CPT 41000 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.

Drain Abscess Inside 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) Involving An Incision (Cut) In The Mouth.

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Digestive System
Common Place of Service	11 - Office 21 - Inpatient Hospital
Common Modifiers	51 - Multiple procedures 59 - Distinct Procedural Service
Complexity Level	Low
Medicare Fee Schedule	$159.32 national non-facility rate (2026) · View Medicare rates for 41000
Medicaid Fee Schedule	$124.535 median of the 8 states in the free preview · View Medicaid rates for 41000

National average reimbursement for CPT 41000 by major payers:

$191.51

$208.42

$211.20

$246.69

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CPT 41000

5 of 25 sample ratesHigher to lower in this preview

Mansfield Endoscopy Center, LLC
Mansfield Endoscopy Center LLC
TXAmbulatory Surgical Clinic/CenterNPI 1366047433Tax ID 86-1354607
$1,029.00Published rate
Lebonheur East Surgery Center II Lp, Lebonheur East Surgery Center Lp
Lebonheur East Surgery Center II Lp
TNAmbulatory Surgical Clinic/CenterNPI 1073763652Tax ID 80-0247391
$409.00Published rate
Anne Arundel-Sca Surgicenter, LLC
Anne Arundelsca Surgicenter LLC
MDAmbulatory Surgical Clinic/CenterNPI 1225531544Tax ID 82-4763728
$205.00Published rate
South Hill Ambulatory Surgical Center Ps
WAAmbulatory Surgical Clinic/CenterNPI 1811950298Tax ID 91-1546856
$132.00Published rate
Treasure Coast Surgical Center Inc
Treasure Coast Surgical Center, Inc.
FLAmbulatory Surgical Clinic/CenterNPI 1124296173Tax ID 26-0770428
$80.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 41000 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 41000 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 41000 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
41000-CPT	Low	Drain Abscess Inside 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) Involving An Incision (Cut) In The Mouth.
41005-CPT	Moderate	Drain Abscess Inside 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) Involving An Incision (Cut) In The Mouth.
41006-CPT	Moderate	Drain Abscess Inside 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) Involving An Incision (Cut) In The Mouth.
41007-CPT	Moderate	Drain Abscess Inside 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) Involving An Incision (Cut) In The Mouth.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 41000. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 41000 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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