper abdominal operations on the pancreas, including partial or total pancreatectomy and laparoscopic Whipple procedures. This code is important nationally because it captures complex anesthetic management for high-risk, resource-intensive surgeries that influence perioperative workflows, billing classifications, and hospital case-mix metrics. Payers commonly involved in coverage for these services include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
Readers will find in this publication a succinct overview of clinical context for CPT 00794, how the code fits within anesthesiology service lines, and comparisons to related anesthesia codes for hepatobiliary and transplant procedures. The content highlights coding definitions, typical sites of service, common billing modifiers used alongside anesthesia claims, and the clinical scenarios that generate use of this code. The material also outlines practical considerations for documentation and claim submission clarity, and summarizes related CPT references to help users distinguish closely related anesthesia codes. Data not available in the input is noted where applicable.
CPT Code Overview
CPT 00794 covers anesthesia services for procedures on the upper abdomen specifically for partial or total pancreatectomy, including laparoscopic approaches (commonly referenced as the Whipple procedure). This code reflects anesthesiology services associated with major abdominal surgery on the pancreas.
Service Type: Anesthesiology
Typical Site of Service: Hospital or Ambulatory Surgical Center (likely POS 21/24)
Clinical & Coding Specifications
Clinical Context
A typical adult patient is scheduled for partial or total pancreatectomy (including laparoscopic Whipple procedure) under general anesthesia. The patient presents with a pancreatic mass requiring resection; preoperative assessment includes history, physical exam, airway evaluation, review of comorbidities (cardiopulmonary disease, diabetes, coagulation status), and informed consent for anesthetic care. On the day of surgery the anesthesia team performs standard monitoring, IV access, induction of general anesthesia, endotracheal intubation, intraoperative hemodynamic and analgesic management, and coordinate perioperative ventilatory and fluid management. Postoperatively the patient is transferred to the post-anesthesia care unit (PACU) or intensive care unit as indicated for recovery, pain control, and ongoing hemodynamic monitoring.
Coding Specifications
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Modifiers
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QS: Indicates monitored anesthesia care service. Use when anesthesia services meet criteria for monitored anesthesia care rather than general anesthesia. -
QX: Indicates a Certified Registered Nurse Anesthetist (CRNA) service performed under medical direction by a physician. Use when a CRNA provides services with physician medical direction as defined by payer rules. -
Provider Taxonomies
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207L00000X: Anesthesiology — physicians specializing in perioperative anesthesia and pain management. -
207LA0401X: Anesthesiology Assistant — non-physician anesthesia providers who assist anesthesiologists under supervision. -
367500000X: Certified Registered Nurse Anesthetist — advanced practice nurses providing anesthesia services.
Related Diagnoses
H25.9— Unspecified age-related cataract
Clinical relevance: Represents lens opacity unrelated to pancreatic surgery; not typically related to 00794 but listed in the input.
H26.9— Unspecified cataract
Clinical relevance: General cataract diagnosis; not directly related to pancreatic procedures.
H27.00— Aphakia, unspecified eye
Clinical relevance: Absence of the lens of the eye; not directly related to anesthesia for pancreatic surgery.
H28— Cataract in diseases classified elsewhere
Clinical relevance: Cataract secondary to systemic disease; not directly related to upper abdominal anesthesia.
H52.4— Presbyopia
Clinical relevance: Age-related near vision impairment; not directly related to 00794.
Related CPT Codes
00792— Anesthesia for partial hepatectomy or management of liver hemorrhage (includes laparoscopy; does not include liver biopsy).
Explanation: Used for anesthesia services for liver resections or hemorrhage control; relates clinically as an alternative for major upper abdominal hepatic procedures in the same anatomical region and may be used in workflows where hepatic resection is performed instead of or in conjunction with pancreatic procedures.
00796— Anesthesia for liver transplant, including laparoscopic services.
Explanation: Used for anesthesia care for liver transplantation; relates clinically as an alternative for complex upper abdominal transplant procedures and in workflows involving multiorgan abdominal surgery where transplant-level anesthetic considerations apply.
Common usage notes: These codes are related by anatomical site (upper abdomen) and complexity. They may be used alternatively depending on the primary organ/procedure being addressed; they are not additions to 00794 for the same primary procedure but may appear in the same patient’s record when separate qualifying procedures on different organs are performed.
National Reimbursement Benchmarks
National commercial mean rates exceed Medicare's typical reimbursement for this CPT by a wide margin when using BUCA (the average commercial benchmark) as the commercial reference point; BUCA's mean rate is $230.84 compared with Medicare, for which no mean rate was provided in the input. Blue Cross Blue Shield, Cigna, and Aetna show substantially higher mean rates than BUCA, while UnitedHealth Group's mean sits well below BUCA.
Rate dispersion (P75 minus P25) varies notably across payers. Cigna and Aetna demonstrate wide dispersion (Cigna P75–P25 ≈ $604.18; Aetna P75–P25 = $500.00), indicating broader variability in accepted rates. UnitedHealth Group and BUCA exhibit the tightest distributions (UHC P75–P25 ≈ $25.29; BUCA P75–P25 ≈ $279.58), with UHC being the tightest. The table and chart below present the full percentile and mean breakdown for each payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska demonstrates a significant spread in reimbursement rates for CPT code 00794, with Blue Cross Blue Shield showing the widest range between the 25th and 75th percentiles ($173.40), while Aetna and UnitedHealth Group have minimal spread ($0 to $4). This indicates that some payers in Alaska maintain consistent rates, while others, particularly Blue Cross Blue Shield and BUCA, offer a broader range of payments. Compared to national averages, Alaska's mean rates for most payers are substantially higher, especially for Blue Cross Blue Shield and BUCA, highlighting a premium in the state's reimbursement landscape.
The table and chart below present the full breakdown of mean rates and percentile values by payer for Alaska, providing a clear comparison across the major commercial insurers.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 00794, with a mean rate of $513.57.
- UnitedHealth Group offers the lowest mean rate at $75.12.
- Alaska's mean rates for most payers are notably higher than national averages, especially for Blue Cross Blue Shield and BUCA.
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