CPT code 40804: Foreign body removal, simple intraoral removal2026 Medicare rate & RVUs in Beaumont, TX
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.
In Beaumont, TX, Medicare pays $194.21 for 40804 in the office and $109.10 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 Beaumont, TX 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. Beaumont, TX pays $194.21. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Beaumont, TX · this page$194.21
- Austin, TX · Texas$217.75+$23.54
- Brazoria, TX · Texas$206.59+$12.38
- Dallas, TX · Texas$207.93+$13.72
- Fort Worth, TX · Texas$206.41+$12.20
- Galveston, TX · Texas$207.22+$13.01
- Houston, TX · Texas$210.69+$16.48
Other areas in Texas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Rest of TexasTexas | $200.30 | $111.54 |
| Los Angeles, CACalifornia | $238.04 | $127.40 |
| Washington, DC areaDistrict of Columbia | $240.64 | $130.47 |
| Miami, FLFlorida | $225.37 | $128.01 |
| Chicago, ILIllinois | $218.41 | $124.42 |
| Manhattan, NYNew York | $241.50 | $132.82 |
| AlaskaAlaska | $237.87 | $138.27 |
| 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 |
| Madera, CACalifornia | $222.26 | $119.76 |
| Merced, CACalifornia | $222.26 | $119.76 |
| Modesto, CACalifornia | $222.26 | $119.76 |
| Napa, CACalifornia | $259.62 | $136.36 |
| Oxnard, CACalifornia | $237.06 | $126.52 |
| Redding, CACalifornia | $222.26 | $119.76 |
| Rest of CaliforniaCalifornia | $222.26 | $119.76 |
| Riverside, CACalifornia | $224.31 | $121.81 |
| Sacramento, CACalifornia | $233.80 | $125.04 |
| Salinas, CACalifornia | $232.95 | $124.56 |
| San Diego, CACalifornia | $238.88 | $127.03 |
| Marin County, CACalifornia | $275.42 | $143.55 |
| San Francisco, CACalifornia | $275.20 | $143.34 |
| San Benito County, CACalifornia | $281.67 | $146.81 |
| Santa Clara County, CACalifornia | $280.79 | $145.93 |
| San Luis Obispo, CACalifornia | $229.15 | $122.63 |
| Santa Cruz, CACalifornia | $241.51 | $127.88 |
| Santa Maria, CACalifornia | $233.95 | $124.90 |
| Santa Rosa, CACalifornia | $243.97 | $129.13 |
| Stockton, CACalifornia | $222.26 | $119.76 |
| Vallejo, CACalifornia | $259.31 | $136.05 |
| Visalia, CACalifornia | $222.26 | $119.76 |
| Yuba City, CACalifornia | $222.26 | $119.76 |
| ColoradoColorado | $218.47 | $118.96 |
| ConnecticutConnecticut | $223.62 | $122.89 |
| DelawareDelaware | $206.74 | $114.34 |
| Fort Lauderdale, FLFlorida | $216.30 | $121.56 |
| Rest of FloridaFlorida | $205.23 | $115.82 |
| Atlanta, GAGeorgia | $213.06 | $118.04 |
| Rest of GeorgiaGeorgia | $192.99 | $109.57 |
| Hawaii, Guam, HIHawaii | $228.38 | $122.05 |
| IowaIowa | $191.64 | $106.06 |
| IdahoIdaho | $192.92 | $106.88 |
| East St. Louis, ILIllinois | $202.70 | $116.66 |
| Rest of IllinoisIllinois | $198.71 | $113.33 |
| Suburban Chicago, ILIllinois | $218.61 | $122.57 |
| IndianaIndiana | $194.12 | $107.43 |
| KansasKansas | $190.55 | $106.01 |
| KentuckyKentucky | $190.75 | $107.61 |
| New Orleans, LALouisiana | $200.49 | $112.49 |
| Rest of LouisianaLouisiana | $190.39 | $107.62 |
| Metropolitan Boston, MAMassachusetts | $241.23 | $129.57 |
| Rest of MassachusettsMassachusetts | $216.98 | $118.50 |
| Baltimore area, MDMaryland | $222.98 | $122.63 |
| Rest of MarylandMaryland | $210.92 | $116.27 |
