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CPT code 40810: Mouth lesion excision, without repair2026 Medicare rate & RVUs in Washington, DC area

Reports removal of a lesion from the mucosa and submucosa of the mouth vestibule when the excision is performed without repair.

CMS RVU26DEffective Oct 1, 2026One payment locality2K Medicare services in 2024

In Washington, DC area, Medicare pays $248.67 for 40810 in the office and $129.45 when it’s performed in a hospital or facility.

$248.67Office (non-facility)
$129.45Hospital or facility
+15.1%vs the national office rate ($216.10)

Check a contract rate as a % of Medicare · 40810 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 40810 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 40810 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 40810 covers

This service removes a lesion from the lining and underlying tissue of the oral vestibule, the space between the lips or cheeks and the teeth or gums. It may be performed by an oral and maxillofacial surgeon, dentist, or other qualified clinician in an office or surgical setting. A persistent or suspicious inner-lip or cheek lesion may be excised for treatment or tissue diagnosis; the specimen can be submitted for pathologic examination.

Choose this code when the documented work is excision in the vestibule and no repair is performed. If the operative note describes repair, compare the repair-specific codes in this family rather than reporting this code. Document the precise site, lesion and extent removed, and whether repair was performed. The service 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% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 Washington, DC area compares for 40810

Across 109 of 109 payment localities, the office rate for 40810 runs from $189.83 in Arkansas to $291.43 in San Benito County, CA. Washington, DC area pays $248.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

40810 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$248.67
  2. Los Angeles, CA · California$246.22−$2.45
  3. Miami, FL · Florida$232.09−$16.58
  4. Chicago, IL · Illinois$225.03−$23.64
  5. Manhattan, NY · New York$249.31+$0.64
  6. Alaska · Alaska$246.38−$2.29
  7. Alabama · Alabama$192.79−$55.88

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

40810 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$189.83$102.89
ArizonaArizona$210.10$112.03
Bakersfield, CACalifornia$230.50$119.58
Chico, CACalifornia$229.97$119.05
El Centro, CACalifornia$230.00$119.08
Fresno, CACalifornia$229.97$119.05
Hanford, CACalifornia$229.97$119.05
Madera, CACalifornia$229.97$119.05

40810 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.

$189.83

$260.70

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

View every state and territory as a table
40810 office rate range by state
State / territoryOffice rate rangeLocalities
AK$246.381
AL$192.791
AR$189.831
AZ$210.101
CA$229.97–$291.4329
CO$225.921
CT$231.011
DC$248.671
DE$213.731
FL$211.84–$232.093
GA$199.37–$220.102
GU$236.271
HI$236.271
IA$198.401
ID$199.681
IL$205.08–$225.534
IN$200.921
KS$197.221
KY$197.201
LA$196.80–$207.152
MA$224.37–$249.402
MD$218.04–$248.673
ME$200.58–$212.392
MI$202.47–$214.432
MN$216.681
MO$193.09–$208.163
MS$191.511
MT$216.091
NC$202.831
ND$212.531
NE$199.611
NH$222.141
NJ$233.71–$245.822
NM$203.561
NV$215.271
NY$206.03–$255.415
OH$201.741
OK$197.041
OR$213.66–$233.662
PA$202.19–$224.862
PR$217.841
RI$221.771
SC$202.611
SD$212.111
TN$198.241
TX$200.77–$225.128
UT$205.551
VA$211.52–$248.672
VI$217.841
VT$211.481
WA$224.02–$254.832
WI$204.991
WV$196.991
WY$214.541

See 40810 in every payment locality

How the 40810 rate is calculated

Each of 40810’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 · 40810

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.33

1.33 RVUs× 1.000 GPCI

Practice expense4.96

4.96 RVUs× 1.000 GPCI

Malpractice0.18

0.18 RVUs× 1.000 GPCI

Adjusted RVUs

6.4700

Conversion factor

$33.4009

Medicare rate

$216.10

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,863

Code
40810
Physician work
1.33
Practice expense
4.96
Malpractice
0.18

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 40810 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.33× 1.0541.4018
Practice expense4.96× 1.1785.8429
Malpractice0.18× 1.1130.2003
Total RVUs7.4450
Conversion factor× 33.4009

Office rate, Washington, DC area$248.67

Office: (1.33 × 1.054 + 4.96 × 1.178 + 0.18 × 1.113) × $33.4009 = $248.67

Facility: (1.33 × 1.054 + 1.93 × 1.178 + 0.18 × 1.113) × $33.4009 = $129.45

Open 40810 in the RVU calculator

Payment rules and modifiers for 40810

40810 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40810

Mouth lesion excision, without repair

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)1Not paid (statutory restriction).
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 · 40810

Mouth lesion excision, without repair

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

40810 without 51 · national office

$216.10

Mouth lesion excision, without repair

40810-51 · Second procedure: 50%

$108.05

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 40810

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

Codes related to 40810
CodeHow it relatesOffice range, Washington, DC area
Used instead
40808Mouth biopsy, oral vestibuleBiopsy is a sampling service; 40810 represents excision of a vestibular lesion.$193.38
40800Oral drainage, simple vestibular drainageUsed for drainage of a mouth lesion rather than excision.$241.78
Same family
40812Oral lesion excision, simple repairVestibular lesion excision code for cases involving simple repair.$321.10
40814Oral lesion excision, complex repairVestibular lesion excision code associated with complex repair.$434.96
40816Mouth lesion excision, with full-thickness skin graftRelated vestibular lesion excision code for a different extent of procedure.$464.90

How 40810 has changed in Washington, DC area

40810 · Office / nonfacility

$248.67

Effective 2026-10-01

The base rate is $6.43 higher than on 2025-10-01, moving from $242.24 to $248.67 (2.7%).

