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See a sample rate comparisonCPT 39540 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Repair Of Diaphragm Injury, Surgery To Repair A Serious Injury To The Diaphragm That Pushes The Abdominal Contents Up Into The Chest Cavity. The Diaphragm Hole Is Patched Or Stitched Closed.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Mediastinum and Diaphragm |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | 51 - Multiple procedures GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $818.32 national non-facility rate (2026) · View Medicare rates for 39540 |
| Medicaid Fee Schedule | $639.81 median of the 8 states in the free preview · View Medicaid rates for 39540 |
National average reimbursement for CPT 39540 by major payers:
$1,051.12
$1,142.51
$1,132.16
$1,391.60
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CPT 39540
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Azle
$11,727.00Published rateWoodland Surgery Center LLC
Woodland Surgery Center, LLC
$1,383.00Published rateLongview Surgical Center LLC, Pacific Surgical Center
Longview Surgical Center, LLC
$821.00Published rateLakeside Surgery LLC, Lakeside Surgery Center
Lakeside Surgery Center, LLC
$450.00Published rateAmerican Access Care Of Towson Asc LLC
$150.00Published rate
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See a sample payer proposalCPT 39540 vs. Other Surgical Procedures on the Mediastinum and Diaphragm Codes
The CPT 39540 code is part of the Surgery services used for Surgical Procedures on the Mediastinum and Diaphragm. 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 39540 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 |
|---|---|---|
| 39503-CPT | High | Repair Of A Stomach Hernia, Surgery To Repair A Stomach Hernia. The Protruding Stomach Is Moved Back Into Place And The Opening In The Diaphragm Is Stitched Smaller. Mesh May Be Implanted To Hold The Tissue In Place. |
| 39540-CPT | High | Repair Of Diaphragm Injury, Surgery To Repair A Serious Injury To The Diaphragm That Pushes The Abdominal Contents Up Into The Chest Cavity. The Diaphragm Hole Is Patched Or Stitched Closed. |
| 39541-CPT | High | Repair Of Diaphragm Injury, Surgery To Repair A Serious Injury To The Diaphragm That Pushes The Abdominal Contents Up Into The Chest Cavity. The Diaphragm Hole Is Patched Or Stitched Closed. |
| 39560-CPT | Moderate | Partial Diaphragm Removal, Surgery To Remove A Portion Of The Diaphragm. The Remaining Sections May Be Sewn Together Or Patched With A Muscle Graft. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 39540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 39540 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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