CPT code 40840: Mouth reconstruction, anterior vestibuloplasty2026 Medicare rate & RVUs in North Carolina
Reports surgical deepening of the anterior oral vestibule, typically to address restricted vestibular depth affecting the alveolar ridge or denture-bearing area.
In North Carolina, Medicare pays $830.87 for 40840 in the office and $532.02 when it’s performed in a hospital or facility.
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.
On this page 11 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.
How North Carolina 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. North Carolina pays $830.87. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$830.87
- Los Angeles, CA · California$979.24+$148.37
- Washington, DC area · District of Columbia$1,000.81+$169.94
- Miami, FL · Florida$975.05+$144.18
- Chicago, IL · Illinois$947.07+$116.20
- Manhattan, NY · New York$1,016.64+$185.77
- Alaska · Alaska$1,047.13+$216.26
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $796.23 | $515.95 |
| 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 |
| Merced, CACalifornia | $919.29 | $568.23 |
| Modesto, CACalifornia | $919.29 | $568.23 |
| Napa, CACalifornia | $1,051.62 | $629.45 |
| Oxnard, CACalifornia | $972.97 | $594.36 |
| Redding, CACalifornia | $919.29 | $568.23 |
| Rest of CaliforniaCalifornia | $919.29 | $568.23 |
| Riverside, CACalifornia | $933.99 | $582.92 |
| Sacramento, CACalifornia | $961.14 | $588.61 |
| Salinas, CACalifornia | $957.49 | $586.24 |
| San Diego, CACalifornia | $977.45 | $594.35 |
| Marin County, CACalifornia | $1,108.62 | $656.98 |
| San Francisco, CACalifornia | $1,107.08 | $655.43 |
| San Benito County, CACalifornia | $1,133.87 | $671.98 |
| Santa Clara County, CACalifornia | $1,127.56 | $665.66 |
| San Luis Obispo, CACalifornia | $942.51 | $577.68 |
| Santa Cruz, CACalifornia | $984.75 | $595.57 |
| Santa Maria, CACalifornia | $960.37 | $586.89 |
| Santa Rosa, CACalifornia | $994.46 | $601.11 |
| Stockton, CACalifornia | $919.29 | $568.23 |
| Vallejo, CACalifornia | $1,049.40 | $627.22 |
| Visalia, CACalifornia | $919.29 | $568.23 |
| Yuba City, CACalifornia | $919.29 | $568.23 |
| ColoradoColorado | $911.65 | $570.83 |
| ConnecticutConnecticut | $940.54 | $595.56 |
| DelawareDelaware | $873.87 | $557.40 |
| Fort Lauderdale, FLFlorida | $927.18 | $602.70 |
| Rest of FloridaFlorida | $882.54 | $576.32 |
| Atlanta, GAGeorgia | $902.12 | $576.68 |
| Rest of GeorgiaGeorgia | $833.85 | $548.12 |
| Hawaii, Guam, HIHawaii | $938.32 | $574.12 |
| IowaIowa | $810.15 | $517.07 |
| IdahoIdaho | $816.31 | $521.62 |
| East St. Louis, ILIllinois | $886.31 | $591.62 |
| Rest of IllinoisIllinois | $862.04 | $569.59 |
| Suburban Chicago, ILIllinois | $935.19 | $606.23 |
| IndianaIndiana | $820.68 | $523.75 |
