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CPT code 40812: Oral lesion excision, simple repair2026 Medicare rate & RVUs in Arkansas

Reports excision of a lesion in the mouth vestibule when the resulting defect is closed with a simple repair.

CMS RVU26DEffective Oct 1, 2026One payment locality5.2K Medicare services in 2024

In Arkansas, Medicare pays $249.13 for 40812 in the office and $152.15 when it’s performed in a hospital or facility.

$249.13Office (non-facility)
$152.15Hospital or facility
−11.4%vs the national office rate ($281.24)

Check a contract rate as a % of Medicare · 40812 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 40812 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Arkansas
  2. What 40812 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 40812 covers

The clinician removes a lesion from the oral vestibule, the space between the lips or cheeks and the teeth or gums, and closes the resulting defect with a simple repair. Oral and maxillofacial surgeons, otolaryngologists, and other clinicians who perform oral surgery may provide this service in an office or facility setting. The code describes lesion removal with closure, rather than a diagnostic tissue sample alone or treatment of an abscess.

Report the code when the operative note identifies the vestibular site, excision, and simple repair. A 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate for this code’s anatomy. Medicare does not pay an assistant at surgery; 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 Arkansas compares for 40812

Across 109 of 109 payment localities, the office rate for 40812 runs from $249.13 in Arkansas to $371.15 in San Benito County, CA. Arkansas pays $249.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

40812 in Arkansas vs other payment areas
  1. Arkansas · this page$249.13
  2. Los Angeles, CA · California$316.72+$67.59
  3. Washington, DC area · District of Columbia$321.10+$71.97
  4. Miami, FL · Florida$304.02+$54.89
  5. Chicago, IL · Illinois$295.29+$46.16
  6. Manhattan, NY · New York$323.34+$74.21
  7. Alaska · Alaska$328.10+$78.97

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

Every other payment area

40812 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$252.73$153.95
ArizonaArizona$273.81$164.42
Bakersfield, CACalifornia$297.58$173.84
Chico, CACalifornia$296.71$172.98
El Centro, CACalifornia$296.76$173.03
Fresno, CACalifornia$296.71$172.98
Hanford, CACalifornia$296.71$172.98
Madera, CACalifornia$296.71$172.98

40812 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.

$249.13

$333.93

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

View every state and territory as a table
40812 office rate range by state
State / territoryOffice rate rangeLocalities
AK$328.101
AL$252.731
AR$249.131
AZ$273.811
CA$296.71–$371.1529
CO$292.481
CT$299.781
DC$321.101
DE$278.311
FL$277.55–$304.023
GA$262.10–$286.522
GU$303.791
HI$303.791
IA$258.871
ID$260.581
IL$269.78–$295.294
IN$262.071
KS$257.771
KY$258.831
LA$258.47–$271.082
MA$290.81–$321.052
MD$283.55–$321.103
ME$262.02–$275.912
MI$265.57–$281.082
MN$280.051
MO$254.16–$271.923
MS$251.691
MT$281.221
NC$264.711
ND$275.481
NE$260.241
NH$287.991
NJ$303.15–$317.862
NM$267.051
NV$279.811
NY$268.64–$331.225
OH$264.401
OK$258.281
OR$277.58–$301.572
PA$264.76–$292.462
PR$283.231
RI$288.071
SC$265.011
SD$274.801
TN$259.061
TX$263.05–$291.568
UT$268.581
VA$275.08–$321.102
VI$283.231
VT$274.511
WA$290.23–$327.452
WI$266.371
WV$259.941
WY$278.721

See 40812 in every payment locality

How the 40812 rate is calculated

Each of 40812’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 · 40812

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.31

2.31 RVUs× 1.000 GPCI

Practice expense5.82

5.82 RVUs× 1.000 GPCI

Malpractice0.29

0.29 RVUs× 1.000 GPCI

Adjusted RVUs

8.4200

Conversion factor

$33.4009

Medicare rate

$281.24

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

The exact Arkansas inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,864

Code
40812
Physician work
2.31
Practice expense
5.82
Malpractice
0.29

GPCI2026.csv

7

Locality
Arkansas
Physician work
1.000
Practice expense
0.859
Malpractice
0.515
Office calculation for 40812 in Arkansas
ComponentRVULocality factorAdjusted
Physician work2.31× 1.0002.3100
Practice expense5.82× 0.8594.9994
Malpractice0.29× 0.5150.1493
Total RVUs7.4587
Conversion factor× 33.4009

