CPT code 40812: Oral lesion excision, simple repair2026 Medicare rate & RVUs in North Dakota
Reports excision of a lesion in the mouth vestibule when the resulting defect is closed with a simple repair.
In North Dakota, Medicare pays $275.48 for 40812 in the office and $162.59 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 North Dakota 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. North Dakota pays $275.48. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$275.48
- Los Angeles, CA · California$316.72+$41.24
- Washington, DC area · District of Columbia$321.10+$45.62
- Miami, FL · Florida$304.02+$28.54
- Chicago, IL · Illinois$295.29+$19.81
- Manhattan, NY · New York$323.34+$47.86
- Alaska · Alaska$328.10+$52.62
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $252.73 | $153.95 |
| ArkansasArkansas | $249.13 | $152.15 |
| 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 |
| Merced, CACalifornia | $296.71 | $172.98 |
| Modesto, CACalifornia | $296.71 | $172.98 |
| Napa, CACalifornia | $343.15 | $194.35 |
| Oxnard, CACalifornia | $315.12 | $181.68 |
| Redding, CACalifornia | $296.71 | $172.98 |
| Rest of CaliforniaCalifornia | $296.71 | $172.98 |
| Riverside, CACalifornia | $299.86 | $176.13 |
| Sacramento, CACalifornia | $311.20 | $179.91 |
| Salinas, CACalifornia | $310.04 | $179.20 |
| San Diego, CACalifornia | $317.22 | $182.19 |
| Marin County, CACalifornia | $363.03 | $203.84 |
| San Francisco, CACalifornia | $362.70 | $203.52 |
| San Benito County, CACalifornia | $371.15 | $208.36 |
| Santa Clara County, CACalifornia | $369.80 | $207.01 |
| San Luis Obispo, CACalifornia | $305.07 | $176.49 |
| Santa Cruz, CACalifornia | $320.16 | $182.99 |
| Santa Maria, CACalifornia | $311.17 | $179.54 |
| Santa Rosa, CACalifornia | $323.38 | $184.74 |
| Stockton, CACalifornia | $296.71 | $172.98 |
| Vallejo, CACalifornia | $342.67 | $193.88 |
| Visalia, CACalifornia | $296.71 | $172.98 |
| Yuba City, CACalifornia | $296.71 | $172.98 |
| ColoradoColorado | $292.48 | $172.36 |
| ConnecticutConnecticut | $299.78 | $178.19 |
| DelawareDelaware | $278.31 | $166.77 |
| Fort Lauderdale, FLFlorida | $291.59 | $177.23 |
| Rest of FloridaFlorida | $277.55 | $169.63 |
| Atlanta, GAGeorgia | $286.52 | $171.82 |
| Rest of GeorgiaGeorgia | $262.10 | $161.40 |
| Hawaii, Guam, HIHawaii | $303.79 | $175.43 |
| IowaIowa | $258.87 | $155.57 |
| IdahoIdaho | $260.58 | $156.72 |
| East St. Louis, ILIllinois | $275.51 | $171.64 |
| Rest of IllinoisIllinois | $269.78 | $166.70 |
| Suburban Chicago, ILIllinois | $294.50 | $178.56 |
| IndianaIndiana | $262.07 | $157.41 |
| KansasKansas | $257.77 | $155.71 |
| KentuckyKentucky | $258.83 | $158.47 |
| New Orleans, LALouisiana | $271.08 | $164.85 |
| Rest of LouisianaLouisiana | $258.47 | $158.56 |
| Metropolitan Boston, MAMassachusetts | $321.05 | $186.25 |
| Rest of MassachusettsMassachusetts | $290.81 | $171.93 |
| Baltimore area, MDMaryland | $298.96 | $177.82 |
| Rest of MarylandMaryland | $283.55 | $169.30 |
| Rest of MaineMaine | $262.02 | $158.16 |
| Southern Maine, MEMaine | $275.91 | $164.03 |
| Detroit, MIMichigan | $281.08 | $172.13 |
| Rest of MichiganMichigan | $265.57 | $162.50 |
| MinnesotaMinnesota | $280.05 | $163.88 |
| Metropolitan Kansas City, MOMissouri | $269.15 | $163.15 |
| Metropolitan St. Louis, MOMissouri | $271.92 | $164.45 |
| Rest of MissouriMissouri | $254.16 | $156.84 |
| MississippiMississippi | $251.69 | $154.48 |
| MontanaMontana | $281.22 | $168.32 |
| North CarolinaNorth Carolina | $264.71 | $159.38 |
| NebraskaNebraska | $260.24 | $156.04 |
| New HampshireNew Hampshire | $287.99 | $170.47 |
| Northern New JerseyNew Jersey | $317.86 | $186.90 |
| Rest of New JerseyNew Jersey | $303.15 | $179.86 |
| New MexicoNew Mexico | $267.05 | $163.52 |
| NevadaNevada | $279.81 | $166.80 |
| NYC suburbs and Long Island, NYNew York | $331.22 | $196.98 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $305.21 | $181.59 |
| Queens, NYNew York | $325.83 | $192.39 |
| Rest of New YorkNew York | $268.64 | $161.39 |
| OhioOhio | $264.40 | $161.33 |
| OklahomaOklahoma | $258.28 | $157.46 |
| Portland, OROregon | $301.57 | $176.14 |
| Rest of OregonOregon | $277.58 | $165.14 |
| Metropolitan Philadelphia, PAPennsylvania | $292.46 | $174.94 |
| Rest of PennsylvaniaPennsylvania | $264.76 | $161.12 |
| Puerto RicoPuerto Rico | $283.23 | $169.09 |
| Rhode IslandRhode Island | $288.07 | $171.45 |
| South CarolinaSouth Carolina | $265.01 | $160.69 |
| South DakotaSouth Dakota | $274.80 | $161.91 |
| TennesseeTennessee | $259.06 | $156.44 |
| Austin, TXTexas | $291.56 | $172.12 |
| Beaumont, TXTexas | $263.05 | $160.32 |
| Brazoria, TXTexas | $277.97 | $166.09 |
| Dallas, TXTexas | $279.78 | $167.33 |
| Fort Worth, TXTexas | $277.96 | $166.64 |
| Galveston, TXTexas | $278.83 | $166.72 |
| Houston, TXTexas | $284.13 | $172.03 |
| Rest of TexasTexas | $270.38 | $163.24 |
| UtahUtah | $268.58 | $162.46 |
| VirginiaVirginia | $275.08 | $164.11 |
| Virgin Islands, VIUnited States Virgin Islands | $283.23 | $169.09 |
| VermontVermont | $274.51 | $162.74 |
| Rest of WashingtonWashington | $290.23 | $171.35 |
| King County, WAWashington | $327.45 | $188.93 |
| WisconsinWisconsin | $266.37 | $158.21 |
| West VirginiaWest Virginia | $259.94 | $161.84 |
| WyomingWyoming | $278.72 | $165.82 |
40812 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.
$249.13
$333.93
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 | $328.10 | 1 |
| AL | $252.73 | 1 |
| AR | $249.13 | 1 |
| AZ | $273.81 | 1 |
| CA | $296.71–$371.15 | 29 |
| CO | $292.48 | 1 |
| CT | $299.78 | 1 |
| DC | $321.10 | 1 |
| DE | $278.31 | 1 |
| FL | $277.55–$304.02 | 3 |
| GA | $262.10–$286.52 | 2 |
| GU | $303.79 | 1 |
| HI | $303.79 | 1 |
| IA | $258.87 | 1 |
| ID | $260.58 | 1 |
| IL | $269.78–$295.29 | 4 |
| IN | $262.07 | 1 |
| KS | $257.77 | 1 |
| KY | $258.83 | 1 |
| LA | $258.47–$271.08 | 2 |
| MA | $290.81–$321.05 | 2 |
| MD | $283.55–$321.10 | 3 |
| ME | $262.02–$275.91 | 2 |
| MI | $265.57–$281.08 | 2 |
| MN | $280.05 | 1 |
| MO | $254.16–$271.92 | 3 |
| MS | $251.69 | 1 |
| MT | $281.22 | 1 |
| NC | $264.71 | 1 |
| ND | $275.48 | 1 |
| NE | $260.24 | 1 |
| NH | $287.99 | 1 |
| NJ | $303.15–$317.86 | 2 |
| NM | $267.05 | 1 |
| NV | $279.81 | 1 |
| NY | $268.64–$331.22 | 5 |
| OH | $264.40 | 1 |
| OK | $258.28 | 1 |
| OR | $277.58–$301.57 | 2 |
| PA | $264.76–$292.46 | 2 |
| PR | $283.23 | 1 |
| RI | $288.07 | 1 |
| SC | $265.01 | 1 |
| SD | $274.80 | 1 |
| TN | $259.06 | 1 |
| TX | $263.05–$291.56 | 8 |
| UT | $268.58 | 1 |
| VA | $275.08–$321.10 | 2 |
| VI | $283.23 | 1 |
| VT | $274.51 | 1 |
| WA | $290.23–$327.45 | 2 |
| WI | $266.37 | 1 |
| WV | $259.94 | 1 |
| WY | $278.72 | 1 |
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
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 North Dakota 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
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.31 | × 1.000 | 2.3100 |
| Practice expense | 5.82 | × 1.000 | 5.8200 |
| Malpractice | 0.29 | × 0.406 | 0.1177 |
| Total RVUs | 8.2477 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$275.48
Office: (2.31 × 1 + 5.82 × 1 + 0.29 × 0.406) × $33.4009 = $275.48
Facility: (2.31 × 1 + 2.44 × 1 + 0.29 × 0.406) × $33.4009 = $162.59
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
| 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 · 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.
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%).
How 40812 has changed in North Dakota
40812 · Office / nonfacility
$275.48
Effective 2026-10-01
The base rate is $11.56 higher than on 2025-10-01, moving from $263.92 to $275.48 (4.4%).
