CPT code 40808: Mouth biopsy, oral vestibule2026 Medicare rate & RVUs in Montana
Reports tissue sampling of a lesion in the oral vestibule, the space between the lips or cheeks and the teeth and gums, for diagnosis.
In Montana, Medicare pays $168.00 for 40808 in the office and $82.49 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 40808 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 40808 covers
This service samples a lesion in the oral vestibule—the lining inside the lips or cheeks, between them and the teeth and gums. A dentist, oral surgeon, or otolaryngologist may perform it in an office or outpatient setting when a persistent ulcer, abnormal patch, or other lesion needs tissue diagnosis. The specimen is sent for pathologic examination; the code represents the biopsy procedure, not the laboratory’s tissue analysis.
Report 40808 when tissue is sampled from the vestibule rather than when the lesion is removed by excision or lies at a different oral site. Document the lesion’s location and appearance, the tissue obtained, and the procedure performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery for it, 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 Montana compares for 40808
Across 109 of 109 payment localities, the office rate for 40808 runs from $147.51 in Arkansas to $226.72 in San Benito County, CA. Montana pays $168.00. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$168.00
- Los Angeles, CA · California$191.49+$23.49
- Washington, DC area · District of Columbia$193.38+$25.38
- Miami, FL · Florida$180.46+$12.46
- Chicago, IL · Illinois$174.95+$6.95
- Manhattan, NY · New York$193.87+$25.87
- Alaska · Alaska$191.34+$23.34
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $149.82 | $75.00 |
| ArkansasArkansas | $147.51 | $74.06 |
| ArizonaArizona | $163.33 | $80.47 |
| Bakersfield, CACalifornia | $179.23 | $85.52 |
| Chico, CACalifornia | $178.83 | $85.11 |
| El Centro, CACalifornia | $178.85 | $85.13 |
| Fresno, CACalifornia | $178.83 | $85.11 |
| Hanford, CACalifornia | $178.83 | $85.11 |
| Madera, CACalifornia | $178.83 | $85.11 |
| Merced, CACalifornia | $178.83 | $85.11 |
| Modesto, CACalifornia | $178.83 | $85.11 |
| Napa, CACalifornia | $208.96 | $96.26 |
| Oxnard, CACalifornia | $190.72 | $89.65 |
| Redding, CACalifornia | $178.83 | $85.11 |
| Rest of CaliforniaCalifornia | $178.83 | $85.11 |
| Riverside, CACalifornia | $180.34 | $86.63 |
| Sacramento, CACalifornia | $188.13 | $88.69 |
| Salinas, CACalifornia | $187.45 | $88.34 |
| San Diego, CACalifornia | $192.22 | $89.96 |
| Marin County, CACalifornia | $221.71 | $101.15 |
| San Francisco, CACalifornia | $221.55 | $100.99 |
| San Benito County, CACalifornia | $226.72 | $103.42 |
| Santa Clara County, CACalifornia | $226.07 | $102.77 |
| San Luis Obispo, CACalifornia | $184.38 | $86.99 |
| Santa Cruz, CACalifornia | $194.34 | $90.45 |
| Santa Maria, CACalifornia | $188.25 | $88.55 |
| Santa Rosa, CACalifornia | $196.33 | $91.33 |
| Stockton, CACalifornia | $178.83 | $85.11 |
| Vallejo, CACalifornia | $208.73 | $96.03 |
| Visalia, CACalifornia | $178.83 | $85.11 |
| Yuba City, CACalifornia | $178.83 | $85.11 |
| ColoradoColorado | $175.66 | $84.69 |
| ConnecticutConnecticut | $179.62 | $87.53 |
