Price Checker / CPT 40806
How much does Incision Of Lip Fold cost?
CPT 40806 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 185x the fair price — among the most extreme markups. Dispute this.
Fair price
$150–$300
What this should cost
With insurance
~$2,350
Typical out-of-pocket
Overcharged if over
$380
Push back above this
The average hospital charge of $42,609 is $42,379 over the fair price (about 185x the fair rate).
What hospitals charge for Incision Of Lip Fold
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| John Muir Health Behavioral Health Center , CA | $42,609 | $19,174 | 42004% |
| John Muir Health Walnut Creek Medical Center , CA | $42,609 | $19,174 | 42004% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Incision Of Lip Fold
CPT code 40806 refers to incision of lip fold (billing description: "Incision of lip fold"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $29 in a facility (hospital or surgery center) and $101 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.