| KansasKansas | $809.07 | $519.51 |
| KentuckyKentucky | $819.64 | $534.88 |
| New Orleans, LALouisiana | $857.77 | $556.35 |
| Rest of LouisianaLouisiana | $819.44 | $535.96 |
| Metropolitan Boston, MAMassachusetts | $995.45 | $612.99 |
| Rest of MassachusettsMassachusetts | $907.62 | $570.33 |
| Baltimore area, MDMaryland | $938.41 | $594.72 |
| Rest of MarylandMaryland | $889.19 | $565.03 |
| Rest of MaineMaine | $823.08 | $528.39 |
| Southern Maine, MEMaine | $861.83 | $544.40 |
| Detroit, MIMichigan | $895.71 | $586.61 |
| Rest of MichiganMichigan | $842.33 | $549.88 |
| MinnesotaMinnesota | $867.14 | $537.53 |
| Metropolitan Kansas City, MOMissouri | $849.46 | $548.69 |
| Metropolitan St. Louis, MOMissouri | $857.62 | $552.68 |
| Rest of MissouriMissouri | $807.74 | $531.63 |
| MississippiMississippi | $796.52 | $520.73 |
| MontanaMontana | $883.36 | $563.05 |
| North DakotaNorth Dakota | $856.47 | $536.16 |
| NebraskaNebraska | $813.61 | $517.96 |
| New HampshireNew Hampshire | $899.92 | $566.47 |
| Northern New JerseyNew Jersey | $991.73 | $620.16 |
| Rest of New JerseyNew Jersey | $949.47 | $599.68 |
| New MexicoNew Mexico | $847.76 | $554.03 |
| NevadaNevada | $876.41 | $555.77 |
| NYC suburbs and Long Island, NYNew York | $1,043.53 | $662.67 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $957.71 | $606.96 |
| Queens, NYNew York | $1,020.90 | $642.28 |
| Rest of New YorkNew York | $842.96 | $538.66 |
| OhioOhio | $836.83 | $544.38 |
| OklahomaOklahoma | $815.53 | $529.49 |
| Portland, OROregon | $936.54 | $580.67 |
| Rest of OregonOregon | $867.80 | $548.77 |
| Metropolitan Philadelphia, PAPennsylvania | $919.73 | $586.28 |
| Rest of PennsylvaniaPennsylvania | $836.67 | $542.62 |
| Puerto RicoPuerto Rico | $888.71 | $564.88 |
| Rhode IslandRhode Island | $902.03 | $571.15 |
| South CarolinaSouth Carolina | $835.59 | $539.62 |
| South DakotaSouth Dakota | $853.29 | $532.98 |
| TennesseeTennessee | $813.27 | $522.11 |
| Austin, TXTexas | $910.20 | $571.30 |
| Beaumont, TXTexas | $831.62 | $540.13 |
| Brazoria, TXTexas | $870.98 | $553.55 |
| Dallas, TXTexas | $877.52 | $558.49 |
| Fort Worth, TXTexas | $872.71 | $556.88 |
| Galveston, TXTexas | $874.24 | $556.17 |
| Houston, TXTexas | $899.14 | $581.06 |
| Rest of TexasTexas | $851.50 | $547.52 |
| UtahUtah | $846.41 | $545.32 |
| VirginiaVirginia | $860.92 | $546.05 |
| Virgin Islands, VIUnited States Virgin Islands | $888.71 | $564.88 |
| VermontVermont | $855.61 | $538.50 |
| Rest of WashingtonWashington | $905.10 | $567.80 |
| King County, WAWashington | $1,012.64 | $619.61 |
| WisconsinWisconsin | $829.34 | $522.47 |
| West VirginiaWest Virginia | $832.28 | $553.93 |
| WyomingWyoming | $871.64 | $551.33 |
40840 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.