| DelawareDelaware | $166.15 | $81.67 |
| Fort Lauderdale, FLFlorida | $173.47 | $86.85 |
| Rest of FloridaFlorida | $164.67 | $82.93 |
| Atlanta, GAGeorgia | $171.12 | $84.24 |
| Rest of GeorgiaGeorgia | $154.94 | $78.67 |
| Hawaii, Guam, HIHawaii | $183.75 | $86.53 |
| IowaIowa | $154.20 | $75.96 |
| IdahoIdaho | $155.20 | $76.54 |
| East St. Louis, ILIllinois | $162.41 | $83.74 |
| Rest of IllinoisIllinois | $159.39 | $81.33 |
| Suburban Chicago, ILIllinois | $175.35 | $87.53 |
| IndianaIndiana | $156.17 | $76.90 |
| KansasKansas | $153.28 | $75.98 |
| KentuckyKentucky | $153.26 | $77.25 |
| New Orleans, LALouisiana | $161.02 | $80.55 |
| Rest of LouisianaLouisiana | $152.95 | $77.27 |
| Metropolitan Boston, MAMassachusetts | $193.97 | $91.87 |
| Rest of MassachusettsMassachusetts | $174.45 | $84.42 |
| Baltimore area, MDMaryland | $179.10 | $87.35 |
| Rest of MarylandMaryland | $169.51 | $82.98 |
| Rest of MaineMaine | $155.90 | $77.23 |
| Southern Maine, MEMaine | $165.12 | $80.38 |
| Detroit, MIMichigan | $166.69 | $84.18 |
| Rest of MichiganMichigan | $157.36 | $79.30 |
| MinnesotaMinnesota | $168.46 | $80.48 |
| Metropolitan Kansas City, MOMissouri | $160.01 | $79.72 |
| Metropolitan St. Louis, MOMissouri | $161.81 | $80.41 |
| Rest of MissouriMissouri | $150.05 | $76.34 |
| MississippiMississippi | $148.82 | $75.20 |
| North CarolinaNorth Carolina | $157.66 | $77.88 |
| North DakotaNorth Dakota | $165.23 | $79.72 |
| NebraskaNebraska | $155.14 | $76.22 |
| New HampshireNew Hampshire | $172.72 | $83.71 |
| Northern New JerseyNew Jersey | $191.15 | $91.97 |
| Rest of New JerseyNew Jersey | $181.71 | $88.34 |
| New MexicoNew Mexico | $158.22 | $79.81 |
| NevadaNevada | $167.35 | $81.76 |
| NYC suburbs and Long Island, NYNew York | $198.62 | $96.96 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $182.80 | $89.17 |
| Queens, NYNew York | $195.78 | $94.71 |
| Rest of New YorkNew York | $160.15 | $78.92 |
| OhioOhio | $156.80 | $78.73 |
| OklahomaOklahoma | $153.13 | $76.78 |
| Portland, OROregon | $181.70 | $86.71 |
| Rest of OregonOregon | $166.10 | $80.94 |
| Metropolitan Philadelphia, PAPennsylvania | $174.82 | $85.81 |
| Rest of PennsylvaniaPennsylvania | $157.15 | $78.66 |
| Puerto RicoPuerto Rico | $169.36 | $82.91 |
| Rhode IslandRhode Island | $172.41 | $84.09 |
| South CarolinaSouth Carolina | $157.48 | $78.47 |
| South DakotaSouth Dakota | $164.90 | $79.40 |
| TennesseeTennessee | $154.08 | $76.35 |
| Austin, TXTexas | $175.04 | $84.57 |
| Beaumont, TXTexas | $156.04 | $78.23 |
| Brazoria, TXTexas | $166.09 | $81.35 |
| Dallas, TXTexas | $167.13 | $81.97 |
| Fort Worth, TXTexas | $165.90 | $81.59 |
| Galveston, TXTexas | $166.57 | $81.66 |
| Houston, TXTexas | $169.13 | $84.22 |
| Rest of TexasTexas | $160.96 | $79.82 |
| UtahUtah | $159.77 | $79.40 |
| VirginiaVirginia | $164.43 | $80.38 |
| Virgin Islands, VIUnited States Virgin Islands | $169.36 | $82.91 |
| VermontVermont | $164.40 | $79.75 |
| Rest of WashingtonWashington | $174.18 | $84.14 |
| King County, WAWashington | $198.20 | $93.28 |
| WisconsinWisconsin | $159.34 | $77.43 |
| West VirginiaWest Virginia | $153.09 | $78.78 |
| WyomingWyoming | $166.79 | $81.28 |
40808 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.
