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Excision Of A Mouth-Lining Lesion With Muscle

Rhode Island 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?

$417

Typical physician fee. In Rhode Island, July 2026.

Insurers have agreed to pay about $417 for this service. Most negotiated rates run $347 to $513.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,715 · 10th to 90th $2,570 to $7,413Professionalmedian $417 · 10th to 90th $324 to $617
$200.0$500.0$1.0K$2.0K$5.0K$10.0Kfacility $3,715professional $417

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,754.23
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$323.59
Median
$407.38
Typical High
$512.86
BCBS
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$501.19
Typical High
$812.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$501.19
Typical High
$724.44
United
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$4,677.35
Typical High
$7,585.78
United
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$436.52
Typical High
$691.83

Where Rhode Island sits

The same service costs 6.9 times more in California than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Rhode Island $417 · 46th of 51
CA $2,630WV $380

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.