CPT 55040

Other Organ Systems

Current code44 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 55040 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
BHC Fairfax HospitalKirkland	—	$649	$649
EvergreenHealth Medical CenterKirkland	—	$8,315	$10,394
Island HospitalAnacortes	$1,384 – $1,5023 plans	$639 – $798	$639 – $798
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$624Doctor’s fee: $406 – $624	$960Doctor’s fee: $624 – $960
Seattle Children's HospitalSeattle	$204 – $2189 plans	$1,428	$1,428
Three Rivers HospitalBrewster	Doctor’s fee: $1,652	Doctor’s fee: $2,361	Doctor’s fee: $2,361
Trios HealthKennewick	—	—	$20,236 – $30,936
Virginia Mason Medical CenterSeattle	—	$5,064	$9,930

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $345 in a hospital or surgery center
Doctor's fee, rest of Washington: $318 in a hospital or surgery center
Hospital outpatient payment (national): $3,658 (APC 5341)
Surgery center payment (national): $1,744

How hospitals also write this code

Some price files write it differently. These are counted as CPT 55040:

55040P (with a letter after it, P; 2 price lines)