CPT code 40808: Mouth biopsy, oral vestibule2026 Medicare rate & RVUs in Vermont

In Vermont, Medicare pays $164.40 for 40808 in the office and $79.75 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.

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 Vermont 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. Vermont pays $164.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

40808 rates by state

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

See 40808 in every payment locality

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.

Payment rules and modifiers for 40808

40808 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 40808

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

How 40808 has changed in Vermont

Price 40808 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

• Albany
• Alburgh
• Algiers
• Arlington
• Ascutney
• Bakersfield
• Barnet
• Barre

Browse all communities in Vermont

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

Open CMS sourceHow we calculate rates