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CPT code 40805: Foreign body removal, complicated vestibular removal2026 Medicare rate & RVUs in Virginia

Removal of an embedded foreign body from the oral vestibule when the retrieval is complicated, rather than a simple extraction.

CMS RVU26DEffective Oct 1, 2026One payment locality33 Medicare services in 2024

In Virginia, Medicare pays $285.40 for 40805 in the office and $179.68 when it’s performed in a hospital or facility.

$285.40Office (non-facility)
$179.68Hospital or facility
−2.1%vs the national office rate ($291.59)

Check a contract rate as a % of Medicare · 40805 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 40805 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 40805 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 40805 covers

This service removes an embedded object from the oral vestibule, the space between the lips or cheeks and the teeth or gums. The clinician exposes and retrieves the object using the additional work needed for a complicated removal. Oral and maxillofacial surgeons, dentists, and otolaryngologists may perform it in an office or another appropriate setting when an object is lodged in this tissue.

Choose this code rather than 40804 when the removal is complicated; document the object’s location and the work required to expose and retrieve it. A loose object that can be removed simply does not support the complicated level. The procedure has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of 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 Virginia compares for 40805

Across 109 of 109 payment localities, the office rate for 40805 runs from $259.84 in Arkansas to $381.23 in San Benito County, CA. Virginia pays $285.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

40805 in Virginia vs other payment areas
  1. Virginia · this page$285.40
  2. Los Angeles, CA · California$326.85+$41.45
  3. Washington, DC area · District of Columbia$331.58+$46.18
  4. Miami, FL · Florida$314.73+$29.33
  5. Chicago, IL · Illinois$306.16+$20.76
  6. Manhattan, NY · New York$334.17+$48.77
  7. Alaska · Alaska$344.91+$59.51

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

Every other payment area

40805 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$263.40$169.29
ArkansasArkansas$259.84$167.45
ArizonaArizona$284.23$180.02
Bakersfield, CACalifornia$307.71$189.83
Chico, CACalifornia$306.79$188.92
El Centro, CACalifornia$306.84$188.97
Fresno, CACalifornia$306.79$188.92
Hanford, CACalifornia$306.79$188.92

40805 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.

$259.84

$344.91

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

View every state and territory as a table
40805 office rate range by state
State / territoryOffice rate rangeLocalities
AK$344.911
AL$263.401
AR$259.841
AZ$284.231
CA$306.79–$381.2329
CO$302.691
CT$310.201
DC$331.581
DE$288.741
FL$288.24–$314.733
GA$272.92–$296.932
GU$313.501
HI$313.501
IA$269.341
ID$271.051
IL$280.64–$306.164
IN$272.521
KS$268.311
KY$269.571
LA$269.24–$281.702
MA$301.12–$331.212
MD$293.97–$331.583
ME$272.54–$286.182
MI$276.29–$291.792
MN$290.071
MO$265.01–$282.463
MS$262.461
MT$291.571
NC$275.191
ND$285.641
NE$270.671
NH$298.161
NJ$313.74–$328.512
NM$277.771
NV$290.111
NY$279.08–$342.045
OH$275.081
OK$268.951
OR$287.85–$311.652
PA$275.40–$302.982
PR$293.541
RI$298.531
SC$275.591
SD$284.941
TN$269.601
TX$273.71–$301.698
UT$279.121
VA$285.40–$331.582
VI$293.541
VT$284.731
WA$300.48–$337.592
WI$276.651
WV$270.921
WY$288.981

See 40805 in every payment locality

How the 40805 rate is calculated

Each of 40805’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 · 40805

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.72

2.72 RVUs× 1.000 GPCI

Practice expense5.71

5.71 RVUs× 1.000 GPCI

Malpractice0.30

0.30 RVUs× 1.000 GPCI

Adjusted RVUs

8.7300

Conversion factor

$33.4009

Medicare rate

$291.59

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,860

Code
40805
Physician work
2.72
Practice expense
5.71
Malpractice
0.30

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 40805 in Virginia
ComponentRVULocality factorAdjusted
Physician work2.72× 1.0002.7200
Practice expense5.71× 0.9835.6129
Malpractice0.30× 0.7060.2118
Total RVUs8.5447
Conversion factor× 33.4009

Office rate, Virginia$285.40

Office: (2.72 × 1 + 5.71 × 0.983 + 0.3 × 0.706) × $33.4009 = $285.40

Facility: (2.72 × 1 + 2.49 × 0.983 + 0.3 × 0.706) × $33.4009 = $179.68

Open 40805 in the RVU calculator

Payment rules and modifiers for 40805

40805 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40805

Foreign body removal, complicated vestibular 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 · 40805

Foreign body removal, complicated vestibular 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

40805 without 51 · national office

$291.59

Foreign body removal, complicated vestibular removal

40805-51 · Second procedure: 50%

$145.80

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 40805

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

Codes related to 40805
CodeHow it relatesOffice range, Virginia
Same family
40804Foreign body removal, simple intraoral removalSibling code for simple removal of an embedded foreign body from the oral vestibule.$204.50
Used instead
40808Mouth biopsy, oral vestibuleBiopsy applies when the target is oral tissue requiring sampling, rather than an embedded object.$164.43
40810Mouth lesion excision, without repairExcision applies when removing a mouth lesion, rather than retrieving a foreign body.$211.52
40899Unlisted mouth procedure, oral vestibuleUnlisted oral vestibule procedure code when no listed code describes the service.No office rate

How 40805 has changed in Virginia

40805 · Office / nonfacility

$285.40

Effective 2026-10-01

The base rate is $10.46 higher than on 2025-10-01, moving from $274.94 to $285.40 (3.8%).

