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Removal of the Lip's Outer Edge With Tissue Advancement

Pennsylvania rates for HCPCS 40500

This surgery removes the thin, exposed outer edge of the lip, called the vermilion border, usually because of precancerous changes or sun damage in that tissue. After the affected strip is removed, the surgeon advances the healthy inner lip lining forward and stitches it in place to recreate a normal-looking lip edge. It is most often used on the lower lip, which gets the most sun exposure.

Rates data updated July 2026.

How much does Removal of the Lip's Outer Edge With Tissue Advancement cost?

$562

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $562 for this service. The price depends on where it is billed: about $501 from a physician practice, and about $3,631 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$501$380 to $575
FacilityA hospital or hospital-owned outpatient department$3,631$1,585 to $5,370

How much rates vary

Facilitymedian $3,631 · 10th to 90th $631 to $8,318Professionalmedian $501 · 10th to 90th $347 to $851
$500$1K$2K$5K$10Kfacility $3,631professional $501

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$3,890.45
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$489.78
Typical High
$851.14
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$3,801.89
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$912.01
Median
$912.01
Typical High
$912.01
Cigna
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$501.19
Typical High
$831.76
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$407.38
Median
$616.60
Typical High
$870.96
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$2,818.38
Typical High
$8,317.64
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$512.86
Typical High
$2,089.30
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$446.68
Typical High
$478.63
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$1,698.24
Typical High
$2,951.21
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$363.08
Median
$380.19
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$2,818.38
Typical High
$9,772.37
United
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$501.19
Typical High
$812.83

Where Pennsylvania sits

The same service costs 5.6 times more in California than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 40th of 51

$562

CA $2,754WV $490

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.