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CPT 41872 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.

Gingivoplasty
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

11 - Office

22 - On Campus Outpatient Hospital

Common Modifiers

None

51 - Multiple procedures

59 - Distinct Procedural Service

Complexity LevelModerate

National average reimbursement for CPT 41872 by major payers:

bcbs

$553.57

uhc

$536.12

aetna

$592.48

cigna

$719.24

Preview provider-level rates for...
For billing codeCPT 41872
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 41872

United
41872$1005.001073764106 - FLORIDA EYE CLINIC AMBULATORY SURGICAL CENTER, INC.592303141FLAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$3000.001841325214 - AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERY208422547 - (MD) AMBULATORY CENTER FOR AESTHETIC AND RECONSTRUCTIVE SURGERYMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$702.001942242441 - ADVANCED EYE SURGERY CENTER, LLC510567447 - (FL) ADVANCED EYE SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$1500.001558328518 - BUTLER AMBULATORY SURGERY CENTER L L C61728190 - (PA) BUTLER AMBULATORY SURGERY CENTER, LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$2809.001366137440 - SURGERY CENTER OF GEORGETOWN, LLC, GEORGETOWN SURGERY CENTER880604963 - (TX) SURGERY CENTER OF GEORGETOWN LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$4839.001205809795 - OAKHURST ENDOSCOPY ASC LLC, OCEAN SURGICAL PAVILION, INC.223182653NJAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$5610.001073545299 - OREGON OUTPATIENT SURGERY CENTER LLC223883387 - (OR) OREGON OUTPATIENT SURGERY CENTER LLCORAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$2500.001902436348 - DLV VISION ASC842407060 - (CA) DLV VISION ASCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$6506.001699284018 - ONYX & PEARL SURGICAL SUITES LLC821183739 - (OH) ONYX & PEARL SURGICAL SUITES, LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$1420.001669437109 - MARIETTA OUTPATIENT SURGERY, LTD752160466 - (GA) MARIETTA OUTPATIENT SURGERY LTDGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$3162.001437250248 - GEORGIA SURGICAL CENTER ON PEACHTREE, LLC582394271 - (GA) GEORGIA SURGICAL CENTER ON PEACHTREE LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$6506.001295142511 - BAY AREA ENDOSCOPY CENTER LLC463916191 - (CA) BAY AREA ENDOSCOPY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$2300.001336649714 - HEALTHQARE SERVICES ASC LLC, HEALTHQARE SERVICES ASC LLC815460194 - (VA) HEALTHQARE SERVICES ASC LLCVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$1550.001538432844 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS562589722 - BARNET DULANEY PERKINS EYE CENTER PLLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
41872$5433.001356704027 - GLEN ECHO SURGERY CENTER, LLC474049838 - (MD) GLEN ECHO SURGERY CENTER LLCMDAmbulatory 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 41872 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 41872 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 41872 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
41820-CPTModerateGingivectomy Excision Gingiva Each Quadr
41821-CPTModerateOperculectomy Exc Pericoronal Tiss
41850-CPTModerateDestruct Lesion Dentoalveolar
41872-CPTModerateGingivoplasty

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 41872. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 41872 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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