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See a sample rate comparisonCPT 41005 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 | 59 - Distinct Procedural Service RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $231.13 national non-facility rate (2026) · View Medicare rates for 41005 |
| Medicaid Fee Schedule | $181.845 median of the 8 states in the free preview · View Medicaid rates for 41005 |
National average reimbursement for CPT 41005 by major payers:
$270.40
$284.62
$303.34
$360.18
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CPT 41005
5 of 25 sample ratesHigher to lower in this preview
Lone Star Endoscopy Center, LLC
$1,446.00Published rateSummit Ambulatory Surgical Center, LLC
$555.00Published rateTimpview Asc, LLC
Timpview Asc LLC
$300.00Published rateRiver View Surgery Center, LLC
$140.00Published rateEye Surgicenter LLC
$42.00Published rate
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See a sample payer proposalCPT 41005 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 41005 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 41005 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 41005. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 41005 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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