$147.51
$202.78
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 | $191.34 | 1 |
| AL | $149.82 | 1 |
| AR | $147.51 | 1 |
| AZ | $163.33 | 1 |
| CA | $178.83–$226.72 | 29 |
| CO | $175.66 | 1 |
| CT | $179.62 | 1 |
| DC | $193.38 | 1 |
| DE | $166.15 | 1 |
| FL | $164.67–$180.46 | 3 |
| GA | $154.94–$171.12 | 2 |
| GU | $183.75 | 1 |
| HI | $183.75 | 1 |
| IA | $154.20 | 1 |
| ID | $155.20 | 1 |
| IL | $159.39–$175.35 | 4 |
| IN | $156.17 | 1 |
| KS | $153.28 | 1 |
| KY | $153.26 | 1 |
| LA | $152.95–$161.02 | 2 |
| MA | $174.45–$193.97 | 2 |
| MD | $169.51–$193.38 | 3 |
| ME | $155.90–$165.12 | 2 |
| MI | $157.36–$166.69 | 2 |
| MN | $168.46 | 1 |
| MO | $150.05–$161.81 | 3 |
| MS | $148.82 | 1 |
| MT | $168.00 | 1 |
| NC | $157.66 | 1 |
| ND | $165.23 | 1 |
| NE | $155.14 | 1 |
| NH | $172.72 | 1 |
| NJ | $181.71–$191.15 | 2 |
| NM | $158.22 | 1 |
| NV | $167.35 | 1 |
| NY | $160.15–$198.62 | 5 |
| OH | $156.80 | 1 |
| OK | $153.13 | 1 |
| OR | $166.10–$181.70 | 2 |
| PA | $157.15–$174.82 | 2 |
| PR | $169.36 | 1 |
| RI | $172.41 | 1 |
| SC | $157.48 | 1 |
| SD | $164.90 | 1 |
| TN | $154.08 | 1 |
| TX | $156.04–$175.04 | 8 |
| UT | $159.77 | 1 |
| VA | $164.43–$193.38 | 2 |
| VI | $169.36 | 1 |
| VT | $164.40 | 1 |
| WA | $174.18–$198.20 | 2 |
| WI | $159.34 | 1 |
| WV | $153.09 | 1 |
| WY | $166.79 | 1 |
How the 40808 rate is calculated
Each of 40808’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 · 40808
RVUs × geographic indexes × conversion factor
Work1.02
1.02 RVUs× 1.000 GPCI
Practice expense3.87
3.87 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
5.0300
Conversion factor
$33.4009
Medicare rate
$168.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,862
- Code
- 40808
- Physician work
- 1.02
- Practice expense
- 3.87
- Malpractice
- 0.14
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.02 | × 1.000 | 1.0200 |
| Practice expense | 3.87 | × 1.000 | 3.8700 |
| Malpractice | 0.14 | × 0.998 | 0.1397 |
| Total RVUs | 5.0297 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$168.00
Office: (1.02 × 1 + 3.87 × 1 + 0.14 × 0.998) × $33.4009 = $168.00
Facility: (1.02 × 1 + 1.31 × 1 + 0.14 × 0.998) × $33.4009 = $82.49
Payment rules and modifiers for 40808
40808 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 40808
Mouth biopsy, oral vestibule
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 40808
Mouth biopsy, oral vestibule
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
40808 without 51 · national office
$168.01
Mouth biopsy, oral vestibule
40808-51 · Second procedure: 50%
$84.01
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 40808 has changed in Montana
40808 · Office / nonfacility
$168.00
Effective 2026-10-01
The base rate is $4.74 higher than on 2025-10-01, moving from $163.26 to $168.00 (2.9%).
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
$163.26changed to$168.00
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.05 changed to 1.02
- Malpractice RVU 0.13 changed to 0.14
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$169.67changed to$163.26
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.92 changed to 3.87
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$166.90changed to$169.67
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$172.74changed to$166.90
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.93 changed to 3.92
- Malpractice RVU 0.12 changed to 0.13
January 1, 2023
RVU23A
$174.67changed to$172.74
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.89 changed to 3.93
- Malpractice RVU 0.11 changed to 0.12
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$174.01changed to$174.67
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.81 changed to 3.89
- Malpractice RVU 0.13 changed to 0.11
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$165.05changed to$174.01
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.38 changed to 3.81
- Malpractice RVU 0.11 changed to 0.13
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$197.17changed to$165.05
- Conversion factor 36.0391 changed to 36.0896
- Work RVU 1.01 changed to 1.05
- Practice expense RVU 4.20 changed to 3.38
- Malpractice RVU 0.16 changed to 0.11
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$196.23changed to$197.17
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.18 changed to 4.20
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$195.90changed to$196.23
