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

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 Nebraska, Medicare pays $193.78 for 40800 in the office and $107.15 when it’s performed in a hospital or facility.

$193.78Office (non-facility)
$107.15Hospital or facility
−7.6%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 Nebraska
  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 Nebraska 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. Nebraska pays $193.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

40800 in Nebraska vs other payment areas
  1. Nebraska · this page$193.78
  2. Los Angeles, CA · California$239.68+$45.90
  3. Washington, DC area · District of Columbia$241.78+$48.00
  4. Miami, FL · Florida$224.67+$30.89
  5. Chicago, IL · Illinois$217.78+$24.00
  6. Manhattan, NY · New York$242.08+$48.30
  7. Alaska · Alaska$238.08+$44.30

Other areas in Nebraska 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 Nebraska 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

72

Locality
Nebraska
Physician work
1.000
Practice expense
0.923
Malpractice
0.378
Office calculation for 40800 in Nebraska
ComponentRVULocality factorAdjusted
Physician work1.20× 1.0001.2000
Practice expense4.92× 0.9234.5412
Malpractice0.16× 0.3780.0605
Total RVUs5.8016
Conversion factor× 33.4009

Office rate, Nebraska$193.78

Office: (1.2 × 1 + 4.92 × 0.923 + 0.16 × 0.378) × $33.4009 = $193.78

Facility: (1.2 × 1 + 2.11 × 0.923 + 0.16 × 0.378) × $33.4009 = $107.15

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, Nebraska
Same family
40801Mouth drainage, complicated vestibular collectionRelated code for complicated drainage of a vestibular collection.$284.02
Used instead
40808Mouth biopsy, oral vestibuleUsed for biopsy when tissue sampling, rather than drainage, is performed.$155.14
40810Mouth lesion excision, without repairUsed for excision of a vestibular lesion rather than opening and draining it.$199.61
40804Foreign body removal, simple intraoral removalUsed for simple removal of a foreign body from the oral vestibule.$192.80

How 40800 has changed in Nebraska

40800 · Office / nonfacility

$193.78

Effective 2026-10-01

The base rate is $11.53 higher than on 2025-10-01, moving from $182.25 to $193.78 (6.3%).

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

    $182.25changed to$193.78

    • 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 0.917 changed to 0.923
    • Malpractice GPCI 0.304 changed to 0.378

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $186.34changed to$182.25

    • 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

    $183.29changed to$186.34

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $189.12changed to$183.29

    • 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 0.913 changed to 0.917
    • Malpractice GPCI 0.269 changed to 0.304

  5. January 1, 2023

    RVU23A

    $193.11changed to$189.12

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.76 changed to 4.73
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.235 changed to 0.269

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $198.28changed to$193.11

    • 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

    $196.82changed to$198.28

    • 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 0.909 changed to 0.908
    • Malpractice GPCI 0.277 changed to 0.235

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $199.12changed to$196.82

    • 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 0.910 changed to 0.909
    • Malpractice GPCI 0.318 changed to 0.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $200.21changed to$199.12

    • 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

    $200.89changed to$200.21

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.73 changed to 4.69
    • Practice expense GPCI 0.909 changed to 0.910
    • Malpractice GPCI 0.340 changed to 0.318

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $201.71changed to$200.89

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.77 changed to 4.73
    • Practice expense GPCI 0.908 changed to 0.909
    • Malpractice GPCI 0.362 changed to 0.340

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $201.65changed to$201.71

    • 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

    $200.65changed to$201.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $200.31changed to$200.65

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.17 changed to 0.19
    • Practice expense GPCI 0.906 changed to 0.908
    • Malpractice GPCI 0.342 changed to 0.362

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $203.45changed to$200.31

    • 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 0.904 changed to 0.906
    • Malpractice GPCI 0.322 changed to 0.342

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $203.45

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$193.78$107.15RVU26D
2026-07-01$193.78$107.15RVU26C
2026-04-01$193.78$107.15RVU26B
2026-01-01$193.78$107.15RVU26A
2025-10-01$182.25$108.99RVU25D
2025-07-01$182.25$108.99RVU25C
2025-04-01$182.25$108.99RVU25B
2025-01-01$182.25$108.99RVU25A
2024-10-01$186.34$110.02RVU24D
2024-07-01$186.34$110.02RVU24C
2024-04-01$186.34$110.02RVU24B
2024-03-09$186.34$110.02RVU24AR
2024-01-01$183.29$108.23RVU24A
2023-10-01$189.12$110.53RVU23D
2023-07-01$189.12$110.53RVU23C
2023-04-01$189.12$110.53RVU23B
2023-01-01$189.12$110.53RVU23A
2022-10-01$193.11$111.10RVU22D
2022-07-01$193.11$111.10RVU22C
2022-04-01$193.11$111.10RVU22B
2022-01-01$193.11$111.10RVU22A
2021-10-01$198.28$113.37RVU21D
2021-07-01$198.28$113.37RVU21C
2021-04-01$198.28$113.37RVU21B
2021-01-01$198.28$113.37RVU21A
2020-10-01$196.82$118.09RVU20D
2020-07-01$196.82$118.09RVU20C
2020-04-01$196.82$118.09RVU20B
2020-01-01$196.82$118.09RVU20A
2019-10-01$199.12$121.72RVU19D
2019-07-01$199.12$121.72RVU19C
2019-04-01$199.12$121.72RVU19B
2019-01-01$199.12$121.72RVU19A
2018-10-01$200.21$124.54RVU18D
2018-07-01$200.21$124.54RVU18C
2018-04-01$200.21$124.54RVU18B
2018-01-01$200.21$124.54RVU18AR1
2017-10-01$200.89$125.53RVU17D
2017-07-01$200.89$125.53RVU17C
2017-04-01$200.89$125.53RVU17B
2017-01-01$200.89$125.53RVU17A
2016-10-01$201.71$125.96RVU16D
2016-07-01$201.71$125.96RVU16C
2016-04-01$201.71$125.96RVU16B
2016-01-01$201.71$125.96RVU16A
2015-10-01$201.65$126.61RVU15D
2015-07-01$201.65$126.61RVU15C
2015-04-01$200.65$125.98RVU15B
2015-01-01$200.65$125.98RVU15A
2014-10-01$200.31$125.01RVU14D
2014-07-01$200.31$125.01RVU14C
2014-04-01$200.31$125.01RVU14B
2014-01-01$200.31$125.01RVU14A
2013-10-01$203.45$125.63RVU13D
2013-07-01$203.45$125.63RVU13C
2013-04-01$203.45$125.63RVU13B
2013-01-01$203.45$125.63RVU13AR

Price 40800 for an earlier date of service

Where the Nebraska rate applies

Nebraska is a Medicare payment area, not a city. Our Census mapping connects it to 593 cities and communities in Nebraska. Some span more than one payment area; confirm with the service ZIP.

  • Abie
  • Adams
  • Agnew
  • Ainsworth
  • Albion
  • Alda
  • Alexandria
  • Allen

Browse all communities in Nebraska

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 NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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