CPT code 40814: Oral lesion excision, complex repair2026 Medicare rate & RVUs in Alabama

Report this service when a lesion of the mouth vestibule is excised and the resulting site requires complex repair.

CMS RVU26DEffective Oct 1, 2026One payment locality587 Medicare services in 2024

In Alabama, Medicare pays $344.12 for 40814 in the office and $241.25 when it’s performed in a hospital or facility.

$344.12Office (non-facility)
$241.25Hospital or facility
−9.9%vs the national office rate ($382.11)

Check a contract rate as a % of Medicare · 40814 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 40814 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 40814 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 40814 covers

Code 40814 describes excision of a lesion from the mucosa and submucosa of the mouth vestibule, followed by complex repair. The vestibule is the space between the lips or cheeks and the teeth or gums; examples include the inner lip or cheek lining. Oral and maxillofacial surgeons, otolaryngologists, and other surgeons may perform the procedure in an office, ambulatory surgery center, or hospital. A specimen may be sent for pathologic examination, but the operative service is selected by the excision and repair performed, not by the final diagnosis.

Choose this code when the operative report supports a complex repair, rather than no repair or simple repair. Document the lesion’s site, the excision performed, and the repair technique and complexity. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; 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 Alabama compares for 40814

Across 109 of 109 payment localities, the office rate for 40814 runs from $339.33 in Arkansas to $499.65 in San Benito County, CA. Alabama pays $344.12. The RVUs are the same everywhere; the geographic indexes change the dollars.

40814 in Alabama vs other payment areas
  1. Alabama · this page$344.12
  2. Los Angeles, CA · California$428.14+$84.02
  3. Washington, DC area · District of Columbia$434.96+$90.84
  4. Miami, FL · Florida$414.94+$70.82
  5. Chicago, IL · Illinois$403.20+$59.08
  6. Manhattan, NY · New York$439.01+$94.89
  7. Alaska · Alaska$449.23+$105.11

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

Every other payment area

40814 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$339.33$238.33
ArizonaArizona$372.15$258.23
Bakersfield, CACalifornia$402.81$273.95
Chico, CACalifornia$401.51$272.65
El Centro, CACalifornia$401.58$272.72
Fresno, CACalifornia$401.51$272.65
Hanford, CACalifornia$401.51$272.65
Madera, CACalifornia$401.51$272.65

40814 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.

$339.33

$450.58

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

View every state and territory as a table
40814 office rate range by state
State / territoryOffice rate rangeLocalities
AK$449.231
AL$344.121
AR$339.331
AZ$372.151
CA$401.51–$499.6529
CO$396.441
CT$406.951
DC$434.961
DE$378.161
FL$378.37–$414.943
GA$357.62–$389.452
GU$410.561
HI$410.561
IA$351.751
ID$354.131
IL$368.38–$403.204
IN$356.091
KS$350.541
KY$352.791
LA$352.41–$369.192
MA$394.36–$434.242
MD$385.08–$434.963
ME$356.32–$374.412
MI$362.00–$383.342
MN$379.091
MO$346.83–$370.003
MS$343.131
MT$382.081
NC$359.861
ND$373.381
NE$353.501
NH$390.641
NJ$411.38–$430.782
NM$364.071
NV$379.901
NY$365.10–$449.825
OH$360.231
OK$351.771
OR$376.73–$408.242
PA$360.56–$397.372
PR$384.671
RI$391.041
SC$360.691
SD$372.351
TN$352.291
TX$358.31–$395.338
UT$365.441
VA$373.49–$434.962
VI$384.671
VT$372.321
WA$393.48–$442.542
WI$361.321
WV$355.321
WY$378.291

See 40814 in every payment locality

How the 40814 rate is calculated

Each of 40814’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 · 40814

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.43

3.43 RVUs× 1.000 GPCI

Practice expense7.57

7.57 RVUs× 1.000 GPCI

Malpractice0.44

0.44 RVUs× 1.000 GPCI

Adjusted RVUs

11.4400

Conversion factor

$33.4009

Medicare rate

$382.11

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

The exact Alabama inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,865

Code
40814
Physician work
3.43
Practice expense
7.57
Malpractice
0.44

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 40814 in Alabama
ComponentRVULocality factorAdjusted
Physician work3.43× 1.0003.4300
Practice expense7.57× 0.8756.6238
Malpractice0.44× 0.5660.2490
Total RVUs10.3028
Conversion factor× 33.4009

Office rate, Alabama$344.12

Office: (3.43 × 1 + 7.57 × 0.875 + 0.44 × 0.566) × $33.4009 = $344.12

Facility: (3.43 × 1 + 4.05 × 0.875 + 0.44 × 0.566) × $33.4009 = $241.25

Open 40814 in the RVU calculator

Payment rules and modifiers for 40814

40814 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40814

Oral lesion excision, complex repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 40814

Oral lesion excision, complex repair

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

40814 without 51 · national office

$382.11

Oral lesion excision, complex repair

40814-51 · Second procedure: 50%

$191.06

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

How 40814 has changed in Alabama

40814 · Office / nonfacility

$344.12

Effective 2026-10-01

The base rate is $16.97 higher than on 2025-10-01, moving from $327.15 to $344.12 (5.2%).

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

    $327.15changed to$344.12

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.52 changed to 3.43
    • Practice expense RVU 7.33 changed to 7.57
    • Malpractice RVU 0.39 changed to 0.44
    • Practice expense GPCI 0.869 changed to 0.875
    • Malpractice GPCI 0.575 changed to 0.566

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $334.55changed to$327.15

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.25 changed to 7.33
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $329.09changed to$334.55

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $347.00changed to$329.09

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.33 changed to 7.25
    • Malpractice RVU 0.38 changed to 0.40
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575
  5. January 1, 2023

    RVU23A

    $356.71changed to$347.00

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.26 changed to 7.33
    • Malpractice RVU 0.37 changed to 0.38
    • Practice expense GPCI 0.888 changed to 0.878
    • Malpractice GPCI 0.921 changed to 0.748

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $362.13changed to$356.71

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.35 changed to 7.26
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $360.68changed to$362.13

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.98 changed to 7.35
    • Malpractice RVU 0.38 changed to 0.36
    • Practice expense GPCI 0.889 changed to 0.888
    • Malpractice GPCI 0.707 changed to 0.921

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $361.49changed to$360.68

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.00 changed to 6.98
    • Malpractice RVU 0.57 changed to 0.38
    • Practice expense GPCI 0.890 changed to 0.889
    • Malpractice GPCI 0.492 changed to 0.707

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $361.73changed to$361.49

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.02 changed to 7.00

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$361.73

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$344.12$241.25RVU26D
2026-07-01$344.12$241.25RVU26C
2026-04-01$344.12$241.25RVU26B
2026-01-01$344.12$241.25RVU26A
2025-10-01$327.15$253.79RVU25D
2025-07-01$327.15$253.79RVU25C
2025-04-01$327.15$253.79RVU25B
2025-01-01$327.15$253.79RVU25A
2024-10-01$334.55$257.89RVU24D
2024-07-01$334.55$257.89RVU24C
2024-04-01$334.55$257.89RVU24B
2024-03-09$334.55$257.89RVU24AR
2024-01-01$329.09$253.68RVU24A
2023-10-01$347.00$265.78RVU23D
2023-07-01$347.00$265.78RVU23C
2023-04-01$347.00$265.78RVU23B
2023-01-01$347.00$265.78RVU23A
2022-10-01$356.71$271.28RVU22D
2022-07-01$356.71$271.28RVU22C
2022-04-01$356.71$271.28RVU22B
2022-01-01$356.71$271.28RVU22A
2021-10-01$362.13$275.07RVU21D
2021-07-01$362.13$275.07RVU21C
2021-04-01$362.13$275.07RVU21B
2021-01-01$362.13$275.07RVU21A
2020-10-01$360.68$281.43RVU20D
2020-07-01$360.68$281.43RVU20C
2020-04-01$360.68$281.43RVU20B
2020-01-01$360.68$281.43RVU20A
2019-10-01$361.49$285.15RVU19D
2019-07-01$361.49$285.15RVU19C
2019-04-01$361.49$285.15RVU19B
2019-01-01$361.49$285.15RVU19A
2018-10-01$361.73$288.36RVU18D
2018-07-01$361.73$288.36RVU18C
2018-04-01$361.73$288.36RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 40814 for an earlier date of service

Where the Alabama rate applies

Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.

  • Abanda
  • Abbeville
  • Adamsville
  • Addison
  • Akron
  • Alabaster
  • Albertville
  • Alexander City

Browse all communities in Alabama

40814 billing questions

How does 40814 differ from 40812?

Both describe vestibular lesion excision with repair. Use 40814 when the documentation supports complex repair; 40812 is for simple repair.

When is 40810 a better choice?

40810 describes excision without repair. Use 40814 when the excision site receives a complex repair.

Should 40814 be reported for a biopsy?

Use 40814 for excision with complex repair, not for a diagnostic sample alone. Code 40808 describes biopsy of a mouth lesion.

Can modifier 50 be appended for lesions on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment is restricted 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 40814PPRRVU2026_Oct_nonQPP.csv, line 4,865 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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