go back

Excision Of A Mouth-Lining Lesion With Muscle

New York 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 July 2026.

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

$4,408

Typical total for the visit. In New York, July 2026.

Insurers have agreed to pay about $4,408 for this procedure. That total is two separate charges: $427 to the doctor who performs it, and $3,981 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 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$427$347 to $617
Facility feeThe hospital or surgery center$3,981$1,905 to $6,026

How much rates vary

Facilitymedian $3,981 · 10th to 90th $457 to $8,511Professionalmedian $427 · 10th to 90th $302 to $1,096
$100.0$1.0K$10.0Kfacility $3,981professional $427

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
$380.19
Median
$3,019.95
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$426.58
Typical High
$1,122.02
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,630.27
Median
$4,786.30
Typical High
$9,120.11
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$389.05
Typical High
$1,047.13
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$1,698.24
Typical High
$6,165.95
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$426.58
Median
$426.58
Typical High
$575.44
Cigna
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$5,011.87
Cigna
Setting
Professional
Modifier
Global
Typical Low
$309.03
Median
$676.08
Typical High
$1,548.82
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$363.08
Typical High
$1,071.52
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$588.84
Typical High
$851.14
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$537.03
Typical High
$1,000.00
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$398.11
Median
$537.03
Typical High
$1,071.52
United
Setting
Facility
Modifier
Global
Typical Low
$2,290.87
Median
$3,981.07
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$478.63
Typical High
$1,122.02
Univera
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$363.08
Typical High
$1,230.27
Univera
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$524.81
Typical High
$1,071.52

Where New York sits

The same service costs 10.6 times more in Wyoming than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility feeNew York $4,408 · 16th of 50
WY $7,991WV $752

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.