CPT code 40820: Oral lesion treatment, without repair2026 Medicare rate & RVUs in Mississippi

Report this service when a clinician treats a mucosal lesion in the vestibule of the mouth without repairing the treated area.

CMS RVU26DEffective Oct 1, 2026One payment locality1.8K Medicare services in 2024

In Mississippi, Medicare pays $222.59 for 40820 in the office and $137.47 when it’s performed in a hospital or facility.

$222.59Office (non-facility)
$137.47Hospital or facility
−11.7%vs the national office rate ($252.18)

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.

We’ll open 40820 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Mississippi
  2. What 40820 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 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 Mississippi 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. Mississippi pays $222.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

40820 in Mississippi vs other payment areas
  1. Mississippi · this page$222.59
  2. Los Angeles, CA · California$289.51+$66.92
  3. Washington, DC area · District of Columbia$291.31+$68.72
  4. Miami, FL · Florida$268.18+$45.59
  5. Chicago, IL · Illinois$259.99+$37.40
  6. Manhattan, NY · New York$290.87+$68.28
  7. Alaska · Alaska$285.03+$62.44

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

Every other payment area

40820 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$224.58$138.07
ArkansasArkansas$221.07$136.14
ArizonaArizona$245.15$149.35
Bakersfield, CACalifornia$270.58$162.22
Chico, CACalifornia$270.12$161.77
El Centro, CACalifornia$270.15$161.79
Fresno, CACalifornia$270.12$161.77
Hanford, CACalifornia$270.12$161.77

40820 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.

$221.07

$307.35

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

View every state and territory as a table
40820 office rate range by state
State / territoryOffice rate rangeLocalities
AK$285.031
AL$224.581
AR$221.071
AZ$245.151
CA$270.12–$344.5729
CO$264.621
CT$269.771
DC$291.311
DE$249.451
FL$245.75–$268.183
GA$231.17–$256.572
GU$277.931
HI$277.931
IA$231.871
ID$233.261
IL$237.30–$261.844
IN$234.751
KS$230.161
KY$229.171
LA$228.57–$240.862
MA$262.64–$292.882
MD$254.64–$291.313
ME$234.01–$248.502
MI$235.13–$248.492
MN$254.551
MO$223.98–$242.423
MS$222.591
MT$252.171
NC$236.741
ND$249.201
NE$233.401
NH$259.891
NJ$273.13–$287.822
NM$236.301
NV$251.541
NY$240.52–$297.725
OH$234.521
OK$229.291
OR$249.88–$274.172
PA$235.22–$262.272
PR$254.341
RI$259.181
SC$235.971
SD$248.851
TN$231.351
TX$233.51–$263.498
UT$239.461
VA$247.25–$291.312
VI$254.341
VT$247.671
WA$262.33–$299.622
WI$240.171
WV$227.691
WY$250.871

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.

How the rate is built · 40820

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.31

1.31 RVUs× 1.000 GPCI

Practice expense6.09

6.09 RVUs× 1.000 GPCI

Malpractice0.15

0.15 RVUs× 1.000 GPCI

Adjusted RVUs

7.5500

Conversion factor

$33.4009

Medicare rate

$252.18

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

The exact Mississippi inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,869

Code
40820
Physician work
1.31
Practice expense
6.09
Malpractice
0.15

GPCI2026.csv

67

Locality
Mississippi
Physician work
1.000
Practice expense
0.861
Malpractice
0.739
Office calculation for 40820 in Mississippi
ComponentRVULocality factorAdjusted
Physician work1.31× 1.0001.3100
Practice expense6.09× 0.8615.2435
Malpractice0.15× 0.7390.1108
Total RVUs6.6643
Conversion factor× 33.4009

Office rate, Mississippi$222.59

Office: (1.31 × 1 + 6.09 × 0.861 + 0.15 × 0.739) × $33.4009 = $222.59

Facility: (1.31 × 1 + 3.13 × 0.861 + 0.15 × 0.739) × $33.4009 = $137.47

Open 40820 in the RVU calculator

Payment rules and modifiers for 40820

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

CMS payment indicators · 40820

Oral lesion treatment, without 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 · 40820

Oral lesion treatment, without 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

40820 without 51 · national office

$252.18

Oral lesion treatment, without repair

40820-51 · Second procedure: 50%

$126.09

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 40820 has changed in Mississippi

40820 · Office / nonfacility

$222.59

Effective 2026-10-01

The base rate is $6.31 higher than on 2025-10-01, moving from $216.28 to $222.59 (2.9%).

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

    $216.28changed to$222.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.34 changed to 1.31
    • Practice expense RVU 6.14 changed to 6.09
    • Practice expense GPCI 0.852 changed to 0.861
    • Malpractice GPCI 0.768 changed to 0.739

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $227.14changed to$216.28

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.31 changed to 6.14
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $223.43changed to$227.14

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $229.94changed to$223.43

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 0.847 changed to 0.852
    • Malpractice GPCI 0.720 changed to 0.768
  5. January 1, 2023

    RVU23A

    $236.81changed to$229.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.44 changed to 6.31
    • Malpractice RVU 0.12 changed to 0.14
    • Practice expense GPCI 0.842 changed to 0.847
    • Malpractice GPCI 0.671 changed to 0.720

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $240.12changed to$236.81

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.47 changed to 6.44
    • Malpractice RVU 0.14 changed to 0.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $234.62changed to$240.12

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.95 changed to 6.47
    • Malpractice RVU 0.13 changed to 0.14
    • Practice expense GPCI 0.856 changed to 0.842
    • Malpractice GPCI 0.521 changed to 0.671

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $238.90changed to$234.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.99 changed to 5.95
    • Malpractice RVU 0.21 changed to 0.13
    • Practice expense GPCI 0.870 changed to 0.856
    • Malpractice GPCI 0.370 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $240.52changed to$238.90

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.05 changed to 5.99

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $242.85changed to$240.52

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.14 changed to 6.05
    • Practice expense GPCI 0.867 changed to 0.870
    • Malpractice GPCI 0.492 changed to 0.370

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $244.47changed to$242.85

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.21 changed to 6.14
    • Malpractice RVU 0.20 changed to 0.21
    • Practice expense GPCI 0.864 changed to 0.867
    • Malpractice GPCI 0.613 changed to 0.492

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $245.14changed to$244.47

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.19 changed to 0.20

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $243.92changed to$245.14

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $242.44changed to$243.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.14 changed to 6.21
    • Malpractice RVU 0.17 changed to 0.19
    • Practice expense GPCI 0.865 changed to 0.864
    • Malpractice GPCI 0.687 changed to 0.613

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $252.37changed to$242.44

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.86 changed to 6.14
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.866 changed to 0.865
    • Malpractice GPCI 0.761 changed to 0.687

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $252.37

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$222.59$137.47RVU26D
2026-07-01$222.59$137.47RVU26C
2026-04-01$222.59$137.47RVU26B
2026-01-01$222.59$137.47RVU26A
2025-10-01$216.28$142.98RVU25D
2025-07-01$216.28$142.98RVU25C
2025-04-01$216.28$142.98RVU25B
2025-01-01$216.28$142.98RVU25A
2024-10-01$227.14$148.30RVU24D
2024-07-01$227.14$148.30RVU24C
2024-04-01$227.14$148.30RVU24B
2024-03-09$227.14$148.30RVU24AR
2024-01-01$223.43$145.88RVU24A
2023-10-01$229.94$149.28RVU23D
2023-07-01$229.94$149.28RVU23C
2023-04-01$229.94$149.28RVU23B
2023-01-01$229.94$149.28RVU23A
2022-10-01$236.81$152.31RVU22D
2022-07-01$236.81$152.31RVU22C
2022-04-01$236.81$152.31RVU22B
2022-01-01$236.81$152.31RVU22A
2021-10-01$240.12$154.04RVU21D
2021-07-01$240.12$154.04RVU21C
2021-04-01$240.12$154.04RVU21B
2021-01-01$240.12$154.04RVU21A
2020-10-01$234.62$153.06RVU20D
2020-07-01$234.62$153.06RVU20C
2020-04-01$234.62$153.06RVU20B
2020-01-01$234.62$153.06RVU20A
2019-10-01$238.90$156.44RVU19D
2019-07-01$238.90$156.44RVU19C
2019-04-01$238.90$156.44RVU19B
2019-01-01$238.90$156.44RVU19A
2018-10-01$240.52$158.15RVU18D
2018-07-01$240.52$158.15RVU18C
2018-04-01$240.52$158.15RVU18B
2018-01-01$240.52$158.15RVU18AR1
2017-10-01$242.85$160.39RVU17D
2017-07-01$242.85$160.39RVU17C
2017-04-01$242.85$160.39RVU17B
2017-01-01$242.85$160.39RVU17A
2016-10-01$244.47$161.26RVU16D
2016-07-01$244.47$161.26RVU16C
2016-04-01$244.47$161.26RVU16B
2016-01-01$244.47$161.26RVU16A
2015-10-01$245.14$161.31RVU15D
2015-07-01$245.14$161.31RVU15C
2015-04-01$243.92$160.51RVU15B
2015-01-01$243.92$160.51RVU15A
2014-10-01$242.44$160.33RVU14D
2014-07-01$242.44$160.33RVU14C
2014-04-01$242.44$160.33RVU14B
2014-01-01$242.44$160.33RVU14A
2013-10-01$252.37$164.57RVU13D
2013-07-01$252.37$164.57RVU13C
2013-04-01$252.37$164.57RVU13B
2013-01-01$252.37$164.57RVU13AR

Price 40820 for an earlier date of service

Where the Mississippi rate applies

Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Aberdeen
  • Ackerman
  • Agricola
  • Alcorn State University
  • Algoma
  • Alligator
  • Amory

Browse all communities in Mississippi

40820 billing questions

How is 40820 different from a biopsy or excision?

Use 40820 when the clinician treats the lesion without taking a diagnostic sample or cutting the lesion out. Report a biopsy when tissue is sampled for diagnosis and an excision code when the lesion is removed.

What documentation supports 40820?

Document the lesion’s location in the vestibule, its relevant clinical characteristics, the treatment performed, and that the treated area was not repaired.

Can 40820 be billed with a repair code?

This code describes treatment without repair. If the service includes repair, review the code for treatment with repair rather than reporting 40820 for the same work.

What postoperative care is included?

Related postoperative visits for 10 days are included in the minor-procedure global period.

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for 40820.

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 40820PPRRVU2026_Oct_nonQPP.csv, line 4,869 (RVU26D)
Geographic factors for MississippiGPCI2026.csv, line 67 (RVU26D)

Open CMS sourceHow we calculate rates

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