CPT 41000 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Digestive System |
| Common Place of Service | • 11 - Office • 21 - Inpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 41000 by major payers:
$191.51
$208.42
$211.20
$252.67
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 41000 | ||||||
United | 41000 | $74.00 | 1942793823 - STARKVILLE SURGERY CENTER LLC | 465332869 - (MS) STARKVILLE SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $325.00 | 1316015738 - KRAMBERG OBS | 205126110 - (NJ) KRAMBERG OBS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $1446.00 | 1437552643 - BEAR CREEK SURGERY CENTER, LLC | 465530768 - (TX) BEAR CREEK SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $83.00 | 1164473922 - OPHTHALMOLOGY CENTER OF BREVARD LP, ASC OF BREVARD | 621546274 - (FL) OPHTHALMOLOGY CENTER OF BREVARD LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $200.00 | 1477949766 - DESCHUTES SURGERY CENTER, LLC, DESCHUTES SURGERY CENTER, LLC | 472920584 - (OR) DESCHUTES SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $300.00 | 1952868622 - YORK ENDOSCOPY CENTER LLC | 833765021 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $118.00 | 1922016898 - JAMES TRICE MD PA, DIGESTIVE DISEASE CENTER | 710758882 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $108.00 | 1679526297 - WEST BLOOMFIELD SURGERY CENTER, LLC, LAKES SURGERY CENTER | 200449191 - (MI) WEST BLOOMFIELD SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $168.00 | 1750414983 - ROCKLEDGE SURGERY CENTER, INC. | 522098503 - (MD) ROCKLEDGE SURGERY CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $92.00 | 1336138635 - EYE SURGICAL SPECIALISTS OF NEW JERSEY, SURGERY CENTER OF CENTRAL NEW JERSEY | 223411416 - (NJ) EYE SURGICAL SPECIALISTS OF NEW JERSEY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $98.00 | 1336213099 - SAN GABRIEL AMBULATORY SURGERY CENTER, LP | 510470714 - (CA) SAN GABRIEL AMBULATORY SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $125.00 | 1104833839 - ROCHESTER SURGERY CENTER, P.C. | 200510602 - (MI) ROCHESTER SURGERY CENTER PC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $150.00 | 1891406328 - CEI PHYSICIANS PSC, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $225.00 | 1609039056 - FARSHID PAYDAR MD PC, THE EYE CLINIC | 454779006 - (AZ) FARSHID PAYDAR MD PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41000 | $906.00 | 1295776920 - ROSE AMBULATORY SURGERY CENTER LP | 200415436 - (CO) ROSE AMBULATORY SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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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 | I&D Les Intraoral Lingual |
| 41005-CPT | Moderate | I&D Les Intraoral Sublingual |
| 41006-CPT | Moderate | Intraoral Incision And Drainage Of Abscess, Cyst, Or Hematoma Of Tongue Or Floor Of Mouth; Sublingual, Deep, Supramylohyoid |
| 41007-CPT | Moderate | Intraoral I&D-Cyst..Tongue-Floor;Subment |
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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