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See a sample rate comparisonCPT 41009 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 | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 51 - Multiple procedures GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $432.88 national non-facility rate (2026) · View Medicare rates for 41009 |
| Medicaid Fee Schedule | $338.695 median of the 8 states in the free preview · View Medicaid rates for 41009 |
National average reimbursement for CPT 41009 by major payers:
$506.79
$530.00
$566.63
$486.15
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CPT 41009
5 of 25 sample ratesHigher to lower in this preview
Spine Sports Surgery Center, LLC, Spine And Sports Surgery Center
$1,675.00Published rateReston Surgery Center, Lp
Reston Surgery Center Lp
$979.00Published rateOak Tree Surgery Center, LLC
Oak Tree Surgery Center, Ll, LLC
$371.00Published rateAustin Eye Clinic Association, Austin Eye Laser And Surgicenter
Austin Eye Clinic Association
$200.00Published rateEye Surgery Limited LLC, Virginia Center For Eye Surgery
Eye Surgery Limited, LLC
$59.00Published rate
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See a sample payer proposalCPT 41009 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 41009 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 41009 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 |
|---|---|---|
| 41008-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. |
| 41009-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. |
| 41010-CPT | Moderate | Surgery For Tongue Mobility, Surgery To Cut Into Remove Or Reconstruct The Lingual Frenum. This Is A Vertical Piece Of Tissue That Attaches The Tongue To The Floor Of The Mouth. The Surgery Improves Mobility Of The Tongue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 41009. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 41009 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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