Summary & Overview
CPT 00796: Anesthesia for Liver Transplant (Recipient)
CPT code 00796 represents anesthesia for intraperitoneal procedures in the upper abdomen, specifically for liver transplant recipients. This code is significant nationally due to the complexity and critical nature of liver transplantation, which requires advanced anesthesiology care in hospital inpatient settings. The publication covers key payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, providing a comprehensive overview of payer coverage and policy considerations for this high-acuity service.
Readers will gain insights into clinical benchmarks, policy updates, and billing practices relevant to anesthesia for liver transplant procedures. The summary includes an overview of associated modifiers, provider taxonomies, and related CPT codes, offering context for coding and reimbursement. Additionally, common ICD-10 diagnoses linked to this code are highlighted, supporting accurate clinical documentation and coding. The publication is designed to inform healthcare professionals, administrators, and policy analysts about the latest developments and requirements for reporting anesthesia services for liver transplantation.
CPT Code Overview
CPT code 00796 is used to report anesthesia services for intraperitoneal procedures in the upper abdomen, specifically for liver transplant (recipient) surgeries. This code falls under the anesthesiology service type and is most commonly utilized in the hospital inpatient setting, such as Place of Service 21. The procedure involves complex anesthesia management for patients undergoing liver transplantation, requiring specialized expertise and resources in acute care environments.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves a patient admitted to the hospital inpatient setting for a liver transplant due to end-stage liver disease or acute liver failure. The procedure is performed in the upper abdomen and requires intraperitoneal access, often via laparoscopy. The anesthesiology team provides anesthesia services throughout the surgery, ensuring patient safety and comfort. The clinical workflow includes preoperative assessment, induction and maintenance of anesthesia, intraoperative monitoring, and postoperative care. The anesthesia provider may be an anesthesiology physician or a certified registered nurse anesthetist (CRNA), sometimes with medical direction by a physician.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care rather than general anesthesia.QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia services under the medical direction of an anesthesiology physician.
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207L00000X | Anesthesiology Physician |
367500000X | Certified Registered Nurse Anesthetist (CRNA) |
207LA0401X | Pain Medicine (Anesthesiology) |
These taxonomies represent the specialties eligible to provide and bill for anesthesia services for liver transplant procedures.
Related Diagnoses
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K56.60: Unspecified intestinal obstruction- Relevant when a patient undergoing liver transplant has a history or presence of intestinal obstruction, which may complicate the surgical procedure.
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K65.9: Peritonitis, unspecified- Indicates inflammation of the peritoneum, which may be a comorbidity or complication requiring surgical intervention in the upper abdomen.
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N83.20: Unspecified ovarian cyst- May be an incidental finding or comorbidity in female patients undergoing upper abdominal surgery.
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K66.1: Hemoperitoneum- Presence of blood in the peritoneal cavity, which can be a complication or indication for surgery in the upper abdomen.
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K63.5: Polyp of colon- May be a concurrent diagnosis in patients undergoing abdominal surgery, though not directly related to liver transplant, it can affect surgical planning.
Each diagnosis code represents a potential clinical scenario or comorbidity relevant to patients undergoing intraperitoneal procedures in the upper abdomen, including liver transplant.
Related CPT Codes
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00792: Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; partial hepatectomy or management of liver hemorrhage (excluding liver biopsy)- Used for anesthesia during partial liver removal or management of liver bleeding, related to but distinct from liver transplant.
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00794: Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; pancreatectomy, partial or total (eg, Whipple procedure)- Used for anesthesia during pancreatic surgery, which may occur in similar anatomical regions as liver transplant but is a separate procedure.
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00797: Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; gastric restrictive procedure for morbid obesity- Used for anesthesia during bariatric surgery, also performed in the upper abdomen. This code is an alternative for cases involving gastric restrictive procedures rather than liver transplant.
These codes are related by anatomical region and surgical approach. They are alternatives or used in similar clinical workflows but are not typically billed together for the same procedure.
National Reimbursement Benchmarks
For CPT code 00796, national mean rates vary significantly between payers. The average commercial rate, represented by BUCA, is $591.07, while UnitedHealth Group's mean rate is notably lower at $65.58. Blue Cross Blue Shield and Cigna both report substantially higher mean rates, at $1,553.74 and $1,580.28 respectively. Aetna's mean rate is $792.52.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, is widest for Cigna ($2,504.31) and BCBS ($911.67), indicating greater variability in contracted rates. UnitedHealth Group shows the tightest range ($25.63), suggesting more consistent reimbursement levels. BUCA and Aetna also display considerable dispersion, with ranges of $986.78 and $1,588.00 respectively.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a wide range in reimbursement rates for CPT code 00796, with Blue Cross Blue Shield offering the highest mean rate and UnitedHealth Group the lowest. The rate spread, calculated as the difference between the 75th and 25th percentiles, is most pronounced for Blue Cross Blue Shield ($704.09), while Aetna, Cigna, and UnitedHealth Group show minimal spreads, indicating little variation in their payment rates. This suggests that Blue Cross Blue Shield and BUCA have more variability in their reimbursement, while the other payers are relatively consistent.
Compared to national averages, Blue Cross Blue Shield and BUCA in Alaska pay substantially more, whereas Cigna and UnitedHealth Group rates are well below their national benchmarks. The table and chart below present the full breakdown of payer-specific rates for Alaska, highlighting these differences and the overall landscape for CPT code 00796 in the state.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer for CPT 00796 in Alaska, with a mean rate of $1,859.16.
- UnitedHealth Group offers the lowest mean rate at $75.12.
- Cigna and UnitedHealth Group rates are significantly below their respective national averages, while Blue Cross Blue Shield's mean rate in Alaska is notably higher than the national mean.
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.