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CPT code 40840: Mouth reconstruction, anterior vestibuloplasty2026 Medicare rate & RVUs in Washington, DC area

Reports surgical deepening of the anterior oral vestibule, typically to address restricted vestibular depth affecting the alveolar ridge or denture-bearing area.

CMS RVU26DEffective Oct 1, 2026One payment locality165 Medicare services in 2024

In Washington, DC area, Medicare pays $1,000.81 for 40840 in the office and $623.48 when it’s performed in a hospital or facility.

$1,000.81Office (non-facility)
$623.48Hospital or facility
+13.3%vs the national office rate ($883.45)

Check a contract rate as a % of Medicare · 40840 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 40840 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 40840 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 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.

How Washington, DC area compares for 40840

Across 109 of 109 payment localities, the office rate for 40840 runs from $785.27 in Arkansas to $1,133.87 in San Benito County, CA. Washington, DC area pays $1,000.81. The RVUs are the same everywhere; the geographic indexes change the dollars.

40840 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$1,000.81
  2. Los Angeles, CA · California$979.24−$21.57
  3. Miami, FL · Florida$975.05−$25.76
  4. Chicago, IL · Illinois$947.07−$53.74
  5. Manhattan, NY · New York$1,016.64+$15.83
  6. Alaska · Alaska$1,047.13+$46.32
  7. Alabama · Alabama$796.23−$204.58

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

40840 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$785.27$510.12
ArizonaArizona$860.17$549.78
Bakersfield, CACalifornia$923.20$572.14
Chico, CACalifornia$919.29$568.23
El Centro, CACalifornia$919.52$568.45
Fresno, CACalifornia$919.29$568.23
Hanford, CACalifornia$919.29$568.23
Madera, CACalifornia$919.29$568.23

40840 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.

$785.27

$1,047.13

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

View every state and territory as a table
40840 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,047.131
AL$796.231
AR$785.271
AZ$860.171
CA$919.29–$1,133.8729
CO$911.651
CT$940.541
DC$1,000.811
DE$873.871
FL$882.54–$975.053
GA$833.85–$902.122
GU$938.321
HI$938.321
IA$810.151
ID$816.311
IL$862.04–$947.074
IN$820.681
KS$809.071
KY$819.641
LA$819.44–$857.772
MA$907.62–$995.452
MD$889.19–$1,000.813
ME$823.08–$861.832
MI$842.33–$895.712
MN$867.141
MO$807.74–$857.623
MS$796.521
MT$883.361
NC$830.871
ND$856.471
NE$813.611
NH$899.921
NJ$949.47–$991.732
NM$847.761
NV$876.411
NY$842.96–$1,043.535
OH$836.831
OK$815.531
OR$867.80–$936.542
PA$836.67–$919.732
PR$888.711
RI$902.031
SC$835.591
SD$853.291
TN$813.271
TX$831.62–$910.208
UT$846.411
VA$860.92–$1,000.812
VI$888.711
VT$855.611
WA$905.10–$1,012.642
WI$829.341
WV$832.281
WY$871.641

See 40840 in every payment locality

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

Office or facility?

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.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,872

Code
40840
Physician work
8.92
Practice expense
16.17
Malpractice
1.36

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 40840 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work8.92× 1.0549.4017
Practice expense16.17× 1.17819.0483
Malpractice1.36× 1.1131.5137
Total RVUs29.9636
Conversion factor× 33.4009

Office rate, Washington, DC area$1000.81

Office: (8.92 × 1.054 + 16.17 × 1.178 + 1.36 × 1.113) × $33.4009 = $1000.81

Facility: (8.92 × 1.054 + 6.58 × 1.178 + 1.36 × 1.113) × $33.4009 = $623.48

Open 40840 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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%).

When to use modifier 51

Codes related to 40840

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

Codes related to 40840
CodeHow it relatesOffice range, Washington, DC area
Same family
40842Mouth reconstruction, extensive reconstructionPosterior unilateral vestibuloplasty rather than anterior reconstruction.$947.37
40843Mouth reconstruction, extensive, with skin graftPosterior bilateral vestibuloplasty; the code identifies the bilateral service.$1,467.98
40844Mouth reconstruction, mucosal graft includedVestibuloplasty involving the entire arch.$1,836.21
40845Mouth reconstruction, with bone graftComplex vestibuloplasty, including ridge extension.$1,655.73

How 40840 has changed in Washington, DC area

40840 · Office / nonfacility

$1000.81

Effective 2026-10-01

The base rate is $47.07 higher than on 2025-10-01, moving from $953.74 to $1000.81 (4.9%).

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

    $953.74changed to$1000.81

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 9.15 changed to 8.92
    • Practice expense RVU 15.27 changed to 16.17
    • Malpractice RVU 1.38 changed to 1.36
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $992.19changed to$953.74

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 15.52 changed to 15.27
    • Malpractice RVU 1.40 changed to 1.38

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $975.99changed to$992.19

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1024.31changed to$975.99

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 15.53 changed to 15.52
    • Malpractice RVU 1.39 changed to 1.40
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $1050.81changed to$1024.31

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 15.33 changed to 15.53
    • Malpractice RVU 1.37 changed to 1.39
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1027.90changed to$1050.81

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 14.67 changed to 15.33
    • Malpractice RVU 1.30 changed to 1.37

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1000.21changed to$1027.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 13.53 changed to 14.67
    • Malpractice RVU 1.25 changed to 1.30
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $973.29changed to$1000.21

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 12.97 changed to 13.53
    • Malpractice RVU 1.44 changed to 1.25
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $960.07changed to$973.29

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.69 changed to 12.97

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $962.51changed to$960.07

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 12.78 changed to 12.69
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $972.10changed to$962.51

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 13.00 changed to 12.78
    • Malpractice RVU 1.46 changed to 1.44
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $974.85changed to$972.10

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 13.11 changed to 13.00
    • Malpractice RVU 1.34 changed to 1.46

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $970.00changed to$974.85

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $951.42changed to$970.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.97 changed to 13.11
    • Malpractice RVU 1.13 changed to 1.34
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $952.35changed to$951.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 14.24 changed to 12.97
    • Malpractice RVU 1.18 changed to 1.13
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $952.35

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,000.81$623.48RVU26D
2026-07-01$1,000.81$623.48RVU26C
2026-04-01$1,000.81$623.48RVU26B
2026-01-01$1,000.81$623.48RVU26A
2025-10-01$953.74$694.26RVU25D
2025-07-01$953.74$694.26RVU25C
2025-04-01$953.74$694.26RVU25B
2025-01-01$953.74$694.26RVU25A
2024-10-01$992.19$714.83RVU24D
2024-07-01$992.19$714.83RVU24C
2024-04-01$992.19$714.83RVU24B
2024-03-09$992.19$714.83RVU24AR
2024-01-01$975.99$703.17RVU24A
2023-10-01$1,024.31$733.86RVU23D
2023-07-01$1,024.31$733.86RVU23C
2023-04-01$1,024.31$733.86RVU23B
2023-01-01$1,024.31$733.86RVU23A
2022-10-01$1,050.81$747.12RVU22D
2022-07-01$1,050.81$747.12RVU22C
2022-04-01$1,050.81$747.12RVU22B
2022-01-01$1,050.81$747.12RVU22A
2021-10-01$1,027.90$734.63RVU21D
2021-07-01$1,027.90$734.63RVU21C
2021-04-01$1,027.90$734.63RVU21B
2021-01-01$1,027.90$734.63RVU21A
2020-10-01$1,000.21$739.79RVU20D
2020-07-01$1,000.21$739.79RVU20C
2020-04-01$1,000.21$739.79RVU20B
2020-01-01$1,000.21$739.79RVU20A
2019-10-01$973.29$735.74RVU19D
2019-07-01$973.29$735.74RVU19C
2019-04-01$973.29$735.74RVU19B
2019-01-01$973.29$735.74RVU19A
2018-10-01$960.07$733.20RVU18D
2018-07-01$960.07$733.20RVU18C
2018-04-01$960.07$733.20RVU18B
2018-01-01$960.07$733.20RVU18AR1
2017-10-01$962.51$738.93RVU17D
2017-07-01$962.51$738.93RVU17C
2017-04-01$962.51$738.93RVU17B
2017-01-01$962.51$738.93RVU17A
2016-10-01$972.10$746.03RVU16D
2016-07-01$972.10$746.03RVU16C
2016-04-01$972.10$746.03RVU16B
2016-01-01$972.10$746.03RVU16A
2015-10-01$974.85$745.80RVU15D
2015-07-01$974.85$745.80RVU15C
2015-04-01$970.00$742.09RVU15B
2015-01-01$970.00$742.09RVU15A
2014-10-01$951.42$728.38RVU14D
2014-07-01$951.42$728.38RVU14C
2014-04-01$951.42$728.38RVU14B
2014-01-01$951.42$728.38RVU14A
2013-10-01$952.35$718.79RVU13D
2013-07-01$952.35$718.79RVU13C
2013-04-01$952.35$718.79RVU13B
2013-01-01$952.35$718.79RVU13AR

Price 40840 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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
RVUs for 40840PPRRVU2026_Oct_nonQPP.csv, line 4,872 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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