Office rate, Arkansas$249.13

Office: (2.31 × 1 + 5.82 × 0.859 + 0.29 × 0.515) × $33.4009 = $249.13

Facility: (2.31 × 1 + 2.44 × 0.859 + 0.29 × 0.515) × $33.4009 = $152.15

Open 40812 in the RVU calculator

Payment rules and modifiers for 40812

40812 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40812

Oral lesion excision, simple 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 · 40812

Oral lesion excision, simple 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

40812 without 51 · national office

$281.24

Oral lesion excision, simple repair

40812-51 · Second procedure: 50%

$140.62

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 40812

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

Codes related to 40812
CodeHow it relatesOffice range, Arkansas
Used instead
40808Mouth biopsy, oral vestibuleDiagnostic biopsy of a mouth lesion rather than excision with simple repair.$147.51
Same family
40810Mouth lesion excision, without repairVestibular lesion excision without repair.$189.83
40814Oral lesion excision, complex repairVestibular lesion excision with complex repair.$339.33
40816Mouth lesion excision, with full-thickness skin graftMore extensive, radical resection of a vestibular lesion.$362.60

How 40812 has changed in Arkansas

40812 · Office / nonfacility

$249.13

Effective 2026-10-01

The base rate is $10.83 higher than on 2025-10-01, moving from $238.30 to $249.13 (4.5%).

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

    $238.30changed to$249.13

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.37 changed to 2.31
    • Practice expense RVU 5.66 changed to 5.82
    • Malpractice RVU 0.25 changed to 0.29
    • Practice expense GPCI 0.860 changed to 0.859
    • Malpractice GPCI 0.518 changed to 0.515

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $246.55changed to$238.30

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.70 changed to 5.66
    • Malpractice RVU 0.26 changed to 0.25

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $242.53changed to$246.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $253.46changed to$242.53

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.84 changed to 5.70
    • Practice expense GPCI 0.853 changed to 0.860
    • Malpractice GPCI 0.492 changed to 0.518

  5. January 1, 2023

    RVU23A

    $260.15changed to$253.46

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.94 changed to 5.84
    • Malpractice RVU 0.25 changed to 0.26
    • Practice expense GPCI 0.847 changed to 0.853
    • Malpractice GPCI 0.465 changed to 0.492

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $262.90changed to$260.15

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.96 changed to 5.94

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $262.79changed to$262.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.56 changed to 5.96
    • Malpractice RVU 0.26 changed to 0.25
    • Practice expense GPCI 0.859 changed to 0.847
    • Malpractice GPCI 0.521 changed to 0.465

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $267.61changed to$262.79

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.54 changed to 5.56
    • Malpractice RVU 0.39 changed to 0.26
    • Practice expense GPCI 0.872 changed to 0.859
    • Malpractice GPCI 0.576 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $267.42changed to$267.61

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.55 changed to 5.54
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $268.30changed to$267.42

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.62 changed to 5.55
    • Malpractice RVU 0.39 changed to 0.38
    • Practice expense GPCI 0.870 changed to 0.872
    • Malpractice GPCI 0.555 changed to 0.576

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $268.63changed to$268.30

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.68 changed to 5.62
    • Practice expense GPCI 0.867 changed to 0.870
    • Malpractice GPCI 0.534 changed to 0.555

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $269.10changed to$268.63

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.67 changed to 5.68
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $267.76changed to$269.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $266.09changed to$267.76

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.30 changed to 0.38
    • Practice expense GPCI 0.866 changed to 0.867
    • Malpractice GPCI 0.492 changed to 0.534

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $267.85changed to$266.09

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.20 changed to 5.67
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.865 changed to 0.866
    • Malpractice GPCI 0.450 changed to 0.492

