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See a sample rate comparisonCPT 40800 Fee Schedule
Last Verified: October 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.
Drainage Of Abscess In Mouth, Surgery To Drain Blood Pus Or Fluid From An Abscess (Pocket Of Infection) Hematoma (Collection Of Blood Under The Skin) Or Cyst (Pocket Of Fluid) Within The Mouth.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $209.76 national non-facility rate (2026) · View Medicare rates for 40800 |
| Medicaid Fee Schedule | $164.89 median of the 8 states in the free preview · View Medicaid rates for 40800 |
National average reimbursement for CPT 40800 by major payers:
$237.02
$266.79
$282.58
$326.98
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CPT 40800
5 of 25 sample ratesHigher to lower in this preview
Ucsd Ambulatory Surgery Center, LLC, University Ambulatory Surgery Center
$2,802.00Published rateGs Campus Asc, LLC, Lafayette Surgery Center
Gs Campus Asc LLC
$1,233.00Published rateArizona Surgical Specialists Center, LLC, Arizona Surgical Specialsts Center West Phoenix
Arizona Surgical Specialists Center LLC
$525.00Published rateJonesboro Surgery Center, LLC
$343.00Published rateEye Surgery Limited LLC, Virginia Center For Eye Surgery
Eye Surgery Limited, LLC
$135.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 40800 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 40800 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 40800 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 |
|---|---|---|
| 40800-CPT | Moderate | Drainage Of Abscess In Mouth, Surgery To Drain Blood Pus Or Fluid From An Abscess (Pocket Of Infection) Hematoma (Collection Of Blood Under The Skin) Or Cyst (Pocket Of Fluid) Within The Mouth. |
| 40801-CPT | Moderate | Drainage Of Abscess In Mouth, Surgery To Drain Blood Pus Or Fluid From An Abscess (Pocket Of Infection) Hematoma (Collection Of Blood Under The Skin) Or Cyst (Pocket Of Fluid) Within The Mouth. |
| 40804-CPT | Moderate | Removal Of Embedded Foreign B, Removal Of Embedded Foreign Body Vestibule Of Mouthsimple Removal Of Embedded Foreign Body Vestibule Of Mouth |
| 40805-CPT | Moderate | Removal Of Embedded Foreign Bo, Removal Of Embedded Foreign Body Vestibule Of Mouthcomplicated Removal Of Embedded Foreign Body Vestibule Of Mouth |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 40800. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 40800 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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