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See a sample rate comparisonCPT 40810 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.
Xcision Of Lesion Of Mucosa & Submucos Vestibul Of Mouth, Excision Of Lesion Of Mucosa And Submucosa Vestibule Of Mouth; Withou
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $216.10 national non-facility rate (2026) · View Medicare rates for 40810 |
| Medicaid Fee Schedule | $169.625 median of the 8 states in the free preview · View Medicaid rates for 40810 |
National average reimbursement for CPT 40810 by major payers:
$254.08
$268.42
$301.93
$216.57
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CPT 40810
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Port Charlotte Ltd
$5,532.00Published rateNorth Haven Surgery Center LLC, North Haven Pain Medicine Center, LLC
North Haven Surgery Center LLC
$1,276.00Published ratePacificoast Ambulatory Surgicenter, LLC., Pacific Coast Ambulatory Surgicenter
Pacificoast Ambulatory Surgicenter LLC
$862.00Published rateBerkshire Cosmetic & Reconstructive Surgery Center Inc.
Berkshire Cosmetic Reconstructive Surgery Center Inc
$488.00Published rateRhonda Eubanks
Deaconess Hospital Inc
$168.52Published rate
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See a sample payer proposalCPT 40810 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 40810 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 40810 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 |
|---|---|---|
| 40810-CPT | Moderate | Xcision Of Lesion Of Mucosa & Submucos Vestibul Of Mouth, Excision Of Lesion Of Mucosa And Submucosa Vestibule Of Mouth; Withou |
| 40812-CPT | Moderate | Xcision Of Lesion Of Mucosa & Submucos Vestibul Of Mouth, Excision Of Lesion Of Mucosa And Submucosa Vestibule Of Mouth; With S |
| 40814-CPT | Moderate | Xcision Of Lesion Of Mucosa & Submucos Vestibul Of Mouth, Excision Of Lesion Of Mucosa And Submucosa Vestibule Of Mouth; With C |
| 40816-CPT | Moderate | Xcision Of Lesion Of Mucosa & Submucos Vestibul Of Mouth; Comple, Excision Of Lesion Of Mucosa And Submucosa Vestibule Of Mouth; Comple |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 40810. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 40810 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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