CPT code 40804: Foreign body removal, simple intraoral removal2026 Medicare rate & RVUs in New Mexico

Reports straightforward removal of a foreign object from inside the mouth, such as an object lodged in oral soft tissue and extracted without extensive dissection.

CMS RVU26DEffective Oct 1, 2026One payment locality77 Medicare services in 2024

In New Mexico, Medicare pays $197.06 for 40804 in the office and $111.30 when it’s performed in a hospital or facility.

$197.06Office (non-facility)
$111.30Hospital or facility
−5.8%vs the national office rate ($209.09)

Check a contract rate as a % of Medicare · 40804 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 40804 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 40804 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 40804 covers

This service covers a straightforward extraction of a foreign object from inside the mouth. A physician, dentist, or other qualified practitioner may perform it in an office, emergency department, or operating setting when an object is lodged in oral tissue and can be removed without extensive dissection. Examples may include a small fragment embedded in the cheek or gum tissue. The key distinction from 40805 is the complexity of the removal, not simply the object’s identity.

Report 40804 when the documented work supports a simple intraoral extraction; describe the object’s location and the steps used to remove it. Related postoperative visits during the 10-day global period are included. If other procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Do not use modifier 50 for bilateral removal. Assistant-at-surgery payment requires documented medical necessity; 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 New Mexico compares for 40804

Across 109 of 109 payment localities, the office rate for 40804 runs from $183.41 in Arkansas to $281.67 in San Benito County, CA. New Mexico pays $197.06. The RVUs are the same everywhere; the geographic indexes change the dollars.

40804 in New Mexico vs other payment areas
  1. New Mexico · this page$197.06
  2. Los Angeles, CA · California$238.04+$40.98
  3. Washington, DC area · District of Columbia$240.64+$43.58
  4. Miami, FL · Florida$225.37+$28.31
  5. Chicago, IL · Illinois$218.41+$21.35
  6. Manhattan, NY · New York$241.50+$44.44
  7. Alaska · Alaska$237.87+$40.81

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

Every other payment area

40804 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$186.29$104.46
ArkansasArkansas$183.41$103.07
ArizonaArizona$203.21$112.58
Bakersfield, CACalifornia$222.81$120.30
Chico, CACalifornia$222.26$119.76
El Centro, CACalifornia$222.29$119.79
Fresno, CACalifornia$222.26$119.76
Hanford, CACalifornia$222.26$119.76

40804 rates by state

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

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.

$183.41

$251.97

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

View every state and territory as a table
40804 office rate range by state
State / territoryOffice rate rangeLocalities
AK$237.871
AL$186.291
AR$183.411
AZ$203.211
CA$222.26–$281.6729
CO$218.471
CT$223.621
DC$240.641
DE$206.741
FL$205.23–$225.373
GA$192.99–$213.062
GU$228.381
HI$228.381
IA$191.641
ID$192.921
IL$198.71–$218.614
IN$194.121
KS$190.551
KY$190.751
LA$190.39–$200.492
MA$216.98–$241.232
MD$210.92–$240.643
ME$193.86–$205.302
MI$195.96–$207.832
MN$209.271
MO$186.80–$201.413
MS$185.151
MT$209.081
NC$196.061
ND$205.321
NE$192.801
NH$214.871
NJ$226.15–$237.852
NM$197.061
NV$208.191
NY$199.19–$247.545
OH$195.191
OK$190.521
OR$206.56–$225.942
PA$195.59–$217.652
PR$210.761
RI$214.501
SC$195.951
SD$204.881
TN$191.561
TX$194.21–$217.758
UT$198.821
VA$204.50–$240.642
VI$210.761
VT$204.351
WA$216.62–$246.442
WI$197.961
WV$190.821
WY$207.441

See 40804 in every payment locality

How the 40804 rate is calculated

Each of 40804’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 · 40804

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.27

1.27 RVUs× 1.000 GPCI

Practice expense4.80

4.80 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

6.2600

Conversion factor

$33.4009

Medicare rate

$209.09

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

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,859

Code
40804
Physician work
1.27
Practice expense
4.80
Malpractice
0.19

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 40804 in New Mexico
ComponentRVULocality factorAdjusted
Physician work1.27× 1.0001.2700
Practice expense4.80× 0.9174.4016
Malpractice0.19× 1.2010.2282
Total RVUs5.8998
Conversion factor× 33.4009

Office rate, New Mexico$197.06

Office: (1.27 × 1 + 4.8 × 0.917 + 0.19 × 1.201) × $33.4009 = $197.06

Facility: (1.27 × 1 + 2 × 0.917 + 0.19 × 1.201) × $33.4009 = $111.30

Open 40804 in the RVU calculator

Payment rules and modifiers for 40804

40804 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40804

Foreign body removal, simple intraoral removal

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)0Not paid without supporting documentation.
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 · 40804

Foreign body removal, simple intraoral removal

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

40804 without 51 · national office

$209.09

Foreign body removal, simple intraoral removal

40804-51 · Second procedure: 50%

$104.55

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

How 40804 has changed in New Mexico

40804 · Office / nonfacility

$197.06

Effective 2026-10-01

The base rate is $17.87 higher than on 2025-10-01, moving from $179.19 to $197.06 (10.0%).

