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CPT code 40818: Oral graft harvest, vestibular mucosa2026 Medicare rate & RVUs in Connecticut

Reports harvesting oral mucosa from the mouth vestibule for use as a graft during reconstructive surgery, such as urethral reconstruction.

CMS RVU26DEffective Oct 1, 2026One payment locality142 Medicare services in 2024

In Connecticut, Medicare pays $388.76 for 40818 in the office and $261.78 when it’s performed in a hospital or facility.

$388.76Office (non-facility)
$261.78Hospital or facility
+6.7%vs the national office rate ($364.40)

Check a contract rate as a % of Medicare · 40818 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 40818 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Connecticut
  2. What 40818 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 40818 covers

This service removes oral mucosa from the vestibule of the mouth to provide donor tissue for reconstruction at another site. It is performed by a surgeon, often an oral and maxillofacial surgeon, otolaryngologist, or urologist, when a reconstructive procedure calls for oral mucosal graft tissue. A familiar clinical use is harvesting buccal mucosa for urethral reconstruction. The code represents the donor-site harvest, not removal of a mouth lesion or the reconstruction at the recipient site.

Report the harvest when the operative note identifies the oral donor site, the tissue obtained, and its graft purpose; report the recipient-site procedure separately when performed and supported. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery billing 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 Connecticut compares for 40818

Across 109 of 109 payment localities, the office rate for 40818 runs from $322.00 in Arkansas to $484.27 in San Benito County, CA. Connecticut pays $388.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

40818 in Connecticut vs other payment areas
  1. Connecticut · this page$388.76
  2. Los Angeles, CA · California$411.93+$23.17
  3. Washington, DC area · District of Columbia$417.08+$28.32
  4. Miami, FL · Florida$392.96+$4.20
  5. Chicago, IL · Illinois$381.49−$7.27
  6. Manhattan, NY · New York$419.36+$30.60
  7. Alaska · Alaska$422.18+$33.42

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

Every other payment area

40818 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$326.76$223.60
ArkansasArkansas$322.00$220.72
ArizonaArizona$354.64$240.39
Bakersfield, CACalifornia$386.60$257.37
Chico, CACalifornia$385.56$256.33
El Centro, CACalifornia$385.62$256.39
Fresno, CACalifornia$385.56$256.33
Hanford, CACalifornia$385.56$256.33

40818 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.

$322.00

$434.91

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

View every state and territory as a table
40818 office rate range by state
State / territoryOffice rate rangeLocalities
AK$422.181
AL$326.761
AR$322.001
AZ$354.641
CA$385.56–$484.2729
CO$379.621
CT$388.761
DC$417.081
DE$360.561
FL$358.82–$392.963
GA$338.51–$371.202
GU$395.171
HI$395.171
IA$335.211
ID$337.401
IL$348.32–$381.494
IN$339.381
KS$333.591
KY$334.491
LA$333.95–$350.622
MA$377.31–$417.442
MD$367.49–$417.083
ME$339.14–$357.752
MI$343.25–$363.302
MN$363.731
MO$328.15–$351.923
MS$325.141
MT$364.381
NC$342.731
ND$357.461
NE$337.071
NH$373.621
NJ$393.19–$412.692
NM$345.131
NV$362.711
NY$347.91–$429.565
OH$341.831
OK$333.921
OR$359.89–$391.802
PA$342.40–$379.002
PR$367.091
RI$373.491
SC$342.851
SD$356.641
TN$335.281
TX$340.13–$378.378
UT$347.581
VA$356.54–$417.082
VI$367.091
VT$356.021
WA$376.62–$426.012
WI$345.371
WV$335.311
WY$361.361

See 40818 in every payment locality

How the 40818 rate is calculated

Each of 40818’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 · 40818

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.76

2.76 RVUs× 1.000 GPCI

Practice expense7.80

7.80 RVUs× 1.000 GPCI

Malpractice0.35

0.35 RVUs× 1.000 GPCI

Adjusted RVUs

10.9100

Conversion factor

$33.4009

Medicare rate

$364.40

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

The exact Connecticut inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,867

Code
40818
Physician work
2.76
Practice expense
7.80
Malpractice
0.35

GPCI2026.csv

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 40818 in Connecticut
ComponentRVULocality factorAdjusted
Physician work2.76× 1.0202.8152
Practice expense7.80× 1.0778.4006
Malpractice0.35× 1.2100.4235
Total RVUs11.6393
Conversion factor× 33.4009

Office rate, Connecticut$388.76

Office: (2.76 × 1.02 + 7.8 × 1.077 + 0.35 × 1.21) × $33.4009 = $388.76

Facility: (2.76 × 1.02 + 4.27 × 1.077 + 0.35 × 1.21) × $33.4009 = $261.78

Open 40818 in the RVU calculator

Payment rules and modifiers for 40818

40818 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40818

Oral graft harvest, vestibular mucosa

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)0Not paid without supporting documentation.
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 · 40818

Oral graft harvest, vestibular mucosa

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

40818 without 51 · national office

$364.40

Oral graft harvest, vestibular mucosa

40818-51 · Second procedure: 50%

$182.20

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 40818

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

Codes related to 40818
CodeHow it relatesOffice range, Connecticut
Often billed with
53410Urethral reconstruction, male anterior, one-stageMay accompany one-stage anterior urethral reconstruction when oral mucosa is harvested as graft tissue.No office rate
53415Urethroplasty, one-stage, transpubic or perinealMay accompany staged urethral reconstruction when oral mucosa is harvested for the repair.No office rate
Same family
40810Mouth lesion excision, without repairRelated vestibular mucosa surgery, but used for lesion excision rather than graft harvest.$231.01
40812Oral lesion excision, simple repairMouth lesion excision with repair, distinct from harvesting mucosa for grafting.$299.78

How 40818 has changed in Connecticut

40818 · Office / nonfacility

$388.76

Effective 2026-10-01

The base rate is $11.26 higher than on 2025-10-01, moving from $377.50 to $388.76 (3.0%).

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

    $377.50changed to$388.76

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.83 changed to 2.76
    • Practice expense RVU 7.67 changed to 7.80
    • Malpractice RVU 0.34 changed to 0.35
    • Work GPCI 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $392.16changed to$377.50

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.76 changed to 7.67
    • Malpractice RVU 0.35 changed to 0.34

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $385.76changed to$392.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $405.37changed to$385.76

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.88 changed to 7.76
    • Malpractice RVU 0.34 changed to 0.35
    • Work GPCI 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $413.82changed to$405.37

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.84 changed to 7.88
    • Malpractice RVU 0.31 changed to 0.34
    • Work GPCI 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $425.80changed to$413.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.06 changed to 7.84

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $412.17changed to$425.80

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.35 changed to 8.06
    • Malpractice RVU 0.30 changed to 0.31
    • Work GPCI 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $413.32changed to$412.17

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.32 changed to 7.35
    • Malpractice RVU 0.35 changed to 0.30
    • Work GPCI 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $409.66changed to$413.32

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.24 changed to 7.32

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $410.61changed to$409.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.25 changed to 7.24
    • Malpractice RVU 0.36 changed to 0.35
    • Work GPCI 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $410.63changed to$410.61

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $413.72changed to$410.63

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.29 changed to 7.25

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $411.66changed to$413.72

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $406.33changed to$411.66

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.18 changed to 7.29
    • Malpractice RVU 0.35 changed to 0.36
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $402.67changed to$406.33

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.64 changed to 7.18
    • Malpractice RVU 0.37 changed to 0.35
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $402.67

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$388.76$261.78RVU26D
2026-07-01$388.76$261.78RVU26C
2026-04-01$388.76$261.78RVU26B
2026-01-01$388.76$261.78RVU26A
2025-10-01$377.50$277.28RVU25D
2025-07-01$377.50$277.28RVU25C
2025-04-01$377.50$277.28RVU25B
2025-01-01$377.50$277.28RVU25A
2024-10-01$392.16$285.02RVU24D
2024-07-01$392.16$285.02RVU24C
2024-04-01$392.16$285.02RVU24B
2024-03-09$392.16$285.02RVU24AR
2024-01-01$385.76$280.37RVU24A
2023-10-01$405.37$291.10RVU23D
2023-07-01$405.37$291.10RVU23C
2023-04-01$405.37$291.10RVU23B
2023-01-01$405.37$291.10RVU23A
2022-10-01$413.82$294.31RVU22D
2022-07-01$413.82$294.31RVU22C
2022-04-01$413.82$294.31RVU22B
2022-01-01$413.82$294.31RVU22A
2021-10-01$425.80$302.19RVU21D
2021-07-01$425.80$302.19RVU21C
2021-04-01$425.80$302.19RVU21B
2021-01-01$425.80$302.19RVU21A
2020-10-01$412.17$303.72RVU20D
2020-07-01$412.17$303.72RVU20C
2020-04-01$412.17$303.72RVU20B
2020-01-01$412.17$303.72RVU20A
2019-10-01$413.32$309.52RVU19D
2019-07-01$413.32$309.52RVU19C
2019-04-01$413.32$309.52RVU19B
2019-01-01$413.32$309.52RVU19A
2018-10-01$409.66$310.38RVU18D
2018-07-01$409.66$310.38RVU18C
2018-04-01$409.66$310.38RVU18B
2018-01-01$409.66$310.38RVU18AR1
2017-10-01$410.61$311.99RVU17D
2017-07-01$410.61$311.99RVU17C
2017-04-01$410.61$311.99RVU17B
2017-01-01$410.61$311.99RVU17A
2016-10-01$410.63$311.89RVU16D
2016-07-01$410.63$311.89RVU16C
2016-04-01$410.63$311.89RVU16B
2016-01-01$410.63$311.89RVU16A
2015-10-01$413.72$313.42RVU15D
2015-07-01$413.72$313.42RVU15C
2015-04-01$411.66$311.86RVU15B
2015-01-01$411.66$311.86RVU15A
2014-10-01$406.33$309.58RVU14D
2014-07-01$406.33$309.58RVU14C
2014-04-01$406.33$309.58RVU14B
2014-01-01$406.33$309.58RVU14A
2013-10-01$402.67$303.73RVU13D
2013-07-01$402.67$303.73RVU13C
2013-04-01$402.67$303.73RVU13B
2013-01-01$402.67$303.73RVU13AR

Price 40818 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

40818 billing questions

How is graft harvest different from excising a mouth lesion?

This code is for taking oral mucosa as donor tissue for grafting. Lesion-excision codes apply when the purpose is removal of a lesion, with code selection based on the service performed.

Can the recipient-site reconstruction be reported separately?

Yes, when a distinct recipient-site procedure is performed and documented. For example, oral mucosa may be harvested for a urethral reconstruction, with the reconstruction reported under its applicable code.

Does modifier 50 apply when mucosa is harvested from both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

What postoperative care is included?

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

When is an assistant at surgery payable?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery billing are not permitted for this code.

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 40818PPRRVU2026_Oct_nonQPP.csv, line 4,867 (RVU26D)
Geographic factors for ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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