CPT 00790
Anesthesia for upper abdominal surgery
The anesthesia code used for many operations inside the upper abdomen, including gallbladder removal and some hernia repairs. It has a fixed number of base units, and the rest of the charge is time.
Billed to Medicare
$2,466
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$239
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
10.3x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 367,807 services.
Among the 4 anesthesia codes on this site with CMS figures, this gap ranks 3 of 4 (median 10.3x). The widest is Anesthesia for total hip replacement at 10.7x.
Where this line goes wrong
Check the minutes
The anesthesia record's start and stop times set the time units. Anesthesia time is often shorter than operating room time, so if the two are identical the anesthesia time may have been copied from the OR record.
Medical direction modifiers
When an anesthesiologist supervises a nurse anesthetist, each bills part of the fee with a modifier and the total should equal one service. Two full charges for one case is double billing.
Check it, then ask
- 1
Ask for the anesthesia record. It shows the anesthesia start and stop times, which should match the minutes billed.
- 2
Check the modifier on the anesthesia line: AA means an anesthesiologist did it personally, QK or QY means the anesthesiologist directed a nurse anesthetist, QZ means the nurse anesthetist worked alone. Two full-price bills for the same case (one AA, one QZ) is an error.
- 3
Compare the anesthesia bill with the hospital's 0370 line and the operating room times for the same date.
- 4
If you were out of network for the anesthesiologist at an in-network facility, the No Surprises Act limits what you can be billed to your in-network cost sharing.
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Codes that travel with this one
People also ask
How is the anesthesia fee calculated?
Base units for the procedure code, plus one unit for each 15 minutes of anesthesia time, multiplied by the provider's conversion factor. Medicare publishes its own conversion factor by locality; commercial rates are higher.
Sources
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.