CPT 41007 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 | • 21 - Inpatient Hospital • 11 - Office |
| Common Modifiers | • None • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 41007 |
National average reimbursement for CPT 41007 by major payers:
$408.47
$453.41
$466.59
$562.61
| 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 41007 | ||||||
United | 41007 | $611.16 | 1942376116 - KURT BOTTLES | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 41007 | $995.00 | 1740634369 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $745.00 | 1437512993 - UNITED SKIN SPECIALISTS MISSOURI LTD, PC, CHESTERFIELD ASC | 811166184 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $840.00 | 1689632051 - ROSS SURGERY CENTER INC | 743085621 - (OH) ROSS SURGERY CENTER INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $825.00 | 1174005235 - IDAHO FALLS ASC | 823089090 - (ID) IDAHO FALLS ASC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $665.00 | 1093053381 - NORTH COUNTRY EC LLC, NORTHEASTERN NEW YORK SURGICAL CENTER | 453715451 - (NY) NORTH COUNTRY EC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $595.00 | 1467580019 - MIDWEST SURGERY CENTER INC | 204139967 - (NE) MIDWEST SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $650.00 | 1588029870 - PACIFIC GASTROENTEROLOGY PLLC | 201377401 - (WA) PACIFIC GASTROENTEROLOGY, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $675.00 | 1285825075 - SUNNYSIDE SURGERY CENTER, LLC | 201164055 - (ID) SUNNYSIDE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $2718.00 | 1891730644 - LAKEWALK SURGERY CENTER, INC. | 411791860 - (MN) LAKEWALK SURGERY CENTER INC. | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $448.00 | 1588667208 - BRADFORD PARKWAY SURGERY AND LASER CENTER | 20562180 - (MO) BRADFORD PARKWAY SURGERY AND LASER CENTER | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $500.00 | 1497117113 - FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER, LLC | 352551684 - (PA) FERTILITY PARTNERS OF PENNSYLVANIA SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $1886.00 | 1821249616 - LINCOLN SURGERY CENTER LLC | 261790900 - (CO) LINCOLN SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $515.00 | 1669720439 - OCALA SURGICAL CENTER, OCALA SURGICAL CENTER, LLC | 842579958 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 41007 | $1193.00 | 1922141647 - RIVER NORTH SAME DAY SURGERY LLC, NORTHWESTERN MEDICINE SURGERY CENTER RIVER NORTH | 364091497 | IL | 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 41007 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 41007 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 41007 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 41007. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 41007 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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