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See a sample rate comparisonCPT 40650 Fee Schedule
Last Verified: October 2026
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.
Rep Lip Full Thick Vermilion Only
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 23 - Emergency Room 21 - Inpatient Hospital |
| Common Modifiers | 54 - Surgical Care Only AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $573.49 national non-facility rate (2026) · View Medicare rates for 40650 |
| Medicaid Fee Schedule | $434.565 median of the 8 states in the free preview · View Medicaid rates for 40650 |
National average reimbursement for CPT 40650 by major payers:
$556.53
$589.81
$647.40
$756.93
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CPT 40650
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC, Aurora Pleasant Prairie Ambulatory Surgery Center
Aurora Surgery Centers LLC
$1,665.00Published rateTheda Oaks Gastroenterology & Endoscopy Center, LLC
Theda Oaks Gastroenterology & Endoscopy Ctr, Ltd
$688.00Published rateTowne Centre Surgery Center, LLC, St. Mary'S Of Michigan
$400.00Published rateLapeer County Surgery Center LLC
Lapeer County Surgery Center L
$150.00Published rateFianna Hills Surgery Center Inc
$70.00Published rate
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See a sample payer proposalCPT 40650 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 40650 code is part of the Surgery services used for Surgical Procedures on the Digestive 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 40650 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 |
|---|---|---|
| 40525-CPT | Moderate | Xcision Of Lip; Full Thickns Reconstr W/ Local Flap, Excision Of Lip; Full Thickness Reconstruction With Local Flap (Eg E |
| 40527-CPT | Moderate | Xcision Of Lip; Full Thickns Reconstr W/ Cross Lip Flap, Excision Of Lip; Full Thickness Reconstruction With Cross Lip Flap (A |
| 40650-CPT | Moderate | Rep Lip Full Thick Vermilion Only |
| 40652-CPT | Moderate | Rep Lip Full Thick < 1/2 Hgt |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 40650. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 40650 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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