CPT code 40820: Oral lesion treatment, without repair2026 Medicare rate & RVUs in Virgin Islands, VI
Report this service when a clinician treats a mucosal lesion in the vestibule of the mouth without repairing the treated area.
In Virgin Islands, VI, Medicare pays $254.34 for 40820 in the office and $154.38 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.
On this page 11 sections
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 Virgin Islands, VI 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. Virgin Islands, VI pays $254.34. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virgin Islands, VI · this page$254.34
- Los Angeles, CA · California$289.51+$35.17
- Washington, DC area · District of Columbia$291.31+$36.97
- Miami, FL · Florida$268.18+$13.84
- Chicago, IL · Illinois$259.99+$5.65
- Manhattan, NY · New York$290.87+$36.53
- Alaska · Alaska$285.03+$30.69
Other areas in United States Virgin Islands first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $270.12 | $161.77 |
| Merced, CACalifornia | $270.12 | $161.77 |
| Modesto, CACalifornia | $270.12 | $161.77 |
| Napa, CACalifornia | $317.15 | $186.85 |
| Oxnard, CACalifornia | $288.53 | $171.67 |
| Redding, CACalifornia | $270.12 | $161.77 |
| Rest of CaliforniaCalifornia | $270.12 | $161.77 |
| Riverside, CACalifornia | $271.76 | $163.40 |
| Sacramento, CACalifornia | $284.58 | $169.60 |
| Salinas, CACalifornia | $283.55 | $168.96 |
| San Diego, CACalifornia | $291.06 | $172.82 |
| Marin County, CACalifornia | $337.02 | $197.62 |
| San Francisco, CACalifornia | $336.85 | $197.45 |
| San Benito County, CACalifornia | $344.57 | $202.01 |
| Santa Clara County, CACalifornia | $343.88 | $201.31 |
| San Luis Obispo, CACalifornia | $278.87 | $166.26 |
| Santa Cruz, CACalifornia | $294.50 | $174.38 |
| Santa Maria, CACalifornia | $284.84 | $169.57 |
| Santa Rosa, CACalifornia | $297.54 | $176.13 |
| Stockton, CACalifornia | $270.12 | $161.77 |
| Vallejo, CACalifornia | $316.91 | $186.60 |
| Visalia, CACalifornia | $270.12 | $161.77 |
| Yuba City, CACalifornia | $270.12 | $161.77 |
| ColoradoColorado | $264.62 | $159.43 |
| ConnecticutConnecticut | $269.77 | $163.29 |
| DelawareDelaware | $249.45 | $151.77 |
| Fort Lauderdale, FLFlorida | $258.87 | $158.72 |
| Rest of FloridaFlorida | $245.75 | $151.23 |
| Atlanta, GAGeorgia | $256.57 | $156.12 |
| Rest of GeorgiaGeorgia | $231.17 | $142.98 |
| Hawaii, Guam, HIHawaii | $277.93 | $165.52 |
| IowaIowa | $231.87 | $141.40 |
| IdahoIdaho | $233.26 | $142.31 |
| East St. Louis, ILIllinois | $240.98 | $150.03 |
| Rest of IllinoisIllinois | $237.30 | $147.04 |
| Suburban Chicago, ILIllinois | $261.84 | $160.31 |
| IndianaIndiana | $234.75 | $143.10 |
| KansasKansas | $230.16 | $140.79 |
| KentuckyKentucky | $229.17 | $141.28 |
| New Orleans, LALouisiana | $240.86 | $147.82 |
| Rest of LouisianaLouisiana | $228.57 | $141.08 |
| Metropolitan Boston, MAMassachusetts | $292.88 | $174.83 |
| Rest of MassachusettsMassachusetts | $262.64 | $158.53 |
| Baltimore area, MDMaryland | $268.91 | $162.83 |
| Rest of MarylandMaryland | $254.64 | $154.59 |
| Rest of MaineMaine | $234.01 | $143.05 |
| Southern Maine, MEMaine | $248.50 | $150.52 |
| Detroit, MIMichigan | $248.49 | $153.09 |
| Rest of MichiganMichigan | $235.13 | $144.86 |
