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Cost Guide 40702 · Surgery

How much does Repair cleft lip and nasal structure cost?

Medicare pays $903.

By Kevin Nyk , Medical Billing Analyst · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.

4 care settings compared
CMS Medicare benchmark data
Updated 2026-04-03
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Medicare rateAverage chargeHigh end$0$6.5K
$5.9K
Above average
Average hospital charge vs. benchmarks: $904 (Medicare rate) · $5.9K (Average charge)
$904
Medicare rate
$2,917
ASC rate
$5,916
Avg hospital charge
$5,012
Price spread
Rate comparison — Repair cleft lip and nasal structure
Non-facility$99Medicare facility$904ASC rate$2.9KHospital outpatient$5.9KAvg chargemaster$5.9K$5.8K difference between lowest and highest rate
Research suggests 49–80% of hospital bills contain errors. Our system checks every line item against Medicare benchmarks.

Cost by care setting

Setting Medicare rate
Hospital outpatient (facility) $904
Physician office (non-facility) $99
Ambulatory surgery center $2,917
Hospital outpatient (APC) $5,916

What affects the cost?

How to save on Repair cleft lip and nasal structure

  • 1 Ask for an ASC (ambulatory surgery center) option — often 40–60% cheaper than hospital outpatient
  • 2 Request a written cost estimate before scheduling
  • 3 Verify that all providers (surgeon, anesthesiologist, pathologist) are in-network
  • 4 Ask about bundled pricing that includes facility, surgeon, and anesthesia
Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — Repair cleft lip and nasal structure cost

What is a fair price for Repair cleft lip/nasal?
Medicare pays $903 for Repair cleft lip/nasal (40702). This is the government benchmark rate. A fair price for commercially insured or cash-pay patients is typically 1.2–2.5x the Medicare rate, or roughly $1,084–$2,259.
How can I lower my cost for Repair cleft lip/nasal?
To lower your cost: (1) Compare prices at multiple facilities — use the comparison data on this page. (2) Ask about ASC (surgery center) options, which are often 40–60% cheaper. (3) Request cash-pay pricing upfront. (4) After receiving a bill, review each line item against Medicare benchmarks. Research suggests 49–80% of hospital bills contain errors.

Related pricing data

Repair cleft lip and nasal structure — Medicare rate detailsFull Medicare rate breakdown by setting and locality
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Data: Federal physician fee schedules, hospital payment data, surgery center rates, lab fee schedules, and drug pricing data. FY 2024. All publicly available from federal sources.

Methodology: Rates shown are national Medicare reimbursement rates by care setting. Price ranges reflect variation across hospitals reporting the same procedure code. Metro prices are averaged from hospital-level chargemaster data reported to CMS.

This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use

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