CPT 41005 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 • 59 - Distinct Procedural Service • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 41005 by major payers:
$270.40
$284.62
$303.34
$372.11
| 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 41005 | ||||||
United | 41005 | $351.00 | 1700807617 - ENDOSCOPY CENTER OF THE ROCKIES LLC, ENDOSCOPY CENTER OF THE ROCKIES LAFAYETTE | 841562782 - (CO) ENDOSCOPY CENTER OF THE ROCKIES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $719.00 | 1306833009 - SOUTH BROWARD ENDOSCOPY L L C | 113685842 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $150.00 | 1740561018 - CHILDREN 1ST GRAND PRAIRIE, LLC, CHILDREN 1ST DENTAL & SURGERY CENTER | 453126800 - (TX) FIDUCIARY WISE, LLC FBO CHILDREN 1ST DENTAL & SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $464.00 | 1811003205 - VIEWMONT SURGERY CENTER, LLC | 201133583 - (NC) VIEWMONT SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $209.00 | 1659356392 - LASER & CATARACT CENTER OF SHREVEPORT LLC, EYE SURGERY CENTER | 721382751 - (LA) LASER CATARACT CENTER OF SHREVEPORT LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $82.00 | 1487122669 - CONWAY CARDIOVASCULAR SURGERY CENTER, LLC | 832435695 - (AR) CONWAY CARDIOVASCULAR SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $112.00 | 1871529388 - PRG DALLAS ASC, LLC, CENTRAL POINT SURGERY CENTER | 752835144 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $200.00 | 1528145778 - OVERLAKE AMBULATORY SURGERY CENTER, LLC, OVERLAKE SURGERY CENTER LLC | 911925618 - (WA) OVERLAKE AMBULATORY SURGERY CENTER, | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $178.08 | 1285208231 - THOMAS COWLES | 350593390 - DEACONESS HOSPITAL INC | TN | Certified Registered Nurse Anesthetist (367500000X) |
United | 41005 | $300.00 | 1346918646 - TIMPVIEW ASC, LLC | 872314348 - (UT) TIMPVIEW ASC LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $200.00 | 1053388223 - THE OCULAR SURGERY CENTER, LLC | 742462970 - (TX) THE OCULAR SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $83.00 | 1306043617 - UROLOGY HEALTH SURGERY CENTER, LLC | 260412126 - (PA) UROLOGY HEALTH SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $200.00 | 1962869826 - ENDOTECH, LLC | 472926864 - (AZ) ENDOTECH LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $531.00 | 1811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER | 814378043 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41005 | $1073.00 | 1497068761 - CARNEGIE HILL ENDOSCOPY LLC | 270385539 - (NY) CARNEGIE HILL ENDOSCOPY LLC | NY | 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 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 | 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 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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