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CPT 40652 Fee Schedule

Last Verified: January 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 < 1/2 Hgt
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

23 - Emergency Room

11 - Office

Common Modifiers

None

54 - Surgical Care Only

GC - Service performed by resident under supervision

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 40652

National average reimbursement for CPT 40652 by major payers:

bcbs

$633.93

uhc

$659.63

aetna

$703.10

cigna

$832.36

Preview provider-level rates for...
For billing codeCPT 40652
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 40652

United
40652$89.001487655627 - UNION PINES SURGERY CENTER,LLC731622427 - (OK) UNION PINES SURGERY CENTER, LLCOKAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$156.001487221404 - EYE SURGICAL SERVICES LLC, GATEWAY SURGERY CENTER834616432 - (MO) EYE SURGICAL SERVICES, LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$225.001679001028 - CENTERVIEW SURGERY CENTER, LLC815461133 - (AR) CENTERVIEW SURGERY CENTER LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$93.001306320338 - ALABAMA EYE SURGERY CENTER LLC814662532 - (AL) ALABAMA EYE SURGERY CENTER LLCALAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$141.601023162831 - SEATTLE REPRODUCTIVE SURGERY CENTER342014245WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$1446.001790945145 - MANSFIELD SURGICAL PLAZA LLC, MANSFIELD SURGERY CENTER271835675TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$566.001114926714 - ENDOSCOPY CENTER OF DAYTON LTD311460799 - (OH) ENDOSCOPY CENTER OF DAYTON LTDOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$108.001740254572 - THE NORTHERN NV ENDOSCOPY ASC LLC, DIGESTIVE HEALTH CENTER200470103 - THE NORTHERN NV ENDOSCOPY ASC LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$58.001770990376 - ADVANCED VISION SURGERY CENTER LLC453791209 - (VA) ADVANCED VISION SURGERY CENTER LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$167.001003575218 - RENAL FOCUS ASC LLC, RENAL FOCUS ASC PLAINVIEW863151108 - (NY) RENAL FOCUS ASC LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$200.001497368013 - PHYSICIANS REGIONAL SURGERY CENTER LLC842179117 - (OH) PHYSICIANS REGIONAL SURGERY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$179.001033466933 - TOWN CENTER ASC LLC453062883 - (MI) TOWN CENTER ASC LLCMIAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$103.001841347143 - RUXTON SURGICENTER LLC522095835 - (MD) RUXTON SURGICENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$300.001104993799 - SURGERY CENTER OF FORT COLLINS LLC841541559 - (CO) SURGERY CENTER OF FORT COLLINS, LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
40652$385.001871841544 - SPALDING ENDOSCOPY CENTER, LLC453051061 - (GA) SPALDING ENDOSCOPY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 40652 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 40652 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 40652 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.

CodeComplexityDescription
40525-CPTModerateExc Lip Full Thickness W Local Flap
40527-CPTModerateExcision Lip;Full Thick Reconstruct W Cr
40650-CPTModerateRep Lip Full Thick Vermilion Only
40652-CPTModerateRep 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 40652. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 40652 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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