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See a sample rate comparisonCPT 40700 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.
Plstic Rpair Of Clft Lip/Nasal Dformity; Primar Partial Or Compl, Plastic Repair Of Cleft Lip/Nasal Deformity; Primary Partial Or Compl
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | LT - Left side of body GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $911.51 national non-facility rate (2026) · View Medicare rates for 40700 |
| Medicaid Fee Schedule | $729.81 median of the 8 states in the free preview · View Medicaid rates for 40700 |
National average reimbursement for CPT 40700 by major payers:
$1,242.61
$1,313.78
$1,435.64
$1,607.94
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CPT 40700
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Southwest LLP, Memorial Hermann Surgery Center Southwest
Memorial Hermann Surgery Center Southwest LLP
$8,825.00Published rateOrthoatlanta Surgery Center Of Fayetteville, LLC
Orthoatlanta Surgery Center Of Fayetteville LLC
$3,797.00Published rateCheyenne Ocular Surgery, LLC, Cheyenne Eye Surgery
Cheyenne Ocular Surgery LLC
$2,977.00Published rateBentonville Ambulatory Surgery Center, LLC
Bentonville Ambulatory Surgery Center LLC
$1,473.00Published ratePuget Sound Gastroenterology, PLLC, Fremont Endoscopy Center
Puget Sound Gastroenterology, P.S.
$857.00Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 40700-CPT | High | Plstic Rpair Of Clft Lip/Nasal Dformity; Primar Partial Or Compl, Plastic Repair Of Cleft Lip/Nasal Deformity; Primary Partial Or Compl |
| 40701-CPT | High | Plstic Rpair Of Clft Lip/Nasal Dformity; Primar Bilate 1-Stag, Plastic Repair Of Cleft Lip/Nasal Deformity; Primary Bilateral 1-Stag |
| 40702-CPT | High | Plstic Rpair Of Clft Lip/Nasal Dformity; Primar Bilate 1 Of 2, Plastic Repair Of Cleft Lip/Nasal Deformity; Primary Bilateral 1 Of 2 |
| 40720-CPT | High | Plstic Rpair Of Clft Lip/Nasal Dformity; Second By Recreation, Plastic Repair Of Cleft Lip/Nasal Deformity; Secondary By Recreation |
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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