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CPT code 40800: Oral drainage, simple vestibular drainage2026 Medicare rate & RVUs in Indiana

Reports simple drainage of a localized collection in the mouth’s vestibule, such as an abscess along the inner lip or cheek near the teeth.

CMS RVU26DEffective Oct 1, 2026One payment locality1.5K Medicare services in 2024

In Indiana, Medicare pays $195.01 for 40800 in the office and $108.01 when it’s performed in a hospital or facility.

$195.01Office (non-facility)
$108.01Hospital or facility
−7.0%vs the national office rate ($209.76)

Check a contract rate as a % of Medicare · 40800 nationwide

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

We’ll open 40800 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Indiana
  2. What 40800 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 40800 covers

CPT 40800 covers a simple procedure to open and empty a localized fluid collection in the oral vestibule, the space between the lips or cheeks and the teeth and gums. A typical case is a small abscess along the inner lip or cheek beside the dental arch. An oral and maxillofacial surgeon or another clinician treating oral disease may perform the service in an office or facility. This is drainage, not diagnostic tissue sampling, foreign-body removal, or excision of a lesion.

Select 40800 when the documented work supports simple drainage; 40801 is the related code for complicated drainage. Document the collection’s precise vestibular location and the drainage performed. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery services are not paid, 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 Indiana compares for 40800

Across 109 of 109 payment localities, the office rate for 40800 runs from $183.99 in Arkansas to $284.32 in San Benito County, CA. Indiana pays $195.01. The RVUs are the same everywhere; the geographic indexes change the dollars.

40800 in Indiana vs other payment areas
  1. Indiana · this page$195.01
  2. Los Angeles, CA · California$239.68+$44.67
  3. Washington, DC area · District of Columbia$241.78+$46.77
  4. Miami, FL · Florida$224.67+$29.66
  5. Chicago, IL · Illinois$217.78+$22.77
  6. Manhattan, NY · New York$242.08+$47.07
  7. Alaska · Alaska$238.08+$43.07

Other areas in Indiana first, then benchmark localities. Bars start at $0.

Every other payment area

40800 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$186.90$104.77
ArkansasArkansas$183.99$103.37
ArizonaArizona$203.89$112.95
Bakersfield, CACalifornia$224.21$121.34
Chico, CACalifornia$223.74$120.87
El Centro, CACalifornia$223.76$120.90
Fresno, CACalifornia$223.74$120.87
Hanford, CACalifornia$223.74$120.87

40800 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$183.99

$254.03

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
40800 office rate range by state
State / territoryOffice rate rangeLocalities
AK$238.081
AL$186.901
AR$183.991
AZ$203.891
CA$223.74–$284.3229
CO$219.591
CT$224.341
DC$241.781
DE$207.451
FL$205.22–$224.673
GA$193.04–$213.582
GU$230.021
HI$230.021
IA$192.571
ID$193.791
IL$198.47–$218.604
IN$195.011
KS$191.331
KY$191.061
LA$190.63–$200.792
MA$218.02–$242.692
MD$211.69–$241.783
ME$194.59–$206.312
MI$196.15–$207.672
MN$210.761
MO$186.94–$201.883
MS$185.521
MT$209.751
NC$196.821
ND$206.581
NE$193.781
NH$215.831
NJ$227.00–$238.942
NM$197.191
NV$209.031
NY$199.95–$247.965
OH$195.501
OK$190.981
OR$207.51–$227.272
PA$195.99–$218.252
PR$211.491
RI$215.361
SC$196.471
SD$206.211
TN$192.331
TX$194.59–$218.768
UT$199.351
VA$205.39–$241.782
VI$211.491
VT$205.471
WA$217.71–$248.092
WI$199.161
WV$190.531
WY$208.371

See 40800 in every payment locality

How the 40800 rate is calculated

Each of 40800’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.

