FeeBase
Log inGet started
Menu

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

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 Queens, NY, Medicare pays $269.01 for 40830 in the office and $158.86 when it’s performed in a hospital or facility.

$269.01Office (non-facility)
$158.86Hospital or facility
+16.1%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $269.01. The RVUs are the same everywhere; the geographic indexes change the dollars.

40830 in Queens, NY vs other payment areas
  1. Queens, NY · this page$269.01
  2. Manhattan, NY · New York$266.82−$2.19
  3. NYC suburbs and Long Island, NY · New York$273.35+$4.34
  4. Poughkeepsie and northern NYC suburbs, NY · New York$251.75−$17.26
  5. Rest of New York · New York$221.27−$47.74
  6. Los Angeles, CA · California$261.84−$7.17
  7. Washington, DC area · District of Columbia$265.23−$3.78

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

Every other payment area

40830 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$250.31$153.30
Chicago, ILIllinois$242.99$149.34
AlaskaAlaska$268.64$169.39
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

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 40830 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work1.77× 1.0641.8833
Practice expense4.94× 1.1825.8391
Malpractice0.23× 1.4420.3317
Total RVUs8.0540
Conversion factor× 33.4009

Office rate, Queens, NY$269.01

Office: (1.77 × 1.064 + 4.94 × 1.182 + 0.23 × 1.442) × $33.4009 = $269.01

Facility: (1.77 × 1.064 + 2.15 × 1.182 + 0.23 × 1.442) × $33.4009 = $158.86

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, Queens, NY
Same family
40831Laceration repair, complicated vestibular woundSibling code for a complicated repair of a mouth vestibule laceration.$362.59
Used instead
40812Oral lesion excision, simple repairFor excision of a mouth lesion with repair, rather than repair of a traumatic laceration.$325.83
40814Oral lesion excision, complex repairLesion excision with repair when the service is not repair of a traumatic laceration.$441.95
40899Unlisted mouth procedure, oral vestibuleUnlisted vestibule procedure code when no listed code describes the service.No office rate

How 40830 has changed in Queens, NY

40830 · Office / nonfacility

$269.01

Effective 2026-10-01

The base rate is $13.55 higher than on 2025-10-01, moving from $255.46 to $269.01 (5.3%).

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

    $255.46changed to$269.01

    • 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
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $261.70changed to$255.46

    • 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

    $257.43changed to$261.70

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $276.71changed to$257.43

    • 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
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $301.59changed to$276.71

    • 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
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $364.51changed to$301.59

    • 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

    $352.71changed to$364.51

    • 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
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $335.38changed to$352.71

    • 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
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $334.15changed to$335.38

    • 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

    $333.40changed to$334.15

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $331.84changed to$333.40

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.66 changed to 5.68
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $333.39changed to$331.84

    • 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

    $331.73changed to$333.39

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $328.77changed to$331.73

    • 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
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $333.16changed to$328.77

    • 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
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $333.16

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$269.01$158.86RVU26D
2026-07-01$269.01$158.86RVU26C
2026-04-01$269.01$158.86RVU26B
2026-01-01$269.01$158.86RVU26A
2025-10-01$255.46$166.17RVU25D
2025-07-01$255.46$166.17RVU25C
2025-04-01$255.46$166.17RVU25B
2025-01-01$255.46$166.17RVU25A
2024-10-01$261.70$167.82RVU24D
2024-07-01$261.70$167.82RVU24C
2024-04-01$261.70$167.82RVU24B
2024-03-09$261.70$167.82RVU24AR
2024-01-01$257.43$165.08RVU24A
2023-10-01$276.71$176.09RVU23D
2023-07-01$276.71$176.09RVU23C
2023-04-01$276.71$176.09RVU23B
2023-01-01$276.71$176.09RVU23A
2022-10-01$301.59$188.12RVU22D
2022-07-01$301.59$188.12RVU22C
2022-04-01$301.59$188.12RVU22B
2022-01-01$301.59$188.12RVU22A
2021-10-01$364.51$212.82RVU21D
2021-07-01$364.51$212.82RVU21C
2021-04-01$364.51$212.82RVU21B
2021-01-01$364.51$212.82RVU21A
2020-10-01$352.71$215.14RVU20D
2020-07-01$352.71$215.14RVU20C
2020-04-01$352.71$215.14RVU20B
2020-01-01$352.71$215.14RVU20A
2019-10-01$335.38$206.08RVU19D
2019-07-01$335.38$206.08RVU19C
2019-04-01$335.38$206.08RVU19B
2019-01-01$335.38$206.08RVU19A
2018-10-01$334.15$208.01RVU18D
2018-07-01$334.15$208.01RVU18C
2018-04-01$334.15$208.01RVU18B
2018-01-01$334.15$208.01RVU18AR1
2017-10-01$333.40$208.08RVU17D
2017-07-01$333.40$208.08RVU17C
2017-04-01$333.40$208.08RVU17B
2017-01-01$333.40$208.08RVU17A
2016-10-01$331.84$207.34RVU16D
2016-07-01$331.84$207.34RVU16C
2016-04-01$331.84$207.34RVU16B
2016-01-01$331.84$207.34RVU16A
2015-10-01$333.39$209.73RVU15D
2015-07-01$333.39$209.73RVU15C
2015-04-01$331.73$208.69RVU15B
2015-01-01$331.73$208.69RVU15A
2014-10-01$328.77$205.71RVU14D
2014-07-01$328.77$205.71RVU14C
2014-04-01$328.77$205.71RVU14B
2014-01-01$328.77$205.71RVU14A
2013-10-01$333.16$204.68RVU13D
2013-07-01$333.16$204.68RVU13C
2013-04-01$333.16$204.68RVU13B
2013-01-01$333.16$204.68RVU13AR

Price 40830 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 40830 pays in Queens, NY?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 40830 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist