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

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 South Dakota, Medicare pays $204.88 for 40804 in the office and $111.35 when it’s performed in a hospital or facility.

$204.88Office (non-facility)
$111.35Hospital or facility
−2.0%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 South Dakota
  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 South Dakota 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. South Dakota pays $204.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

40804 in South Dakota vs other payment areas
  1. South Dakota · this page$204.88
  2. Los Angeles, CA · California$238.04+$33.16
  3. Washington, DC area · District of Columbia$240.64+$35.76
  4. Miami, FL · Florida$225.37+$20.49
  5. Chicago, IL · Illinois$218.41+$13.53
  6. Manhattan, NY · New York$241.50+$36.62
  7. Alaska · Alaska$237.87+$32.99

Other areas in South Dakota 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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 40804 in South Dakota
ComponentRVULocality factorAdjusted
Physician work1.27× 1.0001.2700
Practice expense4.80× 1.0004.8000
Malpractice0.19× 0.3360.0638
Total RVUs6.1338
Conversion factor× 33.4009

Office rate, South Dakota$204.88

Office: (1.27 × 1 + 4.8 × 1 + 0.19 × 0.336) × $33.4009 = $204.88

Facility: (1.27 × 1 + 2 × 1 + 0.19 × 0.336) × $33.4009 = $111.35

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 South Dakota

40804 · Office / nonfacility

$204.88

Effective 2026-10-01

The base rate is $16.79 higher than on 2025-10-01, moving from $188.09 to $204.88 (8.9%).

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

    $188.09changed to$204.88

    • 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
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $186.65changed to$188.09

    • 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

    $183.61changed to$186.65

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $187.12changed to$183.61

    • 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
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $190.98changed to$187.12

    • 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
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $198.61changed to$190.98

    • 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

    $199.08changed to$198.61

    • 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
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $193.31changed to$199.08

    • 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
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $193.17changed to$193.31

    • Malpractice RVU 0.18 changed to 0.19

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $185.54changed to$193.17

    • 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

    $186.66changed to$185.54

    • 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
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $194.63changed to$186.66

    • 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
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $217.61changed to$194.63

    • 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

    $216.53changed to$217.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $223.98changed to$216.53

    • 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
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $226.90changed to$223.98

    • 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
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $226.90

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$204.88$111.35RVU26D
2026-07-01$204.88$111.35RVU26C
2026-04-01$204.88$111.35RVU26B
2026-01-01$204.88$111.35RVU26A
2025-10-01$188.09$112.73RVU25D
2025-07-01$188.09$112.73RVU25C
2025-04-01$188.09$112.73RVU25B
2025-01-01$188.09$112.73RVU25A
2024-10-01$186.65$111.42RVU24D
2024-07-01$186.65$111.42RVU24C
2024-04-01$186.65$111.42RVU24B
2024-03-09$186.65$111.42RVU24AR
2024-01-01$183.61$109.60RVU24A
2023-10-01$187.12$110.87RVU23D
2023-07-01$187.12$110.87RVU23C
2023-04-01$187.12$110.87RVU23B
2023-01-01$187.12$110.87RVU23A
2022-10-01$190.98$111.04RVU22D
2022-07-01$190.98$111.04RVU22C
2022-04-01$190.98$111.04RVU22B
2022-01-01$190.98$111.04RVU22A
2021-10-01$198.61$113.13RVU21D
2021-07-01$198.61$113.13RVU21C
2021-04-01$198.61$113.13RVU21B
2021-01-01$198.61$113.13RVU21A
2020-10-01$199.08$118.24RVU20D
2020-07-01$199.08$118.24RVU20C
2020-04-01$199.08$118.24RVU20B
2020-01-01$199.08$118.24RVU20A
2019-10-01$193.31$117.27RVU19D
2019-07-01$193.31$117.27RVU19C
2019-04-01$193.17$117.13RVU19B
2019-01-01$193.17$117.13RVU19A
2018-10-01$185.54$114.62RVU18D
2018-07-01$185.54$114.62RVU18C
2018-04-01$185.54$114.62RVU18B
2018-01-01$185.54$114.62RVU18AR1
2017-10-01$186.66$114.88RVU17D
2017-07-01$186.66$114.88RVU17C
2017-04-01$186.66$114.88RVU17B
2017-01-01$186.66$114.88RVU17A
2016-10-01$194.63$118.73RVU16D
2016-07-01$194.63$118.73RVU16C
2016-04-01$194.63$118.73RVU16B
2016-01-01$194.63$118.73RVU16A
2015-10-01$217.61$133.89RVU15D
2015-07-01$217.61$133.89RVU15C
2015-04-01$216.53$133.22RVU15B
2015-01-01$216.53$133.22RVU15A
2014-10-01$223.98$135.85RVU14D
2014-07-01$223.98$135.85RVU14C
2014-04-01$223.98$135.85RVU14B
2014-01-01$223.98$135.85RVU14A
2013-10-01$226.90$136.74RVU13D
2013-07-01$226.90$136.74RVU13C
2013-04-01$226.90$136.74RVU13B
2013-01-01$226.90$136.74RVU13AR

Price 40804 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

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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