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Difficult Removal of an Object From the Mouth Lining

Ohio rates for HCPCS 40805

Removes an object embedded in the tissue between the lips or cheeks and the gums, in cases that need more than a straightforward extraction — for example when it lies deep, is fragmented, or is surrounded by inflamed tissue. Reaching it may require cutting into the tissue and dissecting around it. The wound is cleaned and closed afterwards.

Rates data updated July 2026.

Facilitymedian $2,630 · 10th–90th $302$10,2330%5%10%10th90th$2,630Professionalmedian $288 · 10th–90th $195$7760%20%10th90th$288$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$3,019.95
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$281.84
Typical High
$4,365.16
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$2,238.72
Typical High
$4,073.80
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$288.40
Typical High
$489.78
CareSource
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$204.17
Typical High
$223.87
Cigna
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$323.59
Typical High
$21,379.62
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$331.13
Typical High
$562.34
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$21,379.62
Median
$21,379.62
Typical High
$21,379.62
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$338.84
Typical High
$549.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$295.12
Typical High
$562.34
United
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$912.01
Typical High
$2,818.38
United
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$302.00
Typical High
$501.19