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Excision Of A Mouth-Lining Lesion With Muscle

Montana rates for HCPCS 40816

This surgery removes a growth or lesion from the lining of the inside of the mouth, taking the lesion along with the layer of muscle beneath it. It is used when the lesion extends into the deeper muscle layer, so a simple surface removal would not fully address it. Removing the underlying muscle helps ensure the growth is completely excised.

Rates data updated October 2026.

How much does Excision Of A Mouth-Lining Lesion With Muscle cost?

$1,054

Typical total for the visit. In Montana, October 2026.

Insurers have agreed to pay about $1,054 for this procedure. That total is two separate charges: $479 to the doctor who performs it, and $575 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$479$417 to $646
Facility feeThe hospital or surgery center$575$479 to $708

How much rates vary

Facilitymedian $575 · 10th to 90th $468 to $1,995Professionalmedian $479 · 10th to 90th $288 to $692
$100$200$500$1K$2K$5Kfacility $575professional $479

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$316.23
Median
$416.87
Typical High
$1,174.90
Cigna
Setting
Facility
Modifier
None
Typical Low
$478.63
Median
$2,398.83
Typical High
$6,760.83
Cigna
Setting
Professional
Modifier
None
Typical Low
$478.63
Median
$478.63
Typical High
$645.65
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$467.74
Median
$562.34
Typical High
$758.58
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$309.03
Median
$478.63
Typical High
$741.31
Providence
Setting
Facility
Modifier
None
Typical Low
$478.63
Median
$2,398.83
Typical High
$6,760.83
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$478.63
Typical High
$645.65
United
Setting
Facility
Modifier
None
Typical Low
$1,445.44
Median
$2,238.72
Typical High
$3,162.28
United
Setting
Professional
Modifier
None
Typical Low
$489.78
Median
$588.84
Typical High
$794.33

Where Montana sits

The same service costs 5.2 times more in Alabama than in Montana. 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.

Physician feeFacility fee

Montana· 51st of 51

$1,054

$479 physician + $575 facility

AL $5,469MT $1,054

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.