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See a sample rate comparisonCPT 40701 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 Bilate 1-Stag, Plastic Repair Of Cleft Lip/Nasal Deformity; Primary Bilateral 1-Stag
| 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 | GC - Service performed by resident under supervision AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | $1,065.16 national non-facility rate (2026) · View Medicare rates for 40701 |
| Medicaid Fee Schedule | $852.13 median of the 8 states in the free preview · View Medicaid rates for 40701 |
National average reimbursement for CPT 40701 by major payers:
$1,432.27
$1,562.82
$1,642.27
$1,896.40
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CPT 40701
5 of 25 sample ratesHigher to lower in this preview
North Campus Surgery Center LLC
$10,317.00Published rateCampus Eye Group Asc Inc, Surgicenter Anesthesia Associates
$3,690.00Published rateBrainerd Lakes Surgery Center L L C
Brainerd Lakes Surgery Center, LLC
$2,876.00Published rateVisionary Surgery Center Of Nevada, LLC
Visionary Surgery Center Of Nevada LLC
$1,907.00Published rateGastrointestinal Diagnostic Endoscopy Woodstock, LLC, Town Lake Endoscopy Center
Gastrointestinal Diagnostic Endoscopy Woodstock LLC
$515.00Published rate
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See a sample payer proposalCPT 40701 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 40701 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 40701 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 40701. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 40701 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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