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See a sample rate comparisonCPT 40845 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.
Vestibuloplasty Complex (Incl, Vestibuloplasty Complex (Including Ridge Extension Muscle Repositioning) Vestibuloplasty Complex(Including Ridge Extension Muscle
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 51 - Multiple procedures 78 - Return to OR - related procedure GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | $1,476.99 national non-facility rate (2026) · View Medicare rates for 40845 |
| Medicaid Fee Schedule | $1,223.18 median of the 8 states in the free preview · View Medicaid rates for 40845 |
National average reimbursement for CPT 40845 by major payers:
$1,821.97
$1,947.31
$2,068.16
$1,985.17
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 40845.
CPT 40845
5 of 25 sample ratesHigher to lower in this preview
Hamilton Surgery Center LLC
$10,317.00Published rateBsc Biltmore LLC
$4,014.00Published rateOlol Pontchartrain Surgery Center, LLC, Our Lady Of The Lake Pontchartrain Surgery Center
Olol Pontchartrain Surgery Cente
$2,756.00Published rateBayfront Same Day Surgery Center, LLC.
Ohi West Inc
$1,700.00Published rateSurgery Center Of Coral Gables LLC, Surgery Center Of Coral Gables LLC
$945.00Published rate
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See a sample payer proposalCPT 40845 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 40845 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 40845 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 |
|---|---|---|
| 40840-CPT | High | Surgery On Mouth Opening, Surgery To Enlarge The Opening Of The Mouth And Build Up The Bony Ridge That Holds The Gums And Teeth (Alveolar Process). |
| 40842-CPT | High | Surgery On Mouth Opening, Surgery To Enlarge The Opening Of The Mouth And Build Up The Bony Ridge That Holds The Gums And Teeth (Alveolar Process). |
| 40843-CPT | High | Surgery On Mouth Opening, Surgery To Enlarge The Opening Of The Mouth And Build Up The Bony Ridge That Holds The Gums And Teeth (Alveolar Process). |
| 40845-CPT | High | Vestibuloplasty Complex (Incl, Vestibuloplasty Complex (Including Ridge Extension Muscle Repositioning) Vestibuloplasty Complex(Including Ridge Extension Muscle |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 40845. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 40845 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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