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

    $242.24changed to$248.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.36 changed to 1.33
    • Practice expense RVU 4.92 changed to 4.96
    • Malpractice RVU 0.16 changed to 0.18
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $252.85changed to$242.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.00 changed to 4.92
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $248.73changed to$252.85

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $262.28changed to$248.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.01 changed to 5.00
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $269.80changed to$262.28

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.97 changed to 5.01
    • Malpractice RVU 0.17 changed to 0.18
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $269.84changed to$269.80

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.94 changed to 4.97
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $256.71changed to$269.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.49 changed to 4.94
    • Malpractice RVU 0.16 changed to 0.15
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $252.71changed to$256.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.42 changed to 4.49
    • Malpractice RVU 0.21 changed to 0.16
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $249.83changed to$252.71

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.36 changed to 4.42

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $251.01changed to$249.83

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.40 changed to 4.36
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $253.22changed to$251.01

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.46 changed to 4.40
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $253.30changed to$253.22

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.43 changed to 4.46
    • Malpractice RVU 0.22 changed to 0.21

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $252.04changed to$253.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $250.54changed to$252.04

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.46 changed to 4.43
    • Malpractice RVU 0.17 changed to 0.22
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $255.59changed to$250.54

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.91 changed to 4.46
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $255.59

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$248.67$129.45RVU26D
2026-07-01$248.67$129.45RVU26C
2026-04-01$248.67$129.45RVU26B
2026-01-01$248.67$129.45RVU26A
2025-10-01$242.24$136.98RVU25D
2025-07-01$242.24$136.98RVU25C
2025-04-01$242.24$136.98RVU25B
2025-01-01$242.24$136.98RVU25A
2024-10-01$252.85$140.56RVU24D
2024-07-01$252.85$140.56RVU24C
2024-04-01$252.85$140.56RVU24B
2024-03-09$252.85$140.56RVU24AR
2024-01-01$248.73$138.27RVU24A
2023-10-01$262.28$144.63RVU23D
2023-07-01$262.28$144.63RVU23C
2023-04-01$262.28$144.63RVU23B
2023-01-01$262.28$144.63RVU23A
2022-10-01$269.80$146.19RVU22D
2022-07-01$269.80$146.19RVU22C
2022-04-01$269.80$146.19RVU22B
2022-01-01$269.80$146.19RVU22A
2021-10-01$269.84$145.63RVU21D
2021-07-01$269.84$145.63RVU21C
2021-04-01$269.84$145.63RVU21B
2021-01-01$269.84$145.63RVU21A
2020-10-01$256.71$147.87RVU20D
2020-07-01$256.71$147.87RVU20C
2020-04-01$256.71$147.87RVU20B
2020-01-01$256.71$147.87RVU20A
2019-10-01$252.71$150.66RVU19D
2019-07-01$252.71$150.66RVU19C
2019-04-01$252.71$150.66RVU19B
2019-01-01$252.71$150.66RVU19A
2018-10-01$249.83$152.23RVU18D
2018-07-01$249.83$152.23RVU18C
2018-04-01$249.83$152.23RVU18B
2018-01-01$249.83$152.23RVU18AR1
2017-10-01$251.01$153.71RVU17D
2017-07-01$251.01$153.71RVU17C
2017-04-01$251.01$153.71RVU17B
2017-01-01$251.01$153.71RVU17A
2016-10-01$253.22$154.86RVU16D
2016-07-01$253.22$154.86RVU16C
2016-04-01$253.22$154.86RVU16B
2016-01-01$253.22$154.86RVU16A
2015-10-01$253.30$155.87RVU15D
2015-07-01$253.30$155.87RVU15C
2015-04-01$252.04$155.10RVU15B
2015-01-01$252.04$155.10RVU15A
2014-10-01$250.54$152.79RVU14D
2014-07-01$250.54$152.79RVU14C
2014-04-01$250.54$152.79RVU14B
2014-01-01$250.54$152.79RVU14A
2013-10-01$255.59$153.28RVU13D
2013-07-01$255.59$153.28RVU13C
2013-04-01$255.59$153.28RVU13B
2013-01-01$255.59$153.28RVU13AR

Price 40810 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

40810 billing questions

When should this code be used instead of 40808?

Use 40810 when the lesion is excised from the oral vestibule. Code 40808 describes biopsy rather than this excision service.

Does this code include closure of the excision site?

No repair is included in this code. If the operative note documents repair, compare the repair-specific vestibular lesion excision codes.

Can modifier 50 be reported for lesions on both sides?

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

Are postoperative visits separately reported during the global period?

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

Can an assistant surgeon or co-surgeon be paid?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

Is examination of the removed tissue included?

The code represents removal of the lesion, not the pathologist's examination. A pathology service may be reported separately when performed.

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 40810PPRRVU2026_Oct_nonQPP.csv, line 4,863 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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