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

In South Dakota, Medicare pays $206.21 for 40800 in the office and $112.35 when it’s performed in a hospital or facility.

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.

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 South Dakota 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. South Dakota pays $206.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

40800 rates by state

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

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.

Payment rules and modifiers for 40800

40800 has a 10-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 40800

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

How 40800 has changed in South Dakota

Price 40800 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

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