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See a sample rate comparisonCPT 40702 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 Of 2, Plastic Repair Of Cleft Lip/Nasal Deformity; Primary Bilateral 1 Of 2
| 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 | 58 - Staged or related procedure during postoperative period GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $899.49 national non-facility rate (2026) · View Medicare rates for 40702 |
| Medicaid Fee Schedule | $719.905 median of the 8 states in the free preview · View Medicaid rates for 40702 |
National average reimbursement for CPT 40702 by major payers:
$1,269.77
$1,274.87
$1,357.23
$1,569.08
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CPT 40702
5 of 25 sample ratesHigher to lower in this preview
Denton Regional Ambulatory Surgery Center, L.P., Medical City Surgery Center/Denton
Denton Regional Ambulatory Surgery Center Lp
$7,124.00Published rateSusquehanna Surgery Center Inc
$3,071.00Published rateInnovations Surgery Center, PC
Innovations Surgery Center PC
$2,310.00Published rateInterventional Surgery Institute Of Little Rock, LLC, Interventional Surgery Institute
Interventional Surgery Institute Of Little Rock LLC
$1,550.00Published rateNortheast Endoscopy Center, LLC
Northeast Endoscopy Center LLC
$777.00Published rate
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See a sample payer proposalCPT 40702 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 40702 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 40702 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 40702. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 40702 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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