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 4.22 changed to 4.18
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$196.43changed to$195.90
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 4.28 changed to 4.22
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$196.78changed to$196.43
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 4.27 changed to 4.28
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$195.80changed to$196.78
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$193.74changed to$195.80
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.11 changed to 0.16
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
$199.46changed to$193.74
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 4.72 changed to 4.27
- Malpractice RVU 0.12 changed to 0.11
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $199.46
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $168.00 | $82.49 | RVU26D |
| 2026-07-01 | $168.00 | $82.49 | RVU26C |
| 2026-04-01 | $168.00 | $82.49 | RVU26B |
| 2026-01-01 | $168.00 | $82.49 | RVU26A |
| 2025-10-01 | $163.26 | $88.21 | RVU25D |
| 2025-07-01 | $163.26 | $88.21 | RVU25C |
| 2025-04-01 | $163.26 | $88.21 | RVU25B |
| 2025-01-01 | $163.26 | $88.21 | RVU25A |
| 2024-10-01 | $169.67 | $89.45 | RVU24D |
| 2024-07-01 | $169.67 | $89.45 | RVU24C |
| 2024-04-01 | $169.67 | $89.45 | RVU24B |
| 2024-03-09 | $169.67 | $89.45 | RVU24AR |
| 2024-01-01 | $166.90 | $87.99 | RVU24A |
| 2023-10-01 | $172.74 | $89.71 | RVU23D |
| 2023-07-01 | $172.74 | $89.71 | RVU23C |
| 2023-04-01 | $172.74 | $89.71 | RVU23B |
| 2023-01-01 | $172.74 | $89.71 | RVU23A |
| 2022-10-01 | $174.67 | $88.50 | RVU22D |
| 2022-07-01 | $174.67 | $88.50 | RVU22C |
| 2022-04-01 | $174.67 | $88.50 | RVU22B |
| 2022-01-01 | $174.67 | $88.50 | RVU22A |
| 2021-10-01 | $174.01 | $88.52 | RVU21D |
| 2021-07-01 | $174.01 | $88.52 | RVU21C |
| 2021-04-01 | $174.01 | $88.52 | RVU21B |
| 2021-01-01 | $174.01 | $88.52 | RVU21A |
| 2020-10-01 | $165.05 | $90.35 | RVU20D |
| 2020-07-01 | $165.05 | $90.35 | RVU20C |
| 2020-04-01 | $165.05 | $90.35 | RVU20B |
| 2020-01-01 | $165.05 | $90.35 | RVU20A |
| 2019-10-01 | $197.17 | $113.92 | RVU19D |
| 2019-07-01 | $197.17 | $113.92 | RVU19C |
| 2019-04-01 | $197.17 | $113.92 | RVU19B |
| 2019-01-01 | $197.17 | $113.92 | RVU19A |
| 2018-10-01 | $196.23 | $115.95 | RVU18D |
| 2018-07-01 | $196.23 | $115.95 | RVU18C |
| 2018-04-01 | $196.23 | $115.95 | RVU18B |
| 2018-01-01 | $196.23 | $115.95 | RVU18AR1 |
| 2017-10-01 | $195.90 | $115.87 | RVU17D |
| 2017-07-01 | $195.90 | $115.87 | RVU17C |
| 2017-04-01 | $195.90 | $115.87 | RVU17B |
| 2017-01-01 | $195.90 | $115.87 | RVU17A |
| 2016-10-01 | $196.43 | $115.51 | RVU16D |
| 2016-07-01 | $196.43 | $115.51 | RVU16C |
| 2016-04-01 | $196.43 | $115.51 | RVU16B |
| 2016-01-01 | $196.43 | $115.51 | RVU16A |
| 2015-10-01 | $196.78 | $115.93 | RVU15D |
| 2015-07-01 | $196.78 | $115.93 | RVU15C |
| 2015-04-01 | $195.80 | $115.35 | RVU15B |
| 2015-01-01 | $195.80 | $115.35 | RVU15A |
| 2014-10-01 | $193.74 | $112.78 | RVU14D |
| 2014-07-01 | $193.74 | $112.78 | RVU14C |
| 2014-04-01 | $193.74 | $112.78 | RVU14B |
| 2014-01-01 | $193.74 | $112.78 | RVU14A |
| 2013-10-01 | $199.46 | $114.06 | RVU13D |
| 2013-07-01 | $199.46 | $114.06 | RVU13C |
| 2013-04-01 | $199.46 | $114.06 | RVU13B |
| 2013-01-01 | $199.46 | $114.06 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
40808 billing questions
How is 40808 different from 40810?
40808 is for tissue sampling of a vestibular lesion. Choose an excision code such as 40810 when the service removes the lesion rather than taking a biopsy sample.
Can the pathology examination be billed separately?
The biopsy code represents the clinician’s tissue-sampling procedure. The laboratory or pathologist may separately report the appropriate examination of the submitted specimen.
Should modifier 50 be appended for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for 40808; modifier 50 should not be used for this service.
Are related follow-up visits included?
Yes. The code has a 10-day global period, which includes related postoperative visits during that period.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 40808. Co-surgeons and team surgery are not permitted for this code.
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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