CPT 10040 Fee Schedule
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 | • Surgery • Surgical Procedures on the Integumentary System |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Low |
National average reimbursement for CPT 10040 by major payers:
$121.00
$132.96
$140.15
$182.40
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 10040 | ||||||
United | 10040 | $200.00 | 1194271338 - CONROE ASC, LP, COLLEGE PARK HEART & VASCULAR SURGERY CENTER | 471450737 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $80.00 | 1932298718 - OUTPATIENT SERVICES EAST | 630888861 - (AL) OUTPATIENT SERVICES EAST LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $800.00 | 1619166097 - GPDDC, LLC | 43769350 - (NY) GPDDC, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $110.00 | 1225517279 - ORLANDO OUTPATIENT SURGERY CENTER LLC | 821372628 - (FL) ORLANDO OUTPATIENT SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $124.00 | 1265437743 - REGIONAL UROLOGY ASC LLC | 721455456 - (LA) REGIONAL UROLOGY ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $168.00 | 1619557519 - SCOTTSDALE MULTISPECIALTY SURGERY CENTER, PARADISE VALLEY MULTI SPECIALTY SURGERY CENTER | 833515797 - (AZ) SCOTTSDALE MULTISPECIALTY SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $182.00 | 1194209437 - PRECISION SURGICAL CENTER OF NORTHWEST ARKANSAS, LLC | 830659399 - (AR) PRECISION SURGICAL CENTER OF NORTHWEST ARKANSAS LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $115.00 | 1518998764 - TENNESSEE PAIN SURGERY CENTER, LLC | 621790133 - (TN) TENNESSEE PAIN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $117.00 | 1568864452 - CARPUS SURGERY CENTER LLC | 471128977 - (GA) CARPUS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $1250.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $250.00 | 1679656714 - LITTLETON DAY SURGERY CENTER LLC | 232731319 - (CO) LITTLETON DAY SURGERY CENTER | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $2347.00 | 1548844400 - SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | 863451115 - (KS) SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $125.00 | 1326494147 - CENTER FOR SPINE & PAIN MEDICINE PC, CSPM GAINESVILLE ASC | 341976829 - CENTER FOR SPINE AND PAIN MEDICI | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $64.00 | 1710032842 - MSC AMBULATORY SURGICAL CENTER | 202155076 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10040 | $163.00 | 1275501512 - NORTHWEST KANSAS SURGERY CENTER, LLC | 481209668 - (KS) NORTHWEST KANSAS SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 10040 vs. Other Surgical Procedures on the Integumentary System Codes
The CPT 10040 code is part of the Surgery services used for Surgical Procedures on the Integumentary System. 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 10040 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.
| Code | Complexity | Description |
|---|---|---|
| 10030-CPT | Moderate | Soft Tissue Fluid Collection Drainage By Image-Guided Catheter Such As Drainage Of An Absess Of The Neck, Abdominal Wall Or Extremity. Includes Moderate Sedation And Guidance |
| 10035-CPT | Moderate | Placement Of Soft Tissue Localization Device(S) (Eg Clip Metallic Pellet Wire/Needle Radioactive Seed(S) Percutaneous Including Imaging Guidance; First Lesion. |
| 10036-CPT | Moderate | Placement Of Soft Tissue Localization Device(S) (Eg, Clip, Metallic Pellet, Wire/Needle, Radioactive Seeds), Percutaneous, Including Imaging Guidance; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 10040-CPT | Low | Acne Surgery |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 10040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10040 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.
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