How the rate is built · 40800

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.20

1.20 RVUs× 1.000 GPCI

Practice expense4.92

4.92 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

6.2800

Conversion factor

$33.4009

Medicare rate

$209.76

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Indiana inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,857

Code
40800
Physician work
1.20
Practice expense
4.92
Malpractice
0.16

GPCI2026.csv

52

Locality
Indiana
Physician work
1.000
Practice expense
0.927
Malpractice
0.486
Office calculation for 40800 in Indiana
ComponentRVULocality factorAdjusted
Physician work1.20× 1.0001.2000
Practice expense4.92× 0.9274.5608
Malpractice0.16× 0.4860.0778
Total RVUs5.8386
Conversion factor× 33.4009

Office rate, Indiana$195.01

Office: (1.2 × 1 + 4.92 × 0.927 + 0.16 × 0.486) × $33.4009 = $195.01

Facility: (1.2 × 1 + 2.11 × 0.927 + 0.16 × 0.486) × $33.4009 = $108.01

Open 40800 in the RVU calculator

Payment rules and modifiers for 40800

40800 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40800

Oral drainage, simple vestibular drainage

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 40800

Oral drainage, simple vestibular drainage

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

40800 without 51 · national office

$209.76

Oral drainage, simple vestibular drainage

40800-51 · Second procedure: 50%

$104.88

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 40800

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

Codes related to 40800
CodeHow it relatesOffice range, Indiana
Same family
40801Mouth drainage, complicated vestibular collectionRelated code for complicated drainage of a vestibular collection.$286.09
Used instead
40808Mouth biopsy, oral vestibuleUsed for biopsy when tissue sampling, rather than drainage, is performed.$156.17
40810Mouth lesion excision, without repairUsed for excision of a vestibular lesion rather than opening and draining it.$200.92
40804Foreign body removal, simple intraoral removalUsed for simple removal of a foreign body from the oral vestibule.$194.12

How 40800 has changed in Indiana

40800 · Office / nonfacility

$195.01

Effective 2026-10-01

The base rate is $11.22 higher than on 2025-10-01, moving from $183.79 to $195.01 (6.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $183.79changed to$195.01

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.23 changed to 1.20
    • Practice expense RVU 4.76 changed to 4.92
    • Malpractice RVU 0.13 changed to 0.16
    • Practice expense GPCI 0.922 changed to 0.927
    • Malpractice GPCI 0.485 changed to 0.486

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $187.90changed to$183.79

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.72 changed to 4.76

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $184.84changed to$187.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $189.63changed to$184.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.73 changed to 4.72
    • Malpractice RVU 0.12 changed to 0.13
    • Practice expense GPCI 0.911 changed to 0.922
    • Malpractice GPCI 0.475 changed to 0.485

  5. January 1, 2023

    RVU23A

    $192.75changed to$189.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.76 changed to 4.73
    • Practice expense GPCI 0.900 changed to 0.911
    • Malpractice GPCI 0.465 changed to 0.475

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $197.96changed to$192.75

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.87 changed to 4.76
    • Malpractice RVU 0.13 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $197.62changed to$197.96

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.61 changed to 4.87
    • Malpractice RVU 0.12 changed to 0.13
    • Practice expense GPCI 0.910 changed to 0.900
    • Malpractice GPCI 0.422 changed to 0.465

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $201.07changed to$197.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.65 changed to 4.61
    • Malpractice RVU 0.20 changed to 0.12
    • Practice expense GPCI 0.919 changed to 0.910
    • Malpractice GPCI 0.379 changed to 0.422

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $202.17changed to$201.07

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.69 changed to 4.65

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $203.89changed to$202.17

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.73 changed to 4.69
    • Practice expense GPCI 0.920 changed to 0.919
    • Malpractice GPCI 0.498 changed to 0.379

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $205.75changed to$203.89

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.77 changed to 4.73
    • Practice expense GPCI 0.921 changed to 0.920
    • Malpractice GPCI 0.617 changed to 0.498

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $205.61changed to$205.75

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.75 changed to 4.77
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $204.59changed to$205.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $204.69changed to$204.59

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.17 changed to 0.19
    • Practice expense GPCI 0.922 changed to 0.921
    • Malpractice GPCI 0.615 changed to 0.617

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $208.59changed to$204.69

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.19 changed to 4.75
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.923 changed to 0.922
    • Malpractice GPCI 0.613 changed to 0.615