| Rest of MaineMaine | $193.86 | $107.82 |
| Southern Maine, MEMaine | $205.30 | $112.62 |
| Detroit, MIMichigan | $207.83 | $117.58 |
| Rest of MichiganMichigan | $195.96 | $110.57 |
| MinnesotaMinnesota | $209.27 | $113.04 |
| Metropolitan Kansas City, MOMissouri | $199.16 | $111.35 |
| Metropolitan St. Louis, MOMissouri | $201.41 | $112.37 |
| Rest of MissouriMissouri | $186.80 | $106.18 |
| MississippiMississippi | $185.15 | $104.63 |
| MontanaMontana | $209.08 | $115.55 |
| North CarolinaNorth Carolina | $196.06 | $108.80 |
| North DakotaNorth Dakota | $205.32 | $111.80 |
| NebraskaNebraska | $192.80 | $106.48 |
| New HampshireNew Hampshire | $214.87 | $117.51 |
| Northern New JerseyNew Jersey | $237.85 | $129.36 |
| Rest of New JerseyNew Jersey | $226.15 | $124.03 |
| New MexicoNew Mexico | $197.06 | $111.30 |
| NevadaNevada | $208.19 | $114.57 |
| NYC suburbs and Long Island, NYNew York | $247.54 | $136.35 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $227.56 | $125.15 |
| Queens, NYNew York | $243.79 | $133.24 |
| Rest of New YorkNew York | $199.19 | $110.34 |
| OhioOhio | $195.19 | $109.81 |
| OklahomaOklahoma | $190.52 | $107.00 |
| Portland, OROregon | $225.94 | $122.04 |
| Rest of OregonOregon | $206.56 | $113.42 |
| Metropolitan Philadelphia, PAPennsylvania | $217.65 | $120.29 |
| Rest of PennsylvaniaPennsylvania | $195.59 | $109.74 |
| Puerto RicoPuerto Rico | $210.76 | $116.21 |
| Rhode IslandRhode Island | $214.50 | $117.89 |
| South CarolinaSouth Carolina | $195.95 | $109.54 |
| South DakotaSouth Dakota | $204.88 | $111.35 |
| TennesseeTennessee | $191.56 | $106.55 |
| UtahUtah | $198.82 | $110.91 |
| VirginiaVirginia | $204.50 | $112.57 |
| Virgin Islands, VIUnited States Virgin Islands | $210.76 | $116.21 |
| VermontVermont | $204.35 | $111.76 |
| Rest of WashingtonWashington | $216.62 | $118.14 |
| King County, WAWashington | $246.44 | $131.69 |
| WisconsinWisconsin | $197.96 | $108.37 |
| West VirginiaWest Virginia | $190.82 | $109.55 |
| WyomingWyoming | $207.44 | $113.92 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $237.87 | 1 |
| AL | $186.29 | 1 |
| AR | $183.41 | 1 |
| AZ | $203.21 | 1 |
| CA | $222.26–$281.67 | 29 |
| CO | $218.47 | 1 |
| CT | $223.62 | 1 |
| DC | $240.64 | 1 |
| DE | $206.74 | 1 |
| FL | $205.23–$225.37 | 3 |
| GA | $192.99–$213.06 | 2 |
| GU | $228.38 | 1 |
| HI | $228.38 | 1 |
| IA | $191.64 | 1 |
| ID | $192.92 | 1 |
| IL | $198.71–$218.61 | 4 |
| IN | $194.12 | 1 |
| KS | $190.55 | 1 |
| KY | $190.75 | 1 |
| LA | $190.39–$200.49 | 2 |
| MA | $216.98–$241.23 | 2 |
| MD | $210.92–$240.64 | 3 |
| ME | $193.86–$205.30 | 2 |
| MI | $195.96–$207.83 | 2 |
| MN | $209.27 | 1 |
| MO | $186.80–$201.41 | 3 |
| MS | $185.15 | 1 |
| MT | $209.08 | 1 |
| NC | $196.06 | 1 |
| ND | $205.32 | 1 |
| NE | $192.80 | 1 |
| NH | $214.87 | 1 |
| NJ | $226.15–$237.85 | 2 |
| NM | $197.06 | 1 |
| NV | $208.19 | 1 |
| NY | $199.19–$247.54 | 5 |
| OH | $195.19 | 1 |
| OK | $190.52 | 1 |
| OR | $206.56–$225.94 | 2 |
| PA | $195.59–$217.65 | 2 |
| PR | $210.76 | 1 |
| RI | $214.50 | 1 |
| SC | $195.95 | 1 |
| SD | $204.88 | 1 |
| TN | $191.56 | 1 |
| TX | $194.21–$217.75 | 8 |
| UT | $198.82 | 1 |
| VA | $204.50–$240.64 | 2 |
| VI | $210.76 | 1 |
| VT | $204.35 | 1 |
| WA | $216.62–$246.44 | 2 |
