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CPT 40700 Fee Schedule

Last Verified: January 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.

Rep Lip Cleft Primary Unil
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

22 - On Campus Outpatient Hospital

21 - Inpatient Hospital

Common Modifiers

None

LT - Left side of body

GC - Service performed by resident under supervision

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 40700

National average reimbursement for CPT 40700 by major payers:

bcbs

$1,242.61

uhc

$1,313.78

aetna

$1,435.64

cigna

$1,643.75

Preview provider-level rates for...
For billing codeCPT 40700
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 40700

United
40700$5249.001093985525 - SURGERY CENTER OF CORAL GABLES LLC, CORAL GABLES SURGERY CENTER204843518 - (FL) SURGERY CENTER OF CORAL GABLES LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$3155.001619245230 - AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLC800768614 - (NJ) AMBULATORY SURGICAL PAVILION AT ROBERT WOOD JOHNSON LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$1814.001255390670 - CARROLL COUNTY EYE SURGERY CENTER, LLC50576667 - (MD) CARROLL COUNTY EYE SURGERY CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$2276.001053385328 - MIDWEST ENDOSCOPY SERVICES LLC470808172 - (NE) MIDWEST ENDOSCOPY SERVICES, LLCNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$2977.001326247479 - CHEYENNE OCULAR SURGERY, LLC, CHEYENNE EYE SURGERY300347005 - (WY) CHEYENNE OCULAR SURGERY LLCWYAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$3935.001144333881 - NORTH SCOTTSDALE AMBULATORY SURGERY CENTER, LLC200554616 - (AZ) NORTH SCOTTSDALE AMBULATORY SURGERY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$1900.001619559044 - ASCENT SURGERY CENTER, LLC853327359 - (OH) ASCENT SURGERY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$1196.001194770974 - HAMILTON ENDOSCOPY AND SURGERY CENTER, LLC223837967 - (NJ) HAMILTON ENDOSCOPY & SURGERY CENTER, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$3065.001144499633 - FOOTHILL SURGERY CENTER LP510453471CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$2786.001093352908 - BAPTIST HEALTHCARE SYSTEM, INC., BAPTIST HEALTH SURGERY CENTER EASTPOINT610444707 - BAPTIST HEALTHCARE SYSTEM INCKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$1100.001104829597 - HOGAN SURGICAL CENTER, P. A.300399671 - (MS) HOGAN SURGICAL CENTER P AMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$1400.001013021682 - PHOENIX EYE SURGICAL CENTER PLC, CENTRAL PHOENIX SURGICAL CENTER860905556 - (AZ) PHOENIX EYE SURGICAL CENTER PLAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$857.001386615912 - PUGET SOUND GASTROENTEROLOGY, PLLC, FREMONT ENDOSCOPY CENTER911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$3000.001841325214 - AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY208422547 - (MD) AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERYMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
40700$3250.001548712227 - ARKANSAS OUTPATIENT SURGERY CENTER, LLC474672200 - (AR) ARKANSAS OUTPATIENT SURGERY CENTER LLCARAmbulatory 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 40700 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 40700 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 40700 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
40652-CPTModerateRep Lip Full Thick < 1/2 Hgt
40700-CPTHighRep Lip Cleft Primary Unil
40701-CPTHighRep Lip Cleft Primary Bil 1 Stg
40702-CPTHighRep Lip Cleft Prim Bil 1st Stg Of 2

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 40700. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 40700 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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