CPT code 40701: Cleft lip repair, primary, bilateral2026 Medicare rate & RVUs in Utah

In Utah, Medicare pays $1,030.55 for 40701 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 40701 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 40701 covers

This code describes the initial operative reconstruction of a cleft involving both sides of the lip, with repair of the associated nasal deformity. It is typically performed by a plastic, craniofacial, or oral and maxillofacial surgeon in an operating room, often as part of an infant’s cleft-care plan. The work addresses the bilateral defect in the same operation rather than a later revision of a prior repair.

Report the code when the operative record supports a primary repair and bilateral involvement; document the defect and the reconstruction performed. The code is priced as bilateral, so modifier 50 does not increase payment. It has a 90-day global period that includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Utah compares for 40701

Across 109 of 109 payment localities, the facility rate for 40701 runs from $958.35 in Arkansas to $1,325.09 in Alaska. Utah pays $1,030.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

40701 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 40701 in every payment locality

How the 40701 rate is calculated

Each of 40701’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 40701

40701 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 40701

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 40701 has changed in Utah

Price 40701 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

• Alpine
• Alta
• Altamont
• Alton
• Amalga
• American Fork
• Aneth
• Annabella

Browse all communities in Utah

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates