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CPT code 40831: Laceration repair, complicated vestibular wound2026 Medicare rate & RVUs in Queens, NY

Repair a complicated traumatic laceration of the mouth vestibule when the wound requires more involved closure than a simple repair.

CMS RVU26DEffective Oct 1, 2026One payment locality191 Medicare services in 2024

In Queens, NY, Medicare pays $362.59 for 40831 in the office and $221.65 when it’s performed in a hospital or facility.

$362.59Office (non-facility)
$221.65Hospital or facility
+16.0%vs the national office rate ($312.63)

Check a contract rate as a % of Medicare · 40831 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 40831 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 40831 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 40831 covers

This service repairs a complicated traumatic wound in the oral vestibule, the space between the lips or cheeks and the teeth or gums. It may be performed by an oral and maxillofacial surgeon, otolaryngologist, plastic surgeon, or emergency physician in an office, emergency department, or other appropriate setting. The procedure closes the injured tissue; it is not removal of a mouth lesion or drainage of an abscess.

Choose this code rather than 40830 when the documented laceration requires complicated repair. Record the site, wound extent and tissue involvement, and the repair performed to support that distinction. 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 other procedures are subject to the standard 50% reduction. Do not use modifier 50 for this service. An assistant is paid only when medical necessity is documented; 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 40831

Across 109 of 109 payment localities, the office rate for 40831 runs from $276.47 in Arkansas to $412.69 in San Benito County, CA. Queens, NY pays $362.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

40831 in Queens, NY vs other payment areas
  1. Queens, NY · this page$362.59
  2. Manhattan, NY · New York$359.88−$2.71
  3. NYC suburbs and Long Island, NY · New York$368.83+$6.24
  4. Poughkeepsie and northern NYC suburbs, NY · New York$339.45−$23.14
  5. Rest of New York · New York$298.39−$64.20
  6. Los Angeles, CA · California$352.05−$10.54
  7. Washington, DC area · District of Columbia$357.15−$5.44

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

Every other payment area

40831 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$338.91$214.78
Chicago, ILIllinois$329.01$209.18
AlaskaAlaska$363.59$236.59
AlabamaAlabama$280.52$176.19
ArkansasArkansas$276.47$174.04
ArizonaArizona$304.26$188.71
Bakersfield, CACalifornia$330.66$199.97
Chico, CACalifornia$329.66$198.97

40831 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.

$276.47

$371.18

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

View every state and territory as a table
40831 office rate range by state
State / territoryOffice rate rangeLocalities
AK$363.591
AL$280.521
AR$276.471
AZ$304.261
CA$329.66–$412.6929
CO$325.071
CT$333.441
DC$357.151
DE$309.301
FL$308.78–$338.913
GA$291.33–$318.652
GU$337.641
HI$337.641
IA$287.301
ID$289.251
IL$300.11–$329.014
IN$290.921
KS$286.131
KY$287.531
LA$287.15–$301.352
MA$323.19–$357.002
MD$315.15–$357.153
ME$290.94–$306.482
MI$295.18–$312.812
MN$310.941
MO$282.33–$302.223
MS$279.441
MT$312.611
NC$293.961
ND$305.891
NE$288.831
NH$320.131
NJ$337.09–$353.482
NM$296.871
NV$310.951
NY$298.39–$368.835
OH$293.811
OK$286.831
OR$308.39–$335.202
PA$294.18–$325.252
PR$314.851
RI$320.171
SC$294.401
SD$305.091
TN$287.591
TX$292.26–$324.128
UT$298.431
VA$305.60–$357.152
VI$314.851
VT$304.851
WA$322.53–$364.102
WI$295.641
WV$289.041
WY$309.681

See 40831 in every payment locality

How the 40831 rate is calculated

Each of 40831’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 · 40831

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.51

2.51 RVUs× 1.000 GPCI

Practice expense6.51

6.51 RVUs× 1.000 GPCI

Malpractice0.34

0.34 RVUs× 1.000 GPCI

Adjusted RVUs

9.3600

Conversion factor

$33.4009

Medicare rate

$312.63

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

4,871

Code
40831
Physician work
2.51
Practice expense
6.51
Malpractice
0.34

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 40831 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work2.51× 1.0642.6706
Practice expense6.51× 1.1827.6948
Malpractice0.34× 1.4420.4903
Total RVUs10.8557
Conversion factor× 33.4009

Office rate, Queens, NY$362.59

Office: (2.51 × 1.064 + 6.51 × 1.182 + 0.34 × 1.442) × $33.4009 = $362.59

Facility: (2.51 × 1.064 + 2.94 × 1.182 + 0.34 × 1.442) × $33.4009 = $221.65

Open 40831 in the RVU calculator

Payment rules and modifiers for 40831

40831 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40831

Laceration repair, complicated vestibular wound

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 · 40831

Laceration repair, complicated vestibular wound

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

40831 without 51 · national office

$312.63

Laceration repair, complicated vestibular wound

40831-51 · Second procedure: 50%

$156.32

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 40831

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

Codes related to 40831
CodeHow it relatesOffice range, Queens, NY
Same family
40830Mouth laceration repair, simple vestibular repairSibling code for simple repair of a mouth vestibule laceration.$269.01
Used instead
40840Mouth reconstruction, anterior vestibuloplastyConsider for a mouth defect requiring reconstruction rather than laceration closure.$1,020.90
40899Unlisted mouth procedure, oral vestibuleUnlisted vestibular procedure code when no specific listed code describes the service.No office rate

How 40831 has changed in Queens, NY

40831 · Office / nonfacility

$362.59

Effective 2026-10-01

The base rate is $24.94 higher than on 2025-10-01, moving from $337.65 to $362.59 (7.4%).

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

    $337.65changed to$362.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.57 changed to 2.51
    • Practice expense RVU 6.09 changed to 6.51
    • Malpractice RVU 0.29 changed to 0.34
    • 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

    $343.50changed to$337.65

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.99 changed to 6.09

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $337.89changed to$343.50

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $361.96changed to$337.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.07 changed to 5.99
    • 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

    $397.13changed to$361.96

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.42 changed to 6.07
    • Malpractice RVU 0.33 changed to 0.29
    • 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

    $460.70changed to$397.13

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.61 changed to 6.42
    • Malpractice RVU 0.43 changed to 0.33

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $449.44changed to$460.70

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.18 changed to 7.61
    • 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

    $429.54changed to$449.44

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.99 changed to 7.18
    • Malpractice RVU 0.39 changed to 0.43
    • 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

    $422.59changed to$429.54

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.84 changed to 6.99

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $421.19changed to$422.59

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.81 changed to 6.84
    • Malpractice RVU 0.40 changed to 0.39
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $422.53changed to$421.19

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.86 changed to 6.81
    • 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

    $423.20changed to$422.53

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.84 changed to 6.86

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $421.09changed to$423.20

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $417.35changed to$421.09

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.85 changed to 6.84
    • 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

    $420.72changed to$417.35

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.54 changed to 6.85
    • Malpractice RVU 0.42 changed to 0.40
    • 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: $420.72

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$362.59$221.65RVU26D
2026-07-01$362.59$221.65RVU26C
2026-04-01$362.59$221.65RVU26B
2026-01-01$362.59$221.65RVU26A
2025-10-01$337.65$229.42RVU25D
2025-07-01$337.65$229.42RVU25C
2025-04-01$337.65$229.42RVU25B
2025-01-01$337.65$229.42RVU25A
2024-10-01$343.50$231.32RVU24D
2024-07-01$343.50$231.32RVU24C
2024-04-01$343.50$231.32RVU24B
2024-03-09$343.50$231.32RVU24AR
2024-01-01$337.89$227.55RVU24A
2023-10-01$361.96$242.44RVU23D
2023-07-01$361.96$242.44RVU23C
2023-04-01$361.96$242.44RVU23B
2023-01-01$361.96$242.44RVU23A
2022-10-01$397.13$262.42RVU22D
2022-07-01$397.13$262.42RVU22C
2022-04-01$397.13$262.42RVU22B
2022-01-01$397.13$262.42RVU22A
2021-10-01$460.70$293.16RVU21D
2021-07-01$460.70$293.16RVU21C
2021-04-01$460.70$293.16RVU21B
2021-01-01$460.70$293.16RVU21A
2020-10-01$449.44$294.34RVU20D
2020-07-01$449.44$294.34RVU20C
2020-04-01$449.44$294.34RVU20B
2020-01-01$449.44$294.34RVU20A
2019-10-01$429.54$282.50RVU19D
2019-07-01$429.54$282.50RVU19C
2019-04-01$429.54$282.50RVU19B
2019-01-01$429.54$282.50RVU19A
2018-10-01$422.59$282.19RVU18D
2018-07-01$422.59$282.19RVU18C
2018-04-01$422.59$282.19RVU18B
2018-01-01$422.59$282.19RVU18AR1
2017-10-01$421.19$283.38RVU17D
2017-07-01$421.19$283.38RVU17C
2017-04-01$421.19$283.38RVU17B
2017-01-01$421.19$283.38RVU17A
2016-10-01$422.53$283.44RVU16D
2016-07-01$422.53$283.44RVU16C
2016-04-01$422.53$283.44RVU16B
2016-01-01$422.53$283.44RVU16A
2015-10-01$423.20$283.17RVU15D
2015-07-01$423.20$283.17RVU15C
2015-04-01$421.09$281.76RVU15B
2015-01-01$421.09$281.76RVU15A
2014-10-01$417.35$277.99RVU14D
2014-07-01$417.35$277.99RVU14C
2014-04-01$417.35$277.99RVU14B
2014-01-01$417.35$277.99RVU14A
2013-10-01$420.72$274.36RVU13D
2013-07-01$420.72$274.36RVU13C
2013-04-01$420.72$274.36RVU13B
2013-01-01$420.72$274.36RVU13AR

Price 40831 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

40831 billing questions

How do I distinguish 40831 from 40830?

Use 40831 for a complicated vestibular laceration repair and 40830 for a simple repair. Document the wound and the work that supports the level selected.

Can I report modifier 50 for wounds on both sides of the mouth?

No. Modifier 50 is inappropriate for this service under the CMS bilateral rule.

Are related postoperative visits separately payable during the global period?

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

How does the multiple-procedure reduction affect this code?

For procedures performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.

Can an assistant or another surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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 40831PPRRVU2026_Oct_nonQPP.csv, line 4,871 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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