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

    $179.19changed to$197.06

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.30 changed to 1.27
    • Practice expense RVU 4.45 changed to 4.80
    • Malpractice RVU 0.17 changed to 0.19
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $177.58changed to$179.19

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.25 changed to 4.45
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $174.68changed to$177.58

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $177.94changed to$174.68

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.16 changed to 4.25
    • Malpractice RVU 0.17 changed to 0.15
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172
  5. January 1, 2023

    RVU23A

    $179.94changed to$177.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.17 changed to 4.16
    • Malpractice RVU 0.14 changed to 0.17
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $187.15changed to$179.94

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.34 changed to 4.17
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $190.75changed to$187.15

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.15 changed to 4.34
    • Malpractice RVU 0.18 changed to 0.15
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $187.83changed to$190.75

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.99 changed to 4.15
    • Malpractice RVU 0.19 changed to 0.18
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $187.38changed to$187.83

    • Malpractice RVU 0.18 changed to 0.19

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $180.66changed to$187.38

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.78 changed to 3.99
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $180.89changed to$180.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.83 changed to 3.78
    • Malpractice RVU 0.18 changed to 0.19
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $188.03changed to$180.89

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.06 changed to 3.83
    • Malpractice RVU 0.19 changed to 0.18
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $209.19changed to$188.03

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.68 changed to 4.06

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $208.15changed to$209.19

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $213.18changed to$208.15

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.89 changed to 4.68
    • Malpractice RVU 0.15 changed to 0.19
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $214.83changed to$213.18

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.30 changed to 4.89
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $214.83

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$197.06$111.30RVU26D
2026-07-01$197.06$111.30RVU26C
2026-04-01$197.06$111.30RVU26B
2026-01-01$197.06$111.30RVU26A
2025-10-01$179.19$110.76RVU25D
2025-07-01$179.19$110.76RVU25C
2025-04-01$179.19$110.76RVU25B
2025-01-01$179.19$110.76RVU25A
2024-10-01$177.58$109.27RVU24D
2024-07-01$177.58$109.27RVU24C
2024-04-01$177.58$109.27RVU24B
2024-03-09$177.58$109.27RVU24AR
2024-01-01$174.68$107.49RVU24A
2023-10-01$177.94$109.17RVU23D
2023-07-01$177.94$109.17RVU23C
2023-04-01$177.94$109.17RVU23B
2023-01-01$177.94$109.17RVU23A
2022-10-01$179.94$108.31RVU22D
2022-07-01$179.94$108.31RVU22C
2022-04-01$179.94$108.31RVU22B
2022-01-01$179.94$108.31RVU22A
2021-10-01$187.15$110.55RVU21D
2021-07-01$187.15$110.55RVU21C
2021-04-01$187.15$110.55RVU21B
2021-01-01$187.15$110.55RVU21A
2020-10-01$190.75$117.35RVU20D
2020-07-01$190.75$117.35RVU20C
2020-04-01$190.75$117.35RVU20B
2020-01-01$190.75$117.35RVU20A
2019-10-01$187.83$117.79RVU19D
2019-07-01$187.83$117.79RVU19C
2019-04-01$187.38$117.34RVU19B
2019-01-01$187.38$117.34RVU19A
2018-10-01$180.66$115.34RVU18D
2018-07-01$180.66$115.34RVU18C
2018-04-01$180.66$115.34RVU18B
2018-01-01$180.66$115.34RVU18AR1
2017-10-01$180.89$114.86RVU17D
2017-07-01$180.89$114.86RVU17C
2017-04-01$180.89$114.86RVU17B
2017-01-01$180.89$114.86RVU17A
2016-10-01$188.03$118.28RVU16D
2016-07-01$188.03$118.28RVU16C
2016-04-01$188.03$118.28RVU16B
2016-01-01$188.03$118.28RVU16A
2015-10-01$209.19$132.24RVU15D
2015-07-01$209.19$132.24RVU15C
2015-04-01$208.15$131.59RVU15B
2015-01-01$208.15$131.59RVU15A
2014-10-01$213.18$132.28RVU14D
2014-07-01$213.18$132.28RVU14C
2014-04-01$213.18$132.28RVU14B
2014-01-01$213.18$132.28RVU14A
2013-10-01$214.83$132.24RVU13D
2013-07-01$214.83$132.24RVU13C
2013-04-01$214.83$132.24RVU13B
2013-01-01$214.83$132.24RVU13AR

Price 40804 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

40804 billing questions

How do I choose 40804 rather than 40805?

Use 40804 for a simple intraoral extraction. Use 40805 when the documented removal is complicated; the distinction is the complexity of the extraction.

Can removal of a foreign object be reported with drainage of an oral lesion?

A separate drainage service may be reported when a lesion is independently drained and the work is documented. Do not report drainage merely for extracting the object.

Are postoperative visits billed separately?

Related postoperative visits during the 10-day global period are included in 40804.

Should modifier 50 be used for objects on both sides of the mouth?

No. CMS bilateral adjustment does not apply to this service, and modifier 50 is inappropriate.

What supports reporting 40804?

Document the foreign object’s intraoral location and the removal performed, including enough detail to support a simple rather than complicated extraction.

Can an assistant or another surgeon be paid for the procedure?

Assistant-at-surgery payment requires documentation of medical necessity. 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 40804PPRRVU2026_Oct_nonQPP.csv, line 4,859 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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