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $267.85

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$249.13$152.15RVU26D
2026-07-01$249.13$152.15RVU26C
2026-04-01$249.13$152.15RVU26B
2026-01-01$249.13$152.15RVU26A
2025-10-01$238.30$161.24RVU25D
2025-07-01$238.30$161.24RVU25C
2025-04-01$238.30$161.24RVU25B
2025-01-01$238.30$161.24RVU25A
2024-10-01$246.55$164.96RVU24D
2024-07-01$246.55$164.96RVU24C
2024-04-01$246.55$164.96RVU24B
2024-03-09$246.55$164.96RVU24AR
2024-01-01$242.53$162.27RVU24A
2023-10-01$253.46$167.61RVU23D
2023-07-01$253.46$167.61RVU23C
2023-04-01$253.46$167.61RVU23B
2023-01-01$253.46$167.61RVU23A
2022-10-01$260.15$169.58RVU22D
2022-07-01$260.15$169.58RVU22C
2022-04-01$260.15$169.58RVU22B
2022-01-01$260.15$169.58RVU22A
2021-10-01$262.90$170.98RVU21D
2021-07-01$262.90$170.98RVU21C
2021-04-01$262.90$170.98RVU21B
2021-01-01$262.90$170.98RVU21A
2020-10-01$262.79$177.84RVU20D
2020-07-01$262.79$177.84RVU20C
2020-04-01$262.79$177.84RVU20B
2020-01-01$262.79$177.84RVU20A
2019-10-01$267.61$183.70RVU19D
2019-07-01$267.61$183.70RVU19C
2019-04-01$267.61$183.70RVU19B
2019-01-01$267.61$183.70RVU19A
2018-10-01$267.42$185.80RVU18D
2018-07-01$267.42$185.80RVU18C
2018-04-01$267.42$185.80RVU18B
2018-01-01$267.42$185.80RVU18AR1
2017-10-01$268.30$187.12RVU17D
2017-07-01$268.30$187.12RVU17C
2017-04-01$268.30$187.12RVU17B
2017-01-01$268.30$187.12RVU17A
2016-10-01$268.63$187.30RVU16D
2016-07-01$268.63$187.30RVU16C
2016-04-01$268.63$187.30RVU16B
2016-01-01$268.63$187.30RVU16A
2015-10-01$269.10$187.79RVU15D
2015-07-01$269.10$187.79RVU15C
2015-04-01$267.76$186.85RVU15B
2015-01-01$267.76$186.85RVU15A
2014-10-01$266.09$185.43RVU14D
2014-07-01$266.09$185.43RVU14C
2014-04-01$266.09$185.43RVU14B
2014-01-01$266.09$185.43RVU14A
2013-10-01$267.85$183.09RVU13D
2013-07-01$267.85$183.09RVU13C
2013-04-01$267.85$183.09RVU13B
2013-01-01$267.85$183.09RVU13AR

Price 40812 for an earlier date of service

Where the Arkansas rate applies

Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.

  • Acorn
  • Adona
  • Alexander
  • Alicia
  • Alix
  • Alleene
  • Allport
  • Alma

Browse all communities in Arkansas

40812 billing questions

How does this differ from 40810?

40812 includes simple repair of the defect after lesion excision. 40810 describes excision without repair.

When is 40814 more appropriate?

Use 40814 when the excision requires complex repair. The operative note should support the repair performed, not just the lesion’s size or diagnosis.

Can 40812 be reported for a biopsy?

A diagnostic sample without definitive lesion removal points to 40808. Report 40812 when the lesion is excised and the defect receives simple repair.

Should modifier 50 be appended for lesions on both sides?

No. Modifier 50 is inappropriate for this oral-vestibule service.

How are other procedures in the same session paid?

Medicare pays the highest-valued procedure in full and reduces other procedures in the session to 50%. Related postoperative visits during the 10-day global period are included.

Does Medicare pay an assistant or co-surgeon for this service?

Medicare does not pay an assistant at surgery for this code. 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
RVUs for 40812PPRRVU2026_Oct_nonQPP.csv, line 4,864 (RVU26D)
Geographic factors for ArkansasGPCI2026.csv, line 7 (RVU26D)

Open CMS sourceHow we calculate rates

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