CPT 41006 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 • 23 - Emergency Room |
| Common Modifiers | • 59 - Distinct Procedural Service • None • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 41006 by major payers:
$430.50
$458.96
$485.40
$576.10
| 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 41006 | ||||||
United | 41006 | $1258.00 | 1003004482 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $1193.00 | 1922141647 - RIVER NORTH SAME DAY SURGERY LLC, NORTHWESTERN MEDICINE SURGERY CENTER RIVER NORTH | 364091497 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $624.00 | 1215178835 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $622.85 | 1215031851 - JAMES FOUTS | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 41006 | $1630.00 | 1881612042 - THE HAND AND UPPER EXTREMITY SURGERY CENTER OF GEORGIA, LLC | 200147862 - (GA) THE HAND AND UPPER EXTREMITY SURGERY CENTER OF GEORGIA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $1276.00 | 1568674281 - VILLAGES ENDOSCOPY & SURGICAL CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $730.67 | 1285340430 - CORRIDOR SURGERY CENTER | 832869527 - (IA) CORRIDOR SURGERY CENTER | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $725.00 | 1902213432 - COBBLESTONE SURGERY CENTER, INC. | 464241477 - (GA) COBBLESTONE SURGERY CENTER INC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $736.00 | 1679585772 - MEDICAL CENTER ENDOSCOPY, LLC, MEDICAL CENTER ENDOSCOPY | 760550704 - (TX) MEDICAL CENTER ENDOSCOPY, LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $1276.00 | 1629508387 - WELLINGTON ENDOSCOPY CENTER LLC | 813254698 - (FL) WELLINGTON ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $1017.00 | 1598949281 - POWAY CA MULTI SPECIALTY ASC LLC, POWAY SURGERY CENTER | 261158191 - (CA) POWAY CA MULTI-SPECIALTY ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $418.00 | 1043497019 - PIKESVILLE MD ENDOSCOPY ASC LLC, ENDOCENTRE OF BALTIMORE | 261467040 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $525.00 | 1144382284 - PASADENA SURGERY CENTER LLC, PASADENA SURGERY CENTER | 203571435 - (FL) PASADENA SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $515.00 | 1588665665 - CERTIFIED AMBULATORY SURGERY CENTER, CASC | 522031681 - (MD) CERTIFIED AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41006 | $410.00 | 1255311635 - MELBOURNE ASC LP, THE SURGERY CENTER OF MELBOURNE | 621625311 - (FL) MELBOURNE ASC LP | FL | 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 41006 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 41006 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 41006 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 41006. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 41006 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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