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $208.59

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$195.01$108.01RVU26D
2026-07-01$195.01$108.01RVU26C
2026-04-01$195.01$108.01RVU26B
2026-01-01$195.01$108.01RVU26A
2025-10-01$183.79$110.12RVU25D
2025-07-01$183.79$110.12RVU25C
2025-04-01$183.79$110.12RVU25B
2025-01-01$183.79$110.12RVU25A
2024-10-01$187.90$111.18RVU24D
2024-07-01$187.90$111.18RVU24C
2024-04-01$187.90$111.18RVU24B
2024-03-09$187.90$111.18RVU24AR
2024-01-01$184.84$109.36RVU24A
2023-10-01$189.63$111.22RVU23D
2023-07-01$189.63$111.22RVU23C
2023-04-01$189.63$111.22RVU23B
2023-01-01$189.63$111.22RVU23A
2022-10-01$192.75$111.46RVU22D
2022-07-01$192.75$111.46RVU22C
2022-04-01$192.75$111.46RVU22B
2022-01-01$192.75$111.46RVU22A
2021-10-01$197.96$113.80RVU21D
2021-07-01$197.96$113.80RVU21C
2021-04-01$197.96$113.80RVU21B
2021-01-01$197.96$113.80RVU21A
2020-10-01$197.62$118.80RVU20D
2020-07-01$197.62$118.80RVU20C
2020-04-01$197.62$118.80RVU20B
2020-01-01$197.62$118.80RVU20A
2019-10-01$201.07$122.90RVU19D
2019-07-01$201.07$122.90RVU19C
2019-04-01$201.07$122.90RVU19B
2019-01-01$201.07$122.90RVU19A
2018-10-01$202.17$125.75RVU18D
2018-07-01$202.17$125.75RVU18C
2018-04-01$202.17$125.75RVU18B
2018-01-01$202.17$125.75RVU18AR1
2017-10-01$203.89$127.62RVU17D
2017-07-01$203.89$127.62RVU17C
2017-04-01$203.89$127.62RVU17B
2017-01-01$203.89$127.62RVU17A
2016-10-01$205.75$128.92RVU16D
2016-07-01$205.75$128.92RVU16C
2016-04-01$205.75$128.92RVU16B
2016-01-01$205.75$128.92RVU16A
2015-10-01$205.61$129.49RVU15D
2015-07-01$205.61$129.49RVU15C
2015-04-01$204.59$128.85RVU15B
2015-01-01$204.59$128.85RVU15A
2014-10-01$204.69$128.07RVU14D
2014-07-01$204.69$128.07RVU14C
2014-04-01$204.69$128.07RVU14B
2014-01-01$204.69$128.07RVU14A
2013-10-01$208.59$129.13RVU13D
2013-07-01$208.59$129.13RVU13C
2013-04-01$208.59$129.13RVU13B
2013-01-01$208.59$129.13RVU13AR

Price 40800 for an earlier date of service

Where the Indiana rate applies

Indiana is a Medicare payment area, not a city. Our Census mapping connects it to 974 cities and communities in Indiana. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Abington
  • Adams
  • Adams Lake
  • Advance
  • Akron
  • Alamo
  • Albany

Browse all communities in Indiana

40800 billing questions

How is 40800 distinguished from 40801?

40800 is for simple drainage in the oral vestibule; 40801 is for complicated drainage. The procedure note should support the level selected.

When is a biopsy code more appropriate?

Use 40808 when the service is a biopsy of a vestibular lesion for tissue diagnosis, rather than simple drainage of a collection.

Can modifier 50 be used for collections on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Are related postoperative visits separately payable during the global period?

Related postoperative visits during the 10-day global period are included in the procedure.

Can an assistant or co-surgeon be paid for this procedure?

Assistant-at-surgery services are not paid for this code. Co-surgeons and team surgery are not permitted.

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

Show the CMS file lines behind this rate
RVUs for 40800PPRRVU2026_Oct_nonQPP.csv, line 4,857 (RVU26D)
Geographic factors for IndianaGPCI2026.csv, line 52 (RVU26D)

Open CMS sourceHow we calculate rates

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