| WI | $197.96 | 1 |
| WV | $190.82 | 1 |
| WY | $207.44 | 1 |
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
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 Beaumont, TX 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
97
- Locality
- Beaumont, TX
- Physician work
- 1.000
- Practice expense
- 0.910
- Malpractice
- 0.929
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.27 | × 1.000 | 1.2700 |
| Practice expense | 4.80 | × 0.910 | 4.3680 |
| Malpractice | 0.19 | × 0.929 | 0.1765 |
| Total RVUs | 5.8145 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Beaumont, TX$194.21
Office: (1.27 × 1 + 4.8 × 0.91 + 0.19 × 0.929) × $33.4009 = $194.21
Facility: (1.27 × 1 + 2 × 0.91 + 0.19 × 0.929) × $33.4009 = $109.10
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
How 40804 has changed in Beaumont, TX
40804 · Office / nonfacility
$194.21
Effective 2026-10-01
The base rate is $16.97 higher than on 2025-10-01, moving from $177.24 to $194.21 (9.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$177.24changed to$194.21
- 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 0.903 changed to 0.910
- Malpractice GPCI 0.947 changed to 0.929
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$175.75changed to$177.24
- 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.
March 9, 2024
RVU24AR
$172.88changed to$175.75
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$178.63changed to$172.88
- 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 0.924 changed to 0.903
- Malpractice GPCI 0.749 changed to 0.947
January 1, 2023
RVU23A
$183.88changed to$178.63
- 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 0.944 changed to 0.924
- Malpractice GPCI 0.550 changed to 0.749
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$191.20changed to$183.88
- 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.
January 1, 2021
RVU21A
$191.32changed to$191.20
- 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 0.934 changed to 0.944
- Malpractice GPCI 0.695 changed to 0.550
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$185.46changed to$191.32
- 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 0.924 changed to 0.934
- Malpractice GPCI 0.839 changed to 0.695
Held through RVU20B, RVU20C, RVU20D.
July 1, 2019
RVU19C
$185.16changed to$185.46
- Malpractice RVU 0.18 changed to 0.19
Held through RVU19D.
January 1, 2019
RVU19A
$178.27changed to$185.16
- 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.
January 1, 2018
RVU18AR1
$177.95changed to$178.27
- 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 0.913 changed to 0.924
- Malpractice GPCI 0.897 changed to 0.839
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$184.16changed to$177.95
- 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 0.902 changed to 0.913
- Malpractice GPCI 0.955 changed to 0.897
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$204.92changed to$184.16
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 4.68 changed to 4.06
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$203.90changed to$204.92
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$209.10changed to$203.90
- 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 0.899 changed to 0.902
- Malpractice GPCI 0.939 changed to 0.955
Held through RVU15B.
