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CPT code 40830: Mouth laceration repair, simple vestibular repair2026 Medicare rate & RVUs in Idaho

Report this code for simple repair of a traumatic laceration in the mouth vestibule, such as a cut along the inner lip or cheek.

CMS RVU26DEffective Oct 1, 2026One payment locality463 Medicare services in 2024

In Idaho, Medicare pays $214.55 for 40830 in the office and $128.82 when it’s performed in a hospital or facility.

$214.55Office (non-facility)
$128.82Hospital or facility
−7.4%vs the national office rate ($231.80)

Check a contract rate as a % of Medicare · 40830 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 40830 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Idaho
  2. What 40830 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 40830 covers

This code describes simple repair of a traumatic cut in the oral vestibule—the space between the inner lip or cheek and the teeth or gums. A clinician may use it for an uncomplicated mucosal laceration, such as one caused by a fall or impact. Oral and maxillofacial surgeons, dentists, otolaryngologists, and emergency clinicians may perform the repair in an office, emergency department, or operating room. The key distinction from 40831 is that 40830 is for a simple repair; the record should identify the wound’s location and describe the repair performed.

Report one unit for the repair and document the injury, vestibular site, and basis for selecting the simple repair code. Medicare assigns 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 the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. Assistant-at-surgery payment requires documentation of medical necessity; 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 Idaho compares for 40830

Across 109 of 109 payment localities, the office rate for 40830 runs from $204.81 in Arkansas to $307.67 in San Benito County, CA. Idaho pays $214.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

40830 in Idaho vs other payment areas
  1. Idaho · this page$214.55
  2. Los Angeles, CA · California$261.84+$47.29
  3. Washington, DC area · District of Columbia$265.23+$50.68
  4. Miami, FL · Florida$250.31+$35.76
  5. Chicago, IL · Illinois$242.99+$28.44
  6. Manhattan, NY · New York$266.82+$52.27
  7. Alaska · Alaska$268.64+$54.09

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

Every other payment area

40830 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$207.84$126.30
ArkansasArkansas$204.81$124.76
ArizonaArizona$225.58$135.28
Bakersfield, CACalifornia$245.76$143.63
Chico, CACalifornia$245.08$142.95
El Centro, CACalifornia$245.12$142.99
Fresno, CACalifornia$245.08$142.95
Hanford, CACalifornia$245.08$142.95

40830 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.

$204.81

$276.38

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

View every state and territory as a table
40830 office rate range by state
State / territoryOffice rate rangeLocalities
AK$268.641
AL$207.841
AR$204.811
AZ$225.581
CA$245.08–$307.6729
CO$241.391
CT$247.301
DC$265.231
DE$229.341
FL$228.41–$250.313
GA$215.46–$236.162
GU$251.171
HI$251.171
IA$213.141
ID$214.551
IL$221.77–$242.994
IN$215.811
KS$212.151
KY$212.831
LA$212.50–$223.112
MA$239.93–$265.392
MD$233.74–$265.233
ME$215.70–$227.482
MI$218.44–$231.302
MN$231.181
MO$208.83–$223.903
MS$206.861
MT$231.791
NC$217.971
ND$227.241
NE$214.321
NH$237.611
NJ$250.09–$262.452
NM$219.651
NV$230.681
NY$221.27–$273.355
OH$217.511
OK$212.431
OR$228.86–$249.102
PA$217.85–$241.112
PR$233.501
RI$237.541
SC$218.111
SD$226.701
TN$213.231
TX$216.41–$240.618
UT$221.121
VA$226.74–$265.232
VI$233.501
VT$226.361
WA$239.48–$270.812
WI$219.561
WV$213.501
WY$229.801

See 40830 in every payment locality

How the 40830 rate is calculated

Each of 40830’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 · 40830

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.77

1.77 RVUs× 1.000 GPCI

Practice expense4.94

4.94 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

6.9400

Conversion factor

$33.4009

Medicare rate

$231.80

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

The exact Idaho inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,870

Code
40830
Physician work
1.77
Practice expense
4.94
Malpractice
0.23

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Office calculation for 40830 in Idaho
ComponentRVULocality factorAdjusted
Physician work1.77× 1.0001.7700
Practice expense4.94× 0.9204.5448
Malpractice0.23× 0.4730.1088
Total RVUs6.4236
Conversion factor× 33.4009

Office rate, Idaho$214.55

Office: (1.77 × 1 + 4.94 × 0.92 + 0.23 × 0.473) × $33.4009 = $214.55

Facility: (1.77 × 1 + 2.15 × 0.92 + 0.23 × 0.473) × $33.4009 = $128.82

Open 40830 in the RVU calculator

Payment rules and modifiers for 40830

40830 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40830

Mouth laceration repair, simple vestibular 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)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)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 40830

Mouth laceration repair, simple vestibular 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

40830 without 51 · national office

$231.80

Mouth laceration repair, simple vestibular repair

40830-51 · Second procedure: 50%

$115.90

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 40830

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

Codes related to 40830
CodeHow it relatesOffice range, Idaho
Same family
40831Laceration repair, complicated vestibular woundSibling code for a complicated repair of a mouth vestibule laceration.$289.25
Used instead
40812Oral lesion excision, simple repairFor excision of a mouth lesion with repair, rather than repair of a traumatic laceration.$260.58
40814Oral lesion excision, complex repairLesion excision with repair when the service is not repair of a traumatic laceration.$354.13
40899Unlisted mouth procedure, oral vestibuleUnlisted vestibule procedure code when no listed code describes the service.No office rate

How 40830 has changed in Idaho

40830 · Office / nonfacility

$214.55

Effective 2026-10-01

The base rate is $13.62 higher than on 2025-10-01, moving from $200.93 to $214.55 (6.8%).

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

    $200.93changed to$214.55

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.82 changed to 1.77
    • Practice expense RVU 4.73 changed to 4.94
    • Malpractice RVU 0.21 changed to 0.23
    • Practice expense GPCI 0.908 changed to 0.920
    • Malpractice GPCI 0.461 changed to 0.473

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $205.86changed to$200.93

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.70 changed to 4.73

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $202.50changed to$205.86

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $209.29changed to$202.50

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.77 changed to 4.70
    • Malpractice RVU 0.22 changed to 0.21
    • Practice expense GPCI 0.893 changed to 0.908
    • Malpractice GPCI 0.439 changed to 0.461

  5. January 1, 2023

    RVU23A

    $218.03changed to$209.29

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.99 changed to 4.77
    • Malpractice RVU 0.25 changed to 0.22
    • Practice expense GPCI 0.877 changed to 0.893
    • Malpractice GPCI 0.416 changed to 0.439

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $259.88changed to$218.03

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.27 changed to 4.99
    • Malpractice RVU 0.31 changed to 0.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $258.62changed to$259.88

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.84 changed to 6.27
    • Malpractice RVU 0.32 changed to 0.31
    • Practice expense GPCI 0.890 changed to 0.877
    • Malpractice GPCI 0.464 changed to 0.416

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $255.68changed to$258.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.70 changed to 5.84
    • Malpractice RVU 0.26 changed to 0.32
    • Practice expense GPCI 0.902 changed to 0.890
    • Malpractice GPCI 0.512 changed to 0.464

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $254.75changed to$255.68

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.68 changed to 5.70

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $253.54changed to$254.75

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.900 changed to 0.902
    • Malpractice GPCI 0.510 changed to 0.512

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $251.87changed to$253.54

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.66 changed to 5.68
    • Practice expense GPCI 0.898 changed to 0.900
    • Malpractice GPCI 0.508 changed to 0.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $252.64changed to$251.87

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.65 changed to 5.66
    • Malpractice RVU 0.27 changed to 0.26

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $251.39changed to$252.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $250.92changed to$251.39

