CPT code 40820: Oral lesion treatment, without repair2026 Medicare rate & RVUs in Baltimore area, MD

In Baltimore area, MD, Medicare pays $268.91 for 40820 in the office and $162.83 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 40820 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 40820 covers

This service covers direct treatment of a lesion on the vestibular lining of the mouth—the inner lip or cheek area facing the teeth and gums—when the treatment does not include repair. Oral and maxillofacial surgeons, otolaryngologists, and other clinicians performing oral procedures may provide it in an office or facility. The key distinction is that the lesion is treated in place, rather than sampled for diagnosis or removed by excision.

The record should identify the lesion’s location and nature, describe the treatment performed, and support that no repair was performed. Choose a biopsy code when tissue is sampled for diagnosis, or an excision code when the lesion is cut out. This minor procedure has a 10-day global period, so related postoperative visits during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and 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 Baltimore area, MD compares for 40820

Across 109 of 109 payment localities, the office rate for 40820 runs from $221.07 in Arkansas to $344.57 in San Benito County, CA. Baltimore area, MD pays $268.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

40820 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 40820 in every payment locality

How the 40820 rate is calculated

Each of 40820’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.

Payment rules and modifiers for 40820

40820 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 40820

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

How 40820 has changed in Baltimore area, MD

Price 40820 for an earlier date of service

Where the Baltimore area, MD rate applies

Baltimore area, MD is a Medicare payment area, not a city. Our Census mapping connects it to 100 cities and communities in Maryland. Some span more than one payment area; confirm with the service ZIP.

• Baltimore
• Aberdeen
• Aberdeen Proving Ground
• Abingdon
• Annapolis
• Annapolis Neck
• Arbutus
• Arden on the Severn

Browse all communities in Maryland

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

Open CMS sourceHow we calculate rates