January 1, 2014
RVU14A
$210.82changed to$209.10
- 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 0.896 changed to 0.899
- Malpractice GPCI 0.923 changed to 0.939
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $210.82
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $194.21 | $109.10 | RVU26D |
| 2026-07-01 | $194.21 | $109.10 | RVU26C |
| 2026-04-01 | $194.21 | $109.10 | RVU26B |
| 2026-01-01 | $194.21 | $109.10 | RVU26A |
| 2025-10-01 | $177.24 | $109.18 | RVU25D |
| 2025-07-01 | $177.24 | $109.18 | RVU25C |
| 2025-04-01 | $177.24 | $109.18 | RVU25B |
| 2025-01-01 | $177.24 | $109.18 | RVU25A |
| 2024-10-01 | $175.75 | $107.82 | RVU24D |
| 2024-07-01 | $175.75 | $107.82 | RVU24C |
| 2024-04-01 | $175.75 | $107.82 | RVU24B |
| 2024-03-09 | $175.75 | $107.82 | RVU24AR |
| 2024-01-01 | $172.88 | $106.06 | RVU24A |
| 2023-10-01 | $178.63 | $108.17 | RVU23D |
| 2023-07-01 | $178.63 | $108.17 | RVU23C |
| 2023-04-01 | $178.63 | $108.17 | RVU23B |
| 2023-01-01 | $178.63 | $108.17 | RVU23A |
| 2022-10-01 | $183.88 | $108.42 | RVU22D |
| 2022-07-01 | $183.88 | $108.42 | RVU22C |
| 2022-04-01 | $183.88 | $108.42 | RVU22B |
| 2022-01-01 | $183.88 | $108.42 | RVU22A |
| 2021-10-01 | $191.20 | $110.49 | RVU21D |
| 2021-07-01 | $191.20 | $110.49 | RVU21C |
| 2021-04-01 | $191.20 | $110.49 | RVU21B |
| 2021-01-01 | $191.20 | $110.49 | RVU21A |
| 2020-10-01 | $191.32 | $115.81 | RVU20D |
| 2020-07-01 | $191.32 | $115.81 | RVU20C |
| 2020-04-01 | $191.32 | $115.81 | RVU20B |
| 2020-01-01 | $191.32 | $115.81 | RVU20A |
| 2019-10-01 | $185.46 | $115.20 | RVU19D |
| 2019-07-01 | $185.46 | $115.20 | RVU19C |
| 2019-04-01 | $185.16 | $114.90 | RVU19B |
| 2019-01-01 | $185.16 | $114.90 | RVU19A |
| 2018-10-01 | $178.27 | $112.75 | RVU18D |
| 2018-07-01 | $178.27 | $112.75 | RVU18C |
| 2018-04-01 | $178.27 | $112.75 | RVU18B |
| 2018-01-01 | $178.27 | $112.75 | RVU18AR1 |
| 2017-10-01 | $177.95 | $112.41 | RVU17D |
| 2017-07-01 | $177.95 | $112.41 | RVU17C |
| 2017-04-01 | $177.95 | $112.41 | RVU17B |
| 2017-01-01 | $177.95 | $112.41 | RVU17A |
| 2016-10-01 | $184.16 | $115.70 | RVU16D |
| 2016-07-01 | $184.16 | $115.70 | RVU16C |
| 2016-04-01 | $184.16 | $115.70 | RVU16B |
| 2016-01-01 | $184.16 | $115.70 | RVU16A |
| 2015-10-01 | $204.92 | $129.40 | RVU15D |
| 2015-07-01 | $204.92 | $129.40 | RVU15C |
| 2015-04-01 | $203.90 | $128.76 | RVU15B |
| 2015-01-01 | $203.90 | $128.76 | RVU15A |
| 2014-10-01 | $209.10 | $129.87 | RVU14D |
| 2014-07-01 | $209.10 | $129.87 | RVU14C |
| 2014-04-01 | $209.10 | $129.87 | RVU14B |
| 2014-01-01 | $209.10 | $129.87 | RVU14A |
| 2013-10-01 | $210.82 | $130.04 | RVU13D |
| 2013-07-01 | $210.82 | $130.04 | RVU13C |
| 2013-04-01 | $210.82 | $130.04 | RVU13B |
| 2013-01-01 | $210.82 | $130.04 | RVU13AR |
Where the Beaumont, TX rate applies
Beaumont, TX is a Medicare payment area, not a city. Our Census mapping connects it to 13 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.
- Beaumont
- Beauxart Gardens
- Bevil Oaks
- Central Gardens
- China
- Fannett
- Groves
- Hamshire
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
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