CPT 41009 Surgery - Digestive

Drainage of mouth lesion Cost

Body System: Digestive

Medicare Facility Rate

$264

CMS PFS CY2026

Medicare Non-Facility Rate

$433

Office/clinic setting

Hospital Outpatient

$551

OPPS rate

Surgery Center (ASC)

$295

ASC rate

Relative Value Units (RVUs)

Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)

3.62

Work RVU

3.81

Facility PE RVU

0.48

Malpractice RVU

12.96

Total RVU

Frequently Asked Questions

How much does Drainage of mouth lesion cost?

The Medicare facility rate is $264. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $551. Ambulatory surgery center rate: $295.

How much does Drainage of mouth lesion cost without insurance?

Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $264.