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CPT 40830 Fee Schedule

Last Verified: January 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.

Rep Lac Oral Vestib < 2cm
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

11 - Office

23 - Emergency Room

Common Modifiers

None

59 - Distinct Procedural Service

RT - Right side of body

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 40830

National average reimbursement for CPT 40830 by major payers:

bcbs

$280.78

uhc

$343.66

aetna

$341.57

cigna

$390.29

Preview provider-level rates for...
For billing codeCPT 40830
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 40830

United
40830$566.001952814386 - ADVANCED SURGICAL CARE OF BOERNE, LLC821680961 - (TX) ADVANCED SURGICAL CARE OF BOERNE LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$135.001760518609 - NORTH POINT SURGERY CENTER, INC770557917 - (CA) NORTH POINT SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$273.001316133044 - NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE, LLC260393039 - (MN) NORTH MEMORIAL AMBULATORY SURGERY CENTER AT MAPLE GROVE LLCMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$135.001407334881 - BEACON ORTHOPAEDIC SURGERY CENTER, BEACON AMBULATORY SURGERY CENTER311800570 - (OH) BEACON ORTHOPAEDICS SURGERY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$1096.001063598597 - CLEAR CREEK SURGERY CENTER LLC200871085 - (CO) CLEAR CREEK SURGERY CENTER, LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$500.001124277959 - CPM SURGERY CENTER 2, LLC263297791 - (GA) CPM SURGERY CENTER 2 LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$79.001619487782 - UCH VASCULAR ACCESS ASC LLC820975009 - (TN) UCH VASCULAR ACCESS ASC LLCTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$820.001285870303 - LAPORTE MEDICAL GROUP SURGICAL CENTER, LLC260505795 - (IN) LAPORTE MEDICAL GROUP SURGICAL CENTER LLCINAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$125.001881024271 - DAKOTA GASTROENTEROLOGY, LTD383908818 - (ND) DAKOTA GASTROENTEROLOGY LTD.NDAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$235.001255875126 - VIP SURG ASC, LLC, VIP SURGICAL CENTER811621842 - (TX) VIP SURG ASC LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$566.001114126596 - CORAL RIDGE OUTPATIENT CENTER LLC, CORAL RIDGE OUTPATIENT CENTER205429299 - (FL) CORAL RIDGE OUTPATIENT CENTER, LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$88.001609568922 - BETHESDA ENDOSCOPY CENTER, LLC521915901 - (MD) BETHESDA ENDOSCOPY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$566.001790104248 - METRO SURGERY CENTER, LLC, METRO SURGERY CENTER, LP810587498 - (AZ) METRO SURGERY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$555.001912265653 - BRASELTON ENDOSCOPY CENTER, LLC453369410 - (GA) BRASELTON ENDOSCOPY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40830$76.001831153527 - THE SURGICAL CENTER OF GREATER ANNAPOLIS, INC.521532190 - (MD) THE SURGICAL CENTER OF GREATER ANNAPOLIS INCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 40830 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 40830 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 40830 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.

CodeComplexityDescription
40830-CPTModerateRep Lac Oral Vestib < 2cm
40831-CPTModerateRep Lac Oral Vestib > 2cm/Complex
40840-CPTHighVestibuloplasty Anterior
40842-CPTHighVestibuloplasty; Posterior, Unilateral

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 40830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 40830 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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