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CPT 40831 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/Complex
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

11 - Office

21 - Inpatient Hospital

Common Modifiers

None

59 - Distinct Procedural Service

RT - Right side of body

Complexity LevelModerate
Medicare Fee ScheduleView Medicare rates for 40831

National average reimbursement for CPT 40831 by major payers:

bcbs

$369.20

uhc

$442.37

aetna

$443.48

cigna

$509.43

Preview provider-level rates for...
For billing codeCPT 40831
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 40831

United
40831$83.001245215706 - SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATION, THE FOOT SURGERY CENTER OF SHREVEPORT721198169 - (LA) SOUTHSIDE FOOT CLINIC OF SHREVEPORT INC A PROFESSIONAL CORPORATIONLAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$280.041770211179 - SAMANTHA SOLLMAN350593390 - DEACONESS HOSPITAL INCINNurse Practitioner (363L00000X)
United
40831$578.001063007573 - GEORGIA EYE SURGICENTER, LLC, GEORGIA EYE INSTITUTE SURGERY CENTER861925762GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$566.001114926714 - ENDOSCOPY CENTER OF DAYTON LTD311460799 - (OH) ENDOSCOPY CENTER OF DAYTON LTDOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$107.001952535502 - PLATEAU SURGERY CENTER264769256 - (TN) PLATEAU SURGERY CENTERTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$366.001912982349 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, MEDICAL ARTS SURGERY CENTER AT SOUTH MIAMI201796841FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$553.001902851009 - 90210 SURGERY MEDICAL CENTER, LLC, 90210 SURGERY MEDICAL CENTER AT LINDEN134341801 - (CA) 90210 SURGERY MEDICAL CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$566.001336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER871904768TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$703.001164870895 - SUMMIT ORTHOPEDICS LTD, EAGAN SURGERY CENTER411762331 - SUMMIT ORTHOPEDICS, LTD.MNAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$450.001477695336 - SOMERSET OUTPATIENT SURGERY, LLC, RARITAN VALLEY SURGERY CENTER208433398 - (NJ) SOMERSET OUTPATIENT SURGERY, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$135.001790936847 - RSC SURGERY CENTER, LLC352345966CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$210.001154593481 - RANCHO MIRAGE SURGERY CENTER, LLC, RANCHO MIRAGE SURGERY CENTER262136928 - (CA) RANCHO MIRAGE SURGERY CENTER, LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$200.001093726796 - ROCKY MOUNTAIN EYE SURGERY CENTER INC810493712 - (MT) ROCKY MOUNTAIN EYE SURGERY CENTER INCMTAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$550.001205899705 - EL PASO SURGERY CENTERS LP621846494 - (TX) EL PASO SURGERY CENTERS LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
40831$175.001407095359 - PAIN CARE CENTER OF GEORGIA LLC300523580 - (GA) PAIN CARE CENTER OF GEORGIA LLCGAAmbulatory 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 40831 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 40831 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 40831 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 40831. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 40831 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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