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

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 Tennessee, Medicare pays $287.59 for 40831 in the office and $179.20 when it’s performed in a hospital or facility.

$287.59Office (non-facility)
$179.20Hospital or facility
−8.0%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 Tennessee
  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 Tennessee 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. Tennessee pays $287.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

40831 in Tennessee vs other payment areas
  1. Tennessee · this page$287.59
  2. Los Angeles, CA · California$352.05+$64.46
  3. Washington, DC area · District of Columbia$357.15+$69.56
  4. Miami, FL · Florida$338.91+$51.32
  5. Chicago, IL · Illinois$329.01+$41.42
  6. Manhattan, NY · New York$359.88+$72.29
  7. Alaska · Alaska$363.59+$76.00

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

Every other payment area

40831 in every other Medicare payment locality
Payment localityOfficeFacility
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
El Centro, CACalifornia$329.72$199.03
Fresno, CACalifornia$329.66$198.97
Hanford, CACalifornia$329.66$198.97

40831 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.

$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 Tennessee 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

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for 40831 in Tennessee
ComponentRVULocality factorAdjusted
Physician work2.51× 1.0002.5100
Practice expense6.51× 0.9095.9176
Malpractice0.34× 0.5370.1826
Total RVUs8.6102
Conversion factor× 33.4009

Office rate, Tennessee$287.59

Office: (2.51 × 1 + 6.51 × 0.909 + 0.34 × 0.537) × $33.4009 = $287.59

Facility: (2.51 × 1 + 2.94 × 0.909 + 0.34 × 0.537) × $33.4009 = $179.20

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

How 40831 has changed in Tennessee

40831 · Office / nonfacility

$287.59

Effective 2026-10-01

The base rate is $22.85 higher than on 2025-10-01, moving from $264.74 to $287.59 (8.6%).

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

    $264.74changed to$287.59

    • 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
    • Practice expense GPCI 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $269.46changed to$264.74

    • 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

    $265.06changed to$269.46

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $276.07changed to$265.06

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.07 changed to 5.99
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544
  5. January 1, 2023

    RVU23A

    $292.73changed to$276.07

    • 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
    • Practice expense GPCI 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $333.92changed to$292.73

    • 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

    $333.08changed to$333.92

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.18 changed to 7.61
    • Practice expense GPCI 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $326.99changed to$333.08

    • 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
    • Practice expense GPCI 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $321.76changed to$326.99

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

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$321.76

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$287.59$179.20RVU26D
2026-07-01$287.59$179.20RVU26C
2026-04-01$287.59$179.20RVU26B
2026-01-01$287.59$179.20RVU26A
2025-10-01$264.74$183.59RVU25D
2025-07-01$264.74$183.59RVU25C
2025-04-01$264.74$183.59RVU25B
2025-01-01$264.74$183.59RVU25A
2024-10-01$269.46$185.35RVU24D
2024-07-01$269.46$185.35RVU24C
2024-04-01$269.46$185.35RVU24B
2024-03-09$269.46$185.35RVU24AR
2024-01-01$265.06$182.32RVU24A
2023-10-01$276.07$187.91RVU23D
2023-07-01$276.07$187.91RVU23C
2023-04-01$276.07$187.91RVU23B
2023-01-01$276.07$187.91RVU23A
2022-10-01$292.73$194.88RVU22D
2022-07-01$292.73$194.88RVU22C
2022-04-01$292.73$194.88RVU22B
2022-01-01$292.73$194.88RVU22A
2021-10-01$333.92$212.22RVU21D
2021-07-01$333.92$212.22RVU21C
2021-04-01$333.92$212.22RVU21B
2021-01-01$333.92$212.22RVU21A
2020-10-01$333.08$218.48RVU20D
2020-07-01$333.08$218.48RVU20C
2020-04-01$333.08$218.48RVU20B
2020-01-01$333.08$218.48RVU20A
2019-10-01$326.99$216.59RVU19D
2019-07-01$326.99$216.59RVU19C
2019-04-01$326.99$216.59RVU19B
2019-01-01$326.99$216.59RVU19A
2018-10-01$321.76$216.35RVU18D
2018-07-01$321.76$216.35RVU18C
2018-04-01$321.76$216.35RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 40831 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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 TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

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