CPT code 40840: Mouth reconstruction, anterior vestibuloplasty2026 Medicare rate & RVUs in California
Reports surgical deepening of the anterior oral vestibule, typically to address restricted vestibular depth affecting the alveolar ridge or denture-bearing area.
Medicare pays $919.29–$1,133.87 for 40840 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 40840 covers
This procedure deepens the anterior vestibule by releasing and repositioning soft tissue, creating more space between the lip or cheek and the alveolar ridge. Oral and maxillofacial surgeons commonly perform it for a shallow or tethered anterior vestibule when reconstruction is needed, including in patients with an inadequate denture-bearing area. It is generally performed in a surgical setting, with the operative report identifying the treated site and extent of reconstruction.
Choose this code for anterior vestibuloplasty; posterior procedures, reconstruction of the entire arch, or complex work including ridge extension belong to other codes in the family. Medicare payment is restricted to specific circumstances, so documentation should establish the clinical reason for reconstruction and describe the work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and each other procedure is paid at 50%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate.
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.
Where 40840 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$919.29 to $1133.87
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $923.20 | $572.14 |
| Chico, CA | $919.29 | $568.23 |
| El Centro, CA | $919.52 | $568.45 |
| Fresno, CA | $919.29 | $568.23 |
| Hanford, CA | $919.29 | $568.23 |
| Los Angeles, CA | $979.24 | $600.31 |
| Madera, CA | $919.29 | $568.23 |
| Marin County, CA | $1,108.62 | $656.98 |
| Merced, CA | $919.29 | $568.23 |
| Modesto, CA | $919.29 | $568.23 |
| Napa, CA | $1,051.62 | $629.45 |
| Oxnard, CA | $972.97 | $594.36 |
| Redding, CA | $919.29 | $568.23 |
| Rest of California | $919.29 | $568.23 |
| Riverside, CA | $933.99 | $582.92 |
| Sacramento, CA | $961.14 | $588.61 |
| Salinas, CA | $957.49 | $586.24 |
| San Benito County, CA | $1,133.87 | $671.98 |
| San Diego, CA | $977.45 | $594.35 |
| San Francisco, CA | $1,107.08 | $655.43 |
| San Luis Obispo, CA | $942.51 | $577.68 |
| Santa Clara County, CA | $1,127.56 | $665.66 |
| Santa Cruz, CA | $984.75 | $595.57 |
| Santa Maria, CA | $960.37 | $586.89 |
| Santa Rosa, CA | $994.46 | $601.11 |
| Stockton, CA | $919.29 | $568.23 |
| Vallejo, CA | $1,049.40 | $627.22 |
| Visalia, CA | $919.29 | $568.23 |
| Yuba City, CA | $919.29 | $568.23 |
How the 40840 rate is calculated
Each of 40840’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 · 40840
RVUs × geographic indexes × conversion factor
Work8.92
8.92 RVUs× 1.000 GPCI
Practice expense16.17
16.17 RVUs× 1.000 GPCI
Malpractice1.36
1.36 RVUs× 1.000 GPCI
Adjusted RVUs
26.4500
Conversion factor
$33.4009
Medicare rate
$883.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 40840
40840 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 40840
Mouth reconstruction, anterior vestibuloplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 2 | Paid. |
| 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) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 40840
Mouth reconstruction, anterior vestibuloplasty
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
40840 without 51 · national office
$883.45
Mouth reconstruction, anterior vestibuloplasty
40840-51 · Second procedure: 50%
$441.73
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%).
40840 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 40842Mouth reconstructionExtensive reconstruction
- 40840 is for the anterior vestibule; 40842 is for a posterior unilateral procedure.
- 40843Mouth reconstructionExtensive, with skin graft
- Choose 40843 for posterior bilateral vestibuloplasty, not anterior vestibular reconstruction.
- 40844Mouth reconstructionMucosal graft included
- 40844 represents vestibuloplasty involving the entire arch; 40840 is for the anterior vestibule.
- 40845Mouth reconstructionWith bone graft
- 40845 is for complex vestibuloplasty, including ridge extension. Use 40840 for anterior vestibuloplasty that does not meet that description.
40840 billing questions
When should 40840 be selected instead of a posterior vestibuloplasty code?
Use 40840 for reconstruction of the anterior vestibule. Posterior procedures are reported with the applicable posterior code based on their site and extent.
Can modifier 50 be reported for bilateral anterior work?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting 40840?
Document the clinical need for anterior vestibular reconstruction, the specific site, and the operative steps and extent of tissue release or repositioning.
Does the global period include postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
CMS permits payment for an assistant at surgery for this code. 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 each other procedure performed in the same session is paid at 50% under the standard multiple-procedure reduction.
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
Fee sheets · Coming soon
Put 40840 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist