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Lip or Cheek Frenulum Removal

New Mexico rates for HCPCS 40819

This is the surgical removal of the small band of tissue that connects the inside of the lip or cheek to the gum. It's often done when that band is unusually tight, restricts lip movement, or pulls on the gum line in a way that risks gum recession. The tissue is cut and the area is left to heal, sometimes with a stitch or two.

Rates data updated July 2026.

How much does Lip or Cheek Frenulum Removal cost?

$316

Typical negotiated rate. In New Mexico, July 2026.

Insurers have agreed to pay about $316 for this service. The price depends on where it is billed: about $295 from a physician practice, and about $2,089 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 6 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$295$251 to $380
FacilityA hospital or hospital-owned outpatient department$2,089$437 to $3,236

How much rates vary

Facilitymedian $2,089 · 10th to 90th $302 to $4,365Professionalmedian $295 · 10th to 90th $195 to $562
$50$100$200$500$1K$2K$5Kfacility $2,089professional $295

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
$288.40
Median
$436.52
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$281.84
Typical High
$1,122.02
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$2,754.23
Typical High
$4,365.16
BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$316.23
Typical High
$389.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$346.74
Typical High
$501.19
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$380.19
Providence
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$371.54
Typical High
$691.83
Providence
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$346.74
Typical High
$501.19
United
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$3,630.78
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$251.19
Median
$380.19
Typical High
$575.44

Where New Mexico sits

The same service costs 5.2 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.

New Mexico· 42nd of 51

$316

CA $1,349WV $257

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.