How much does Medicare pay for CPT 00830?

Medicare allowed an average of $137.91 per service and paid $107.40 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1633.52, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 00830?

Anesthesia for other repair of lower abdomen hernia (1 year or older). It was billed 2,992 times to 2,983 Medicare beneficiaries by 199 providers in 2024.

Does 00830 pay differently in an office than a hospital?

Yes. The allowed amount averaged $97.66 in an office setting and $138.17 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 00830 most?

Anesthesiology, with 2,125 services from 142 clinicians. Next are Certified Registered Nurse Anesthetist (CRNA), Critical Care (Intensivists), Internal Medicine.

CPT 00830

Anesthesia for other repair of lower abdomen hernia (1 year or older)

$137.91Medicare-allowed amount per service, averaged across 2,992 services

Providers submitted

$1633.52

Asking price, not received

Medicare allowed

$137.91

The fee schedule figure

Medicare paid

$107.40

Balance is patient coinsurance

Providers submitted an average of $1633.52 for this code and Medicare allowed $137.91 — 11.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $107.40 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $97.66
Hospital / facility: $138.17

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 19 services were billed in an office setting and 2,973 in a facility.

Services: 2,992
Beneficiaries: 2,983
Providers billing it: 199
Total allowed: $412,627

What Medicare pays for CPT 00830

Across 2,992 services billed by 199 providers to 2,983 beneficiaries, Medicare allowed an average of $137.91 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 00830

Specialty	Services	Beneficiaries	Avg allowed	Providers
Anesthesiology	2,125	2,116	$143.25	142
Certified Registered Nurse Anesthetist (CRNA)	830	830	$123.37	54
Critical Care (Intensivists)	13	13	$233.35	1
Internal Medicine	12	12	$120.79	1
Anesthesiology Assistant	12	12	$112.19	1

00830 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	352	$112.49	$84.41	19
New York	326	$176.65	$123.64	21
Pennsylvania	318	$110.14	$85.16	18
Massachusetts	261	$140.61	$105.87	17
Maryland	232	$127.80	$96.68	16
California	200	$202.08	$153.09	14
New Jersey	174	$115.64	$84.28	14
South Carolina	117	$94.79	$75.34	8
Illinois	112	$129.09	$96.43	9
North Carolina	82	$114.92	$91.31	6
Virginia	73	$108.21	$85.04	5
Tennessee	69	$101.93	$73.80	4
Texas	68	$184.03	$144.09	5
Arizona	55	$196.20	$150.23	4
Vermont	53	$122.26	$93.56	4
Alabama	50	$81.99	$70.78	4
Indiana	43	$128.58	$84.93	3
Louisiana	41	$100.10	$79.99	2
Georgia	39	$95.61	$73.90	3
Nevada	38	$208.38	$168.86	2
Ohio	35	$140.26	$110.54	3
Wisconsin	31	$107.25	$90.63	2
New Hampshire	27	$194.00	$154.13	2
Wyoming	23	$263.05	$187.11	2
Connecticut	19	$150.96	$115.09	1
Maine	17	$251.38	$188.32	1
New Mexico	16	$184.55	$147.77	1
Delaware	16	$190.55	$154.58	1
Michigan	16	$163.93	$118.05	1
Idaho	14	$189.62	$153.10	1
Missouri	14	$152.11	$114.59	1
Washington	13	$233.35	$186.05	1
Rhode Island	13	$107.17	$84.03	1
Arkansas	12	$84.95	$75.22	1
Utah	12	$166.97	$120.58	1
Colorado	11	$86.42	$65.92	1

Related codes

00811Anesthesia for other procedure on large bowel$99.16
00812Anesthesia for exam of colon$82.06
00813Anesthesia for procedure on small and large bowel$125.41
00840Anesthesia for other procedure on lower abdomen$197.81
00873Anesthesia for shock wave therapy for urinary system stones without wa$129.00
00865Anesthesia for extensive removal of prostate$273.52
00860Anesthesia for other procedure on lower abdomen outside abdominal cavi$170.50
00862Anesthesia for procedure on upper urinary tubes or removal of kidney f$283.02
00880Anesthesia for other procedure on large blood vessel of lower abdomen$445.90

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.