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See a sample rate comparisonHealthcare 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 | 11 - Office 21 - Inpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $426.20 national non-facility rate (2026) · View Medicare rates for 41806 |
| Medicaid Fee Schedule | $333.975 median of the 8 states in the free preview · View Medicaid rates for 41806 |
National average reimbursement for CPT 41806 by major payers:

$466.38

$486.93

$536.50

$621.95
Choose a payer to see a sample of rates for CPT 41806.
Manatee Surgicare Ltd
Valley Baptist Ambulatory Surgery Center, LLC, Platinum Surgery Center
Surgcenter Northern Phoenix LLC
Physicians Pavilion Lp, Physicians Pavilion Surgery Center
Coppel Surgical Solutions, Nevada Surgical Suites
Coppel Surgical Solutions
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Rate Benchmarking
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See a sample payer proposalCPT 41806 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 41806 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 41806 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 |
|---|---|---|
| 41800-CPT | Moderate | Drain Abscess From Gum Ridge, Surgery To Drain An Infected Pocket Of Blood Pus Or Fluid That Has Collected In The Bony Ridge That Holds The Gum And Teeth (Dentoalveolar Structures). |
| 41805-CPT | Moderate | Removal Of Embedded Foreign Bo, Removal Of Embedded Foreign Body From Dentoalveolarstructures Soft Tissues Removal Of Embedded Foreign Body From Dentoalveolar |
| 41806-CPT | Moderate | Removal Of Embedded Foreign Bo, Removal Of Embedded Foreign Body From Dentoalveolarstructures Bone Removal Of Embedded Foreign Body From Dentoalveolar |
| 41820-CPT | Moderate | Gingivectomy Excision Gingiva Each Quadr |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 41806. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 41806 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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