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.60 changed to 5.65
    • Malpractice RVU 0.30 changed to 0.27
    • Practice expense GPCI 0.896 changed to 0.898
    • Malpractice GPCI 0.556 changed to 0.508

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $256.56changed to$250.92

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.19 changed to 5.60
    • Malpractice RVU 0.31 changed to 0.30
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.603 changed to 0.556

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $256.56

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$214.55$128.82RVU26D
2026-07-01$214.55$128.82RVU26C
2026-04-01$214.55$128.82RVU26B
2026-01-01$214.55$128.82RVU26A
2025-10-01$200.93$133.08RVU25D
2025-07-01$200.93$133.08RVU25C
2025-04-01$200.93$133.08RVU25B
2025-01-01$200.93$133.08RVU25A
2024-10-01$205.86$134.53RVU24D
2024-07-01$205.86$134.53RVU24C
2024-04-01$205.86$134.53RVU24B
2024-03-09$205.86$134.53RVU24AR
2024-01-01$202.50$132.34RVU24A
2023-10-01$209.29$135.15RVU23D
2023-07-01$209.29$135.15RVU23C
2023-04-01$209.29$135.15RVU23B
2023-01-01$209.29$135.15RVU23A
2022-10-01$218.03$136.99RVU22D
2022-07-01$218.03$136.99RVU22C
2022-04-01$218.03$136.99RVU22B
2022-01-01$218.03$136.99RVU22A
2021-10-01$259.88$151.55RVU21D
2021-07-01$259.88$151.55RVU21C
2021-04-01$259.88$151.55RVU21B
2021-01-01$259.88$151.55RVU21A
2020-10-01$258.62$157.76RVU20D
2020-07-01$258.62$157.76RVU20C
2020-04-01$258.62$157.76RVU20B
2020-01-01$258.62$157.76RVU20A
2019-10-01$255.68$158.48RVU19D
2019-07-01$255.68$158.48RVU19C
2019-04-01$255.68$158.48RVU19B
2019-01-01$255.68$158.48RVU19A
2018-10-01$254.75$159.93RVU18D
2018-07-01$254.75$159.93RVU18C
2018-04-01$254.75$159.93RVU18B
2018-01-01$254.75$159.93RVU18AR1
2017-10-01$253.54$159.55RVU17D
2017-07-01$253.54$159.55RVU17C
2017-04-01$253.54$159.55RVU17B
2017-01-01$253.54$159.55RVU17A
2016-10-01$251.87$158.63RVU16D
2016-07-01$251.87$158.63RVU16C
2016-04-01$251.87$158.63RVU16B
2016-01-01$251.87$158.63RVU16A
2015-10-01$252.64$160.03RVU15D
2015-07-01$252.64$160.03RVU15C
2015-04-01$251.39$159.24RVU15B
2015-01-01$251.39$159.24RVU15A
2014-10-01$250.92$158.80RVU14D
2014-07-01$250.92$158.80RVU14C
2014-04-01$250.92$158.80RVU14B
2014-01-01$250.92$158.80RVU14A
2013-10-01$256.56$160.44RVU13D
2013-07-01$256.56$160.44RVU13C
2013-04-01$256.56$160.44RVU13B
2013-01-01$256.56$160.44RVU13AR

Price 40830 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

40830 billing questions

How does 40830 differ from 40831?

40830 is for simple repair of a laceration in the mouth vestibule. Use 40831 when the repair is documented as complicated.

Can this code be used for a mouth lesion that is excised?

No. This code describes repair of a traumatic laceration. Lesion excision with repair is represented by lesion-specific codes such as 40812 or 40814, as appropriate.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure.

Should modifier 50 be appended for wounds on both sides of the mouth?

No. Modifier 50 is inappropriate for this descriptor and anatomy; report the repair without a bilateral adjustment.

When is an assistant-at-surgery payable?

Medicare pays an assistant at surgery only when the record documents medical necessity. Co-surgeons and team surgery 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 40830PPRRVU2026_Oct_nonQPP.csv, line 4,870 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)

Open CMS sourceHow we calculate rates

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