| MinnesotaMinnesota | $254.55 | $152.81 |
| Metropolitan Kansas City, MOMissouri | $239.65 | $146.82 |
| Metropolitan St. Louis, MOMissouri | $242.42 | $148.30 |
| Rest of MissouriMissouri | $223.98 | $138.75 |
| MississippiMississippi | $222.59 | $137.47 |
| MontanaMontana | $252.17 | $153.30 |
| North CarolinaNorth Carolina | $236.74 | $144.50 |
| North DakotaNorth Dakota | $249.20 | $150.33 |
| NebraskaNebraska | $233.40 | $142.14 |
| New HampshireNew Hampshire | $259.89 | $156.97 |
| Northern New JerseyNew Jersey | $287.82 | $173.13 |
| Rest of New JerseyNew Jersey | $273.13 | $165.16 |
| New MexicoNew Mexico | $236.30 | $145.64 |
| NevadaNevada | $251.54 | $152.58 |
| NYC suburbs and Long Island, NYNew York | $297.72 | $180.16 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $274.52 | $166.26 |
| Queens, NYNew York | $294.21 | $177.35 |
| Rest of New YorkNew York | $240.52 | $146.59 |
| OhioOhio | $234.52 | $144.25 |
| OklahomaOklahoma | $229.29 | $141.01 |
| Portland, OROregon | $274.17 | $164.33 |
| Rest of OregonOregon | $249.88 | $151.40 |
| Metropolitan Philadelphia, PAPennsylvania | $262.27 | $159.35 |
| Rest of PennsylvaniaPennsylvania | $235.22 | $144.46 |
| Puerto RicoPuerto Rico | $254.34 | $154.38 |
| Rhode IslandRhode Island | $259.18 | $157.05 |
| South CarolinaSouth Carolina | $235.97 | $144.61 |
| South DakotaSouth Dakota | $248.85 | $149.98 |
| TennesseeTennessee | $231.35 | $141.48 |
| Austin, TXTexas | $263.49 | $158.89 |
| Beaumont, TXTexas | $233.51 | $143.55 |
| Brazoria, TXTexas | $249.59 | $151.62 |
| Dallas, TXTexas | $251.05 | $152.57 |
| Fort Worth, TXTexas | $249.08 | $151.59 |
| Galveston, TXTexas | $250.24 | $152.07 |
| Houston, TXTexas | $252.99 | $154.81 |
| Rest of TexasTexas | $241.32 | $147.49 |
| UtahUtah | $239.46 | $146.53 |
| VirginiaVirginia | $247.25 | $150.06 |
| VermontVermont | $247.67 | $149.79 |
| Rest of WashingtonWashington | $262.33 | $158.22 |
| King County, WAWashington | $299.62 | $178.31 |
| WisconsinWisconsin | $240.17 | $145.45 |
| West VirginiaWest Virginia | $227.69 | $141.77 |
| WyomingWyoming | $250.87 | $152.01 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $285.03 | 1 |
| AL | $224.58 | 1 |
| AR | $221.07 | 1 |
| AZ | $245.15 | 1 |
| CA | $270.12–$344.57 | 29 |
| CO | $264.62 | 1 |
| CT | $269.77 | 1 |
| DC | $291.31 | 1 |
| DE | $249.45 | 1 |
| FL | $245.75–$268.18 | 3 |
| GA | $231.17–$256.57 | 2 |
| GU | $277.93 | 1 |
| HI | $277.93 | 1 |
| IA | $231.87 | 1 |
| ID | $233.26 | 1 |
| IL | $237.30–$261.84 | 4 |
| IN | $234.75 | 1 |
| KS | $230.16 | 1 |
| KY | $229.17 | 1 |
| LA | $228.57–$240.86 | 2 |
| MA | $262.64–$292.88 | 2 |
| MD | $254.64–$291.31 | 3 |
| ME | $234.01–$248.50 | 2 |
| MI | $235.13–$248.49 | 2 |
| MN | $254.55 | 1 |
| MO | $223.98–$242.42 | 3 |
| MS | $222.59 | 1 |
| MT | $252.17 | 1 |
| NC | $236.74 | 1 |
| ND | $249.20 | 1 |
| NE | $233.40 | 1 |
| NH | $259.89 | 1 |
| NJ | $273.13–$287.82 | 2 |
| NM | $236.30 | 1 |
| NV | $251.54 | 1 |
| NY | $240.52–$297.72 | 5 |
| OH | $234.52 | 1 |
| OK | $229.29 | 1 |
| OR | $249.88–$274.17 | 2 |
| PA | $235.22–$262.27 | 2 |
| PR | $254.34 | 1 |
| RI | $259.18 | 1 |
| SC | $235.97 | 1 |
| SD | $248.85 | 1 |
| TN | $231.35 | 1 |
| TX | $233.51–$263.49 | 8 |
| UT | $239.46 | 1 |
| VA | $247.25–$291.31 | 2 |
| VI | $254.34 | 1 |
| VT | $247.67 | 1 |
| WA | $262.33–$299.62 | 2 |
| WI | $240.17 | 1 |
| WV | $227.69 | 1 |
| WY | $250.87 | 1 |
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
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 Virgin Islands, VI 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
107
- Locality
- Virgin Islands, VI
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.31 | × 1.000 | 1.3100 |
| Practice expense | 6.09 | × 1.011 | 6.1570 |
| Malpractice | 0.15 | × 0.985 | 0.1477 |
| Total RVUs | 7.6147 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virgin Islands, VI$254.34
Office: (1.31 × 1 + 6.09 × 1.011 + 0.15 × 0.985) × $33.4009 = $254.34
Facility: (1.31 × 1 + 3.13 × 1.011 + 0.15 × 0.985) × $33.4009 = $154.38
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
| 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 · 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.
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%).
How 40820 has changed in Virgin Islands, VI
40820 · Office / nonfacility
$254.34
Effective 2026-10-01
The base rate is $6.23 higher than on 2025-10-01, moving from $248.11 to $254.34 (2.5%).
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
$248.11changed to$254.34
- 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 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$260.70changed to$248.11
- 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.
March 9, 2024
RVU24AR
$256.44changed to$260.70
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$265.62changed to$256.44
- Conversion factor 33.8872 changed to 32.7442
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$263.98changed to$265.62
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$275.11changed to$263.98
- 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 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$279.14changed to$275.11
- 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.
January 1, 2021
RVU21A
$269.45changed to$279.14
- 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
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$273.17changed to$269.45
- 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 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$275.05changed to$273.17
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 6.05 changed to 5.99
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$277.25changed to$275.05
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 6.14 changed to 6.05
- Practice expense GPCI 1.006 changed to 1.007
- Malpractice GPCI 0.993 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$268.56changed to$277.25
- 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 0.960 changed to 1.006
- Malpractice GPCI 0.996 changed to 0.993
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$269.17changed to$268.56
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.19 changed to 0.20
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$267.83changed to$269.17
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$274.94changed to$267.83
- 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 1.004 changed to 0.960
- Malpractice GPCI 1.003 changed to 0.996
Held through RVU15B.
