CPT 00797 Fee Schedule
Last Updated: August 2025
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Anesthesia • Anesthesia for Procedures on the Upper Abdomen |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus-Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • P3 - A patient with severe systemic disease • None • AA - Anesthesia services performed personally by an anesthesiologist |
| Complexity Level | Moderate |
National average reimbursement for CPT 00797 by major payers:
$439.99
$54.15
$441.53
$88.68
Find Fee Schedule & Reimbursement for Other Codes
Use our free lookup tool to explore fee schedules and reimbursement rates for any billing code. Select a code type, then type or select a code to view its details.
Related Codes
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 00797. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00797 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
CPT 00797 vs. Other Anesthesia for Procedures on the Upper Abdomen Codes
The CPT 00797 code is part of the Anesthesia services used for Anesthesia for Procedures on the Upper Abdomen. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 00797 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| CPT Code | Complexity Level | Description |
|---|---|---|
| 00752 | Moderate | Anes Hernia Rep Up Abd; Lumb/Vent/ Wound |
| 00754 | Moderate | Anes Hernia Rep Up Abd; Omphacele |
| 00790 | Moderate | Anes Intraperitoneal Inc Shunts; Nos |
| 00797 | Moderate | Anesthesia For Intraperitoneal Procedures In Upper Abdomen Including Laparoscopy; Gastric Restrictive Procedure For Morbid Obesity |
See what providers are getting paid in 2025 for 00797:
CPT 00797 Fee Schedule & Reimbursement Rates
The CPT 00797 fee schedule varies by payer type. Below are Medicare rates for 2025 and average in-network rates by state across major payers:
| Code | Medicare Rate | Avg. BCBS National Rate | More Info |
|---|---|---|---|
| 00752 | $265.33 | ||
| 00754 | $272.08 | ||
| 00790 | $306.65 | ||
| 00792 | $466.82 | ||
| 00796 | $944.69 | ||
| 00797 | $439.99 |
Reimbursement rates depend on provider contracts, region, and payer. Always verify rates with your insurance provider or medical billing department.
What is Price Transparency?
The Price Transparency Rule is a federal law that took effect in July 2022, requiring all commercial payers to publicly disclose their prices through machine-readable files (MRFs). This landmark regulation mandates that insurance companies make healthcare costs transparent to the public.
Our data comes directly from these insurer-posted MRFs, ensuring compliance with the Price Transparency Rule. While PayerPrice is working toward a future where providers and payers collaborate for 100% upfront price certainty, it's important to acknowledge that data limitations and occasional errors may exist.
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