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CPT 41016 Fee Schedule

Last Verified: December 2025

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.

I&D Les Extraoral Submental
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

GC - Service performed by resident under supervision

51 - Multiple procedures

Complexity LevelModerate

National average reimbursement for CPT 41016 by major payers:

bcbs

$550.29

uhc

$584.29

aetna

$636.06

cigna

$749.47

Preview provider-level rates for...
For billing codeCPT 41016
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 41016

United
41016$995.001578515995 - RAND SURGICAL PAVILLION CORP650156637 - (FL) RAND SURGICAL PAVILLION CORPFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$1936.001235155730 - MONTPELIER SURGERY CENTER770548811 - (CA) MONTPELIER SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$2388.001649310111 - CROWN POINT SURGERY CENTER, LLC, CROWN POINT SURGERY CENTER810641475 - (CO) CROWN POINT SURGERY CENTER, LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$1348.001922093293 - LEWIS & CLARK ORTHOPAEDIC INSTITUTE LLC352210163 - LEWIS & CLARK ORTHOPAEDIC, LLC 401(K) PLANIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$1923.001801443320 - ST. LUKE'S SURGERY CENTER OF CHESTERFIELD, LLC384106846 - (MO) ST LUKES SURGERY CENTER OF CHESTERFIELD LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$2620.001639261365 - SPECIALISTS ONE- DAY SURGERY LLC, SPECIALISTS ONE-DAY SURGERY161601940 - (NY) SPECIALISTS ONE DAY SURGERY LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$1950.001023072824 - SOUTH JERSEY EYE PHYSICIANS, LLC, THE SURGICAL CENTER AT SOUTH JERSEY EYE PHYSICIANS, PA222116946 - (NJ) SOUTH JERSEY EYE PHYSICIANS, PANJAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$2795.001992713010 - NORTHFIELD SURGICAL CENTER LLC, NORTHFIELD SURGICAL CENTER223509801 - (NJ) NORTHFIELD SURGICAL CENTER LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$3290.001407807050 - EL PASO DAY SURGERY LLC, EL PASO DAY SURGERY, L.P.200285362 - (TX) EL PASO DAY SURGERY LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$935.001851623961 - ALEXANDER EYE SURGERY CENTER, LLC271458954WIAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$796.001801811773 - DUPAGE EYE SURGERY CENTER, LLC920189811 - (IL) DUPAGE EYE SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$840.001467490433 - UROLOGY SURGICAL CENTER LLC470814279 - (NE) UROLOGY SURGICAL CENTERNEAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$796.001093764045 - GASTROENTEROLOGY OF INDIANAPOLIS PC, DIGESTIVE HEALTH CENTER351641181 - (IN) GASTROENTEROLOGY OF INDIANAPOLIS, P . C.INAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$2388.001326453325 - CAPITAL CITY SURGERY CENTER OF FLORIDA LLC471211202FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
41016$743.001205821097 - ADOBE SURGERY CENTER, PC860835901 - (AZ) ADOBE SURGERY CENTER PCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 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.

CodeComplexityDescription
41015-CPTModerateI&D Les Extraoral Sublingual
41016-CPTModerateI&D Les Extraoral Submental
41017-CPTModerateExtraoral I&D Cyst,Etc-Mouth Floor;Subma
41018-CPTModerateI&D Les Extraoral Masticator

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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