CPT code 40761: Cleft repair, secondary cross-lip flap2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $1,063.78 for 40761 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 40761 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 40761 covers

This operation rebuilds a previously repaired cleft lip and associated nasal deformity using a cross-lip flap: tissue from one lip is transferred to restore deficient tissue in the other. The surgeon also closes the flap donor site as part of the service. Plastic surgeons and cleft-craniofacial surgeons typically perform this reconstruction in an operating room when a prior repair leaves a lip or nasal defect that calls for flap tissue rather than direct reclosure.

Select the code when the documented secondary repair uses a cross-lip flap for cleft lip/nasal reconstruction; a routine primary repair or secondary repair by direct recreation and closure is a different service. The operative report should identify the defect, flap design and transfer, repaired lip/nasal structures, and donor-site closure. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant-at-surgery service, and 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 Washington, DC area compares for 40761

Across 109 of 109 payment localities, the facility rate for 40761 runs from $866.62 in Arkansas to $1,200.25 in Alaska. Washington, DC area pays $1,063.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

40761 rates by state

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

See 40761 in every payment locality

How the 40761 rate is calculated

Each of 40761’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 40761

40761 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 40761

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

How 40761 has changed in Washington, DC area

Price 40761 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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