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See a sample rate comparisonCPT 41016 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 Outside 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) Located In The Mouth Involving An Incision (Cut) In The Skin Under The Jaw.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | GC - Service performed by resident under supervision 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $483.65 national non-facility rate (2026) · View Medicare rates for 41016 |
| Medicaid Fee Schedule | $378.20 median of the 8 states in the free preview · View Medicaid rates for 41016 |
National average reimbursement for CPT 41016 by major payers:
$550.29
$584.29
$636.06
$570.23
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CPT 41016
5 of 25 sample ratesHigher to lower in this preview
Reston Surgery Center, Lp
Reston Surgery Center Lp
$5,162.00Published rateCapital City Surgery Center Of Florida LLC
$2,388.00Published rateMethodist Endoscopy Center LLC
Methodist Endoscopy Center, LLC
$1,474.00Published rateAlexander Eye Surgery Center, LLC
$935.00Published rateMaryland Aesthetic And Reconstructive Ambulatory Surgical Center LLC
$345.00Published rate
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See a sample payer proposalCPT 41016 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 41016 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 41016 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 |
|---|---|---|
| 41015-CPT | Moderate | Drain Abscess Outside 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) Located In The Mouth Involving An Incision (Cut) In The Skin Under The Jaw. |
| 41016-CPT | Moderate | Drain Abscess Outside 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) Located In The Mouth Involving An Incision (Cut) In The Skin Under The Jaw. |
| 41017-CPT | Moderate | Drain Abscess Outside 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) Located In The Mouth Involving An Incision (Cut) In The Skin Under The Jaw. |
| 41018-CPT | Moderate | Drain Abscess Outside 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) Located In The Mouth Involving An Incision (Cut) In The Skin Under The Jaw. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 41016. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 41016 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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