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
$263.92changed to$275.48
- 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
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$273.10changed to$263.92
- 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.
March 9, 2024
RVU24AR
$268.65changed to$273.10
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$282.39changed to$268.65
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.84 changed to 5.70
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$291.31changed to$282.39
- 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
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$294.42changed to$291.31
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 5.96 changed to 5.94
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$290.74changed to$294.42
- 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
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$292.66changed to$290.74
- 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
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$292.50changed to$292.66
- 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.
January 1, 2018
RVU18AR1
$294.41changed to$292.50
- 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
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$295.96changed to$294.41
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 5.68 changed to 5.62
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$296.47changed to$295.96
- 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.
July 1, 2015
RVU15C
$294.99changed to$296.47
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$293.78changed to$294.99
- Conversion factor 35.8228 changed to 35.7547
- Malpractice RVU 0.30 changed to 0.38
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$297.03changed to$293.78
- 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
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $297.03
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $275.48 | $162.59 | RVU26D |
| 2026-07-01 | $275.48 | $162.59 | RVU26C |
| 2026-04-01 | $275.48 | $162.59 | RVU26B |
| 2026-01-01 | $275.48 | $162.59 | RVU26A |
| 2025-10-01 | $263.92 | $174.32 | RVU25D |
| 2025-07-01 | $263.92 | $174.32 | RVU25C |
| 2025-04-01 | $263.92 | $174.32 | RVU25B |
| 2025-01-01 | $263.92 | $174.32 | RVU25A |
| 2024-10-01 | $273.10 | $178.24 | RVU24D |
| 2024-07-01 | $273.10 | $178.24 | RVU24C |
| 2024-04-01 | $273.10 | $178.24 | RVU24B |
| 2024-03-09 | $273.10 | $178.24 | RVU24AR |
| 2024-01-01 | $268.65 | $175.33 | RVU24A |
| 2023-10-01 | $282.39 | $181.75 | RVU23D |
| 2023-07-01 | $282.39 | $181.75 | RVU23C |
| 2023-04-01 | $282.39 | $181.75 | RVU23B |
| 2023-01-01 | $282.39 | $181.75 | RVU23A |
| 2022-10-01 | $291.31 | $184.37 | RVU22D |
| 2022-07-01 | $291.31 | $184.37 | RVU22C |
| 2022-04-01 | $291.31 | $184.37 | RVU22B |
| 2022-01-01 | $291.31 | $184.37 | RVU22A |
| 2021-10-01 | $294.42 | $185.90 | RVU21D |
| 2021-07-01 | $294.42 | $185.90 | RVU21C |
| 2021-04-01 | $294.42 | $185.90 | RVU21B |
| 2021-01-01 | $294.42 | $185.90 | RVU21A |
| 2020-10-01 | $290.74 | $191.86 | RVU20D |
| 2020-07-01 | $290.74 | $191.86 | RVU20C |
| 2020-04-01 | $290.74 | $191.86 | RVU20B |
| 2020-01-01 | $290.74 | $191.86 | RVU20A |
| 2019-10-01 | $292.66 | $196.43 | RVU19D |
| 2019-07-01 | $292.66 | $196.43 | RVU19C |
| 2019-04-01 | $292.66 | $196.43 | RVU19B |
| 2019-01-01 | $292.66 | $196.43 | RVU19A |
| 2018-10-01 | $292.50 | $198.90 | RVU18D |
| 2018-07-01 | $292.50 | $198.90 | RVU18C |
| 2018-04-01 | $292.50 | $198.90 | RVU18B |
| 2018-01-01 | $292.50 | $198.90 | RVU18AR1 |
| 2017-10-01 | $294.41 | $201.10 | RVU17D |
| 2017-07-01 | $294.41 | $201.10 | RVU17C |
| 2017-04-01 | $294.41 | $201.10 | RVU17B |
| 2017-01-01 | $294.41 | $201.10 | RVU17A |
| 2016-10-01 | $295.96 | $202.15 | RVU16D |
| 2016-07-01 | $295.96 | $202.15 | RVU16C |
| 2016-04-01 | $295.96 | $202.15 | RVU16B |
| 2016-01-01 | $295.96 | $202.15 | RVU16A |
| 2015-10-01 | $296.47 | $202.68 | RVU15D |
| 2015-07-01 | $296.47 | $202.68 | RVU15C |
| 2015-04-01 | $294.99 | $201.68 | RVU15B |
| 2015-01-01 | $294.99 | $201.68 | RVU15A |
| 2014-10-01 | $293.78 | $200.64 | RVU14D |
| 2014-07-01 | $293.78 | $200.64 | RVU14C |
| 2014-04-01 | $293.78 | $200.64 | RVU14B |
| 2014-01-01 | $293.78 | $200.64 | RVU14A |
| 2013-10-01 | $297.03 | $199.04 | RVU13D |
| 2013-07-01 | $297.03 | $199.04 | RVU13C |
| 2013-04-01 | $297.03 | $199.04 | RVU13B |
| 2013-01-01 | $297.03 | $199.04 | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
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
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