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

    $274.94changed to$285.40

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.79 changed to 2.72
    • Practice expense RVU 5.59 changed to 5.71
    • Malpractice RVU 0.27 changed to 0.30
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $279.74changed to$274.94

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.50 changed to 5.59
    • Malpractice RVU 0.26 changed to 0.27

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $275.18changed to$279.74

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $285.33changed to$275.18

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.47 changed to 5.50
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $291.63changed to$285.33

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.44 changed to 5.47
    • Malpractice RVU 0.25 changed to 0.26
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $297.52changed to$291.63

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.54 changed to 5.44

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $303.76changed to$297.52

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.45 changed to 5.54
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $316.70changed to$303.76

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.65 changed to 5.45
    • Malpractice RVU 0.47 changed to 0.25
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $326.26changed to$316.70

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.92 changed to 5.65
    • Malpractice RVU 0.48 changed to 0.47

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $329.31changed to$326.26

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.07 changed to 5.92
    • Malpractice RVU 0.47 changed to 0.48
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $377.96changed to$329.31

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.80 changed to 6.07
    • Malpractice RVU 0.12 changed to 0.47
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $332.11changed to$377.96

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.17 changed to 7.80
    • Malpractice RVU 0.47 changed to 0.12

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $330.46changed to$332.11

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $392.45changed to$330.46

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.07 changed to 6.17
    • Malpractice RVU 0.33 changed to 0.47
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $405.78changed to$392.45

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.09 changed to 8.07
    • Malpractice RVU 0.35 changed to 0.33
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $405.78

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$285.40$179.68RVU26D
2026-07-01$285.40$179.68RVU26C
2026-04-01$285.40$179.68RVU26B
2026-01-01$285.40$179.68RVU26A
2025-10-01$274.94$192.83RVU25D
2025-07-01$274.94$192.83RVU25C
2025-04-01$274.94$192.83RVU25B
2025-01-01$274.94$192.83RVU25A
2024-10-01$279.74$194.25RVU24D
2024-07-01$279.74$194.25RVU24C
2024-04-01$279.74$194.25RVU24B
2024-03-09$279.74$194.25RVU24AR
2024-01-01$275.18$191.08RVU24A
2023-10-01$285.33$196.76RVU23D
2023-07-01$285.33$196.76RVU23C
2023-04-01$285.33$196.76RVU23B
2023-01-01$285.33$196.76RVU23A
2022-10-01$291.63$199.35RVU22D
2022-07-01$291.63$199.35RVU22C
2022-04-01$291.63$199.35RVU22B
2022-01-01$291.63$199.35RVU22A
2021-10-01$297.52$202.74RVU21D
2021-07-01$297.52$202.74RVU21C
2021-04-01$297.52$202.74RVU21B
2021-01-01$297.52$202.74RVU21A
2020-10-01$303.76$214.70RVU20D
2020-07-01$303.76$214.70RVU20C
2020-04-01$303.76$214.70RVU20B
2020-01-01$303.76$214.70RVU20A
2019-10-01$316.70$228.57RVU19D
2019-07-01$316.70$228.57RVU19C
2019-04-01$316.70$228.57RVU19B
2019-01-01$316.70$228.57RVU19A
2018-10-01$326.26$237.52RVU18D
2018-07-01$326.26$237.52RVU18C
2018-04-01$326.26$237.52RVU18B
2018-01-01$326.26$237.52RVU18AR1
2017-10-01$329.31$240.23RVU17D
2017-07-01$329.31$240.23RVU17C
2017-04-01$329.31$240.23RVU17B
2017-01-01$329.31$240.23RVU17A
2016-10-01$377.96$230.49RVU16D
2016-07-01$377.96$230.49RVU16C
2016-04-01$377.96$230.49RVU16B
2016-01-01$377.96$230.49RVU16A
2015-10-01$332.11$241.33RVU15D
2015-07-01$332.11$241.33RVU15C
2015-04-01$330.46$240.13RVU15B
2015-01-01$330.46$240.13RVU15A
2014-10-01$392.45$239.74RVU14D
2014-07-01$392.45$239.74RVU14C
2014-04-01$392.45$239.74RVU14B
2014-01-01$392.45$239.74RVU14A
2013-10-01$405.78$242.24RVU13D
2013-07-01$405.78$242.24RVU13C
2013-04-01$405.78$242.24RVU13B
2013-01-01$405.78$242.24RVU13AR

Price 40805 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

40805 billing questions

How does this differ from 40804?

40805 is for a complicated removal of an embedded foreign body in the oral vestibule; 40804 represents the simple removal. Document the factors that made retrieval complicated.

Does this code cover removal of a loose object?

No. This code describes a complicated removal of an embedded object. A loose object removed simply does not support this level.

Are related postoperative visits separately reported?

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

Should modifier 50 be appended for objects on both sides?

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

Can an assistant surgeon be reported?

Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

What documentation supports the complicated level?

Record the foreign body’s specific oral vestibule location and the additional work needed to expose and retrieve it, distinguishing the service from simple removal.

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 40805PPRRVU2026_Oct_nonQPP.csv, line 4,860 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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