January 1, 2014
RVU14A
$285.64changed to$274.94
- 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 1.002 changed to 1.004
- Malpractice GPCI 1.010 changed to 1.003
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $285.64
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $254.34 | $154.38 | RVU26D |
| 2026-07-01 | $254.34 | $154.38 | RVU26C |
| 2026-04-01 | $254.34 | $154.38 | RVU26B |
| 2026-01-01 | $254.34 | $154.38 | RVU26A |
| 2025-10-01 | $248.11 | $161.46 | RVU25D |
| 2025-07-01 | $248.11 | $161.46 | RVU25C |
| 2025-04-01 | $248.11 | $161.46 | RVU25B |
| 2025-01-01 | $248.11 | $161.46 | RVU25A |
| 2024-10-01 | $260.70 | $167.51 | RVU24D |
| 2024-07-01 | $260.70 | $167.51 | RVU24C |
| 2024-04-01 | $260.70 | $167.51 | RVU24B |
| 2024-03-09 | $260.70 | $167.51 | RVU24AR |
| 2024-01-01 | $256.44 | $164.78 | RVU24A |
| 2023-10-01 | $265.62 | $169.63 | RVU23D |
| 2023-07-01 | $263.98 | $168.76 | RVU23C |
| 2023-04-01 | $263.98 | $168.76 | RVU23B |
| 2023-01-01 | $263.98 | $168.76 | RVU23A |
| 2022-10-01 | $275.11 | $173.95 | RVU22D |
| 2022-07-01 | $275.11 | $173.95 | RVU22C |
| 2022-04-01 | $275.11 | $173.95 | RVU22B |
| 2022-01-01 | $275.11 | $173.95 | RVU22A |
| 2021-10-01 | $279.14 | $176.08 | RVU21D |
| 2021-07-01 | $279.14 | $176.08 | RVU21C |
| 2021-04-01 | $279.14 | $176.08 | RVU21B |
| 2021-01-01 | $279.14 | $176.08 | RVU21A |
| 2020-10-01 | $269.45 | $173.41 | RVU20D |
| 2020-07-01 | $269.45 | $173.41 | RVU20C |
| 2020-04-01 | $269.45 | $173.41 | RVU20B |
| 2020-01-01 | $269.45 | $173.41 | RVU20A |
| 2019-10-01 | $273.17 | $177.72 | RVU19D |
| 2019-07-01 | $273.17 | $177.72 | RVU19C |
| 2019-04-01 | $273.17 | $177.72 | RVU19B |
| 2019-01-01 | $273.17 | $177.72 | RVU19A |
| 2018-10-01 | $275.05 | $179.70 | RVU18D |
| 2018-07-01 | $275.05 | $179.70 | RVU18C |
| 2018-04-01 | $275.05 | $179.70 | RVU18B |
| 2018-01-01 | $275.05 | $179.70 | RVU18AR1 |
| 2017-10-01 | $277.25 | $181.58 | RVU17D |
| 2017-07-01 | $277.25 | $181.58 | RVU17C |
| 2017-04-01 | $277.25 | $181.58 | RVU17B |
| 2017-01-01 | $277.25 | $181.58 | RVU17A |
| 2016-10-01 | $268.56 | $176.10 | RVU16D |
| 2016-07-01 | $268.56 | $176.10 | RVU16C |
| 2016-04-01 | $268.56 | $176.10 | RVU16B |
| 2016-01-01 | $268.56 | $176.10 | RVU16A |
| 2015-10-01 | $269.17 | $176.03 | RVU15D |
| 2015-07-01 | $269.17 | $176.03 | RVU15C |
| 2015-04-01 | $267.83 | $175.16 | RVU15B |
| 2015-01-01 | $267.83 | $175.16 | RVU15A |
| 2014-10-01 | $274.94 | $179.63 | RVU14D |
| 2014-07-01 | $274.94 | $179.63 | RVU14C |
| 2014-04-01 | $274.94 | $179.63 | RVU14B |
| 2014-01-01 | $274.94 | $179.63 | RVU14A |
| 2013-10-01 | $285.64 | $184.05 | RVU13D |
| 2013-07-01 | $285.64 | $184.05 | RVU13C |
| 2013-04-01 | $285.64 | $184.05 | RVU13B |
| 2013-01-01 | $285.64 | $184.05 | RVU13AR |
Where the Virgin Islands, VI rate applies
Virgin Islands, VI is a Medicare payment area, not a city. Our Census mapping connects it to 10 cities and communities in United States Virgin Islands. Some span more than one payment area; confirm with the service ZIP.
- Charlotte Amalie
- Charlotte Amalie East
- Charlotte Amalie West
- Christiansted
- Coral Bay
- Cruz Bay
- Frederiksted
- Frederiksted Southeast
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
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