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See a sample rate comparisonCPT 41250 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.
Repair Of Laceration 2.5 Cm O, Repair Of Laceration 2.5 Cm Or Less Floor Of Mouth Andor Anterior Two-Thirds Of Tongue Repair Of Laceration 2.5 Cm Or Less Floor Of Mouth Andor
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 23 - Emergency Room 11 - Office |
| Common Modifiers | UA AG - Primary physician |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $336.68 national non-facility rate (2026) · View Medicare rates for 41250 |
| Medicaid Fee Schedule | $255.115 median of the 8 states in the free preview · View Medicaid rates for 41250 |
National average reimbursement for CPT 41250 by major payers:
$318.16
$342.76
$377.99
$424.28
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CPT 41250
5 of 25 sample ratesHigher to lower in this preview
South Anchorage Surgery Center, LLC
South Anchorage Surgery Center LLC
$780.00Published rateAdvanced Surgery Center Of Sarasota, LLC
Advanced Surgery Center Of Sarasota LLC
$566.00Published ratePort Orange Endoscopy & Surgery Center LLC, Adventhealth Surgery Center Port Orange
$290.00Published rateVicki Mcneill
Deaconess Hospital Inc
$221.11Published rateRenaissance Surgery Center Of Chattanooga, LLC
Renaissance Surgery Center Of Chattanooga LLC
$52.00Published rate
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See a sample payer proposalCPT 41250 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 41250 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 41250 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 |
|---|---|---|
| 41116-CPT | Moderate | Exc Lesion Oral Floor |
| 41250-CPT | Moderate | Repair Of Laceration 2.5 Cm O, Repair Of Laceration 2.5 Cm Or Less Floor Of Mouth Andor Anterior Two-Thirds Of Tongue Repair Of Laceration 2.5 Cm Or Less Floor Of Mouth Andor |
| 41251-CPT | Moderate | Rpair Of Lacerat 2.5 Cm Or <; Posteri One-Third Of Tongue, Repair Of Laceration 2.5 Cm Or Less; Posterior One-Third Of Tongue |
| 41252-CPT | Moderate | Repair Of Laceration Of Tongu, Repair Of Laceration Of Tongue Floor Of Mouth Over 2.6 Cmor Complex Repair Of Laceration Of Tongue Floor Of Mouth Over 2.6 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 41250. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 41250 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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