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    v1.0.30
    OpenPayerBilling CodesOther Procedures on the Dentoalveolar StructuresCPT cpt-41899-unlisted-dentoalveolar-procedure
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    CPT 41899: Unlisted Procedure, Dentoalveolar Structures

    Commercial payers pay $1597 on average nationally for this procedure.

    CPT code 41899 is used to report an unlisted procedure on the teeth and adjoining alveolar structures, capturing services that do not have a specific CPT code; typical service type is dentoalveolar surgical or operative procedure performed in an oral surgery or dental clinic setting or comparable ambulatory surgical location.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    National Reimbursement Benchmarks

    Commercial reimbursement for CPT 41899 centers around a BUCA average commercial rate of $1,596.60, with individual payers showing notable differences in central tendency and upper extremes. Blue Cross Blue Shield has an exceptionally high maximum of $63,000 and a $90th percentile at $1,112.40, producing heavy upward skew; Aetna also shows high upper-end payments (90th percentile $6,846.20) but a more moderate mean of $2,829.80. Cigna (mean $595.50) and UnitedHealth Group (mean $876.20) sit closer to BUCA on average, while Blue Cross Blue Shield and Aetna drive much of the high-tail variability. Rate dispersion measured as P75 minus P25 highlights which payers are tightest or widest: Blue Cross Blue Shield has a narrow interquartile span of $37.00 (P75 $215.20 minus P25 $151.80), indicating tight central clustering; Cigna’s IQR is $663.70 (P75 $900.00 minus P25 $236.30) and UnitedHealth Group’s IQR is $811.80 (P75 $1,203.80 minus P25 $392.00), both showing substantial middle-range spread. Aetna’s IQR is $4,320.00, the widest of the set, reflecting large variability across commercial contracts.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 52-year-old patient presents to an oral and maxillofacial surgery clinic with persistent localized gingival overgrowth and an irregular alveolar ridge following prior tooth extraction. The patient reports discomfort with prosthesis seating and recurrent mucosal ulceration adjacent to the affected alveolar segment. Clinical exam and imaging identify an atypical soft-tissue lesion and bony irregularity that do not match standard gingivectomy, gingivoplasty, or alveoloplasty descriptions. The surgeon schedules an operative procedure to excise the lesion and reshape the adjoining alveolar structures using combined soft-tissue and limited osseous recontouring techniques.

    The clinical workflow includes preoperative evaluation, informed consent documenting the unlisted nature of the procedure, operative documentation with detailed description of steps performed, intraoperative photos or diagrams as needed, and submission of an itemized operative report with clinical rationale when billing 41899. The operative report must justify why standard codes such as 41870, 41872, or 41874 are not appropriate and include duration, complexity, tissues treated, and any adjunct services (e.g., anesthesia, pathology). Claims may require a detailed narrative and, for commercial payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, or Medicare, supporting documentation to determine reimbursement.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    99Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    1223S0112X
    1223D0004X
    204E00000X
    207ZI0100X
    207YX0007X
    2472E0500X
    275N00000X
    282N00000X

    Related ICD-10-CM Codes

    5 rows

    ICD-10-CM CodeDescription
    K06.9Disorder of gingiva and edentulous alveolar ridge, unspecified
    K14.0Glossitis
    K12.1Other forms of stomatitis
    K08.8
    K13.79Other lesions of oral mucosa

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-41870-PERIODONTAL-SOFT-TISSUE-GRAFT

    CPT 41870: Connective Tissue Graft to Tooth Root

    CPT-41872-GINGIVAL-CONTOURING-SINGLE-QUADRANT

    CPT 41872: Gingival Reshaping, Single Quadrant

    CPT-41874-ALVEOLOPLASTY-FOR-DENTURE-PREPARATION

    CPT 41874: Alveoloplasty for Denture Preparation

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    41870Gingivectomy, each quadrantStandard code for excision of gingival tissue; used when the procedure fits established gingivectomy definitions rather than an unlisted approach.
    41872Gingivoplasty, each quadrantUsed for reshaping gingival tissue; billed when soft-tissue contouring matches the descriptor instead of an unlisted procedure.
    41874Alveoloplasty, each quadrantUsed for osseous contouring of the alveolar ridge; selected when bony recontouring is within the scope of this code.
    41899Unlisted procedure, dentoalveolar structuresUsed when the combination of soft-tissue and alveolar work or the specific technique performed is not adequately described by 41870, 41872, or 41874.