$785.27
$1,047.13
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,047.13 | 1 |
| AL | $796.23 | 1 |
| AR | $785.27 | 1 |
| AZ | $860.17 | 1 |
| CA | $919.29–$1,133.87 | 29 |
| CO | $911.65 | 1 |
| CT | $940.54 | 1 |
| DC | $1,000.81 | 1 |
| DE | $873.87 | 1 |
| FL | $882.54–$975.05 | 3 |
| GA | $833.85–$902.12 | 2 |
| GU | $938.32 | 1 |
| HI | $938.32 | 1 |
| IA | $810.15 | 1 |
| ID | $816.31 | 1 |
| IL | $862.04–$947.07 | 4 |
| IN | $820.68 | 1 |
| KS | $809.07 | 1 |
| KY | $819.64 | 1 |
| LA | $819.44–$857.77 | 2 |
| MA | $907.62–$995.45 | 2 |
| MD | $889.19–$1,000.81 | 3 |
| ME | $823.08–$861.83 | 2 |
| MI | $842.33–$895.71 | 2 |
| MN | $867.14 | 1 |
| MO | $807.74–$857.62 | 3 |
| MS | $796.52 | 1 |
| MT | $883.36 | 1 |
| NC | $830.87 | 1 |
| ND | $856.47 | 1 |
| NE | $813.61 | 1 |
| NH | $899.92 | 1 |
| NJ | $949.47–$991.73 | 2 |
| NM | $847.76 | 1 |
| NV | $876.41 | 1 |
| NY | $842.96–$1,043.53 | 5 |
| OH | $836.83 | 1 |
| OK | $815.53 | 1 |
| OR | $867.80–$936.54 | 2 |
| PA | $836.67–$919.73 | 2 |
| PR | $888.71 | 1 |
| RI | $902.03 | 1 |
| SC | $835.59 | 1 |
| SD | $853.29 | 1 |
| TN | $813.27 | 1 |
| TX | $831.62–$910.20 | 8 |
| UT | $846.41 | 1 |
| VA | $860.92–$1,000.81 | 2 |
| VI | $888.71 | 1 |
| VT | $855.61 | 1 |
| WA | $905.10–$1,012.64 | 2 |
| WI | $829.34 | 1 |
| WV | $832.28 | 1 |
| WY | $871.64 | 1 |
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.
The exact North Carolina 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
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.92 | × 1.000 | 8.9200 |
| Practice expense | 16.17 | × 0.933 | 15.0866 |
| Malpractice | 1.36 | × 0.639 | 0.8690 |
| Total RVUs | 24.8757 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$830.87
Office: (8.92 × 1 + 16.17 × 0.933 + 1.36 × 0.639) × $33.4009 = $830.87
Facility: (8.92 × 1 + 6.58 × 0.933 + 1.36 × 0.639) × $33.4009 = $532.02
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%).
How 40840 has changed in North Carolina
40840 · Office / nonfacility
$830.87
Effective 2026-10-01
The base rate is $47.83 higher than on 2025-10-01, moving from $783.04 to $830.87 (6.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$783.04changed to$830.87
- 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
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$813.96changed to$783.04
- 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.
March 9, 2024
RVU24AR
$800.68changed to$813.96
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$832.87changed to$800.68
- 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
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$847.79changed to$832.87
- 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
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$831.45changed to$847.79
- 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.
January 1, 2021
RVU21A
$818.48changed to$831.45
- 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
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$801.00changed to$818.48
- 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
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$790.74changed to$801.00
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 12.69 changed to 12.97
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$793.22changed to$790.74
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 12.78 changed to 12.69
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$800.63changed to$793.22
- 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
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$803.88changed to$800.63
- 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.
July 1, 2015
RVU15C
$799.88changed to$803.88
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$789.04changed to$799.88
- 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
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$788.33changed to$789.04
- 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
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $788.33
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $830.87 | $532.02 | RVU26D |
| 2026-07-01 | $830.87 | $532.02 | RVU26C |
| 2026-04-01 | $830.87 | $532.02 | RVU26B |
| 2026-01-01 | $830.87 | $532.02 | RVU26A |
| 2025-10-01 | $783.04 | $581.45 | RVU25D |
| 2025-07-01 | $783.04 | $581.45 | RVU25C |
| 2025-04-01 | $783.04 | $581.45 | RVU25B |
| 2025-01-01 | $783.04 | $581.45 | RVU25A |
| 2024-10-01 | $813.96 | $598.50 | RVU24D |
| 2024-07-01 | $813.96 | $598.50 | RVU24C |
| 2024-04-01 | $813.96 | $598.50 | RVU24B |
| 2024-03-09 | $813.96 | $598.50 | RVU24AR |
| 2024-01-01 | $800.68 | $588.73 | RVU24A |
| 2023-10-01 | $832.87 | $611.09 | RVU23D |
| 2023-07-01 | $832.87 | $611.09 | RVU23C |
| 2023-04-01 | $832.87 | $611.09 | RVU23B |
| 2023-01-01 | $832.87 | $611.09 | RVU23A |
| 2022-10-01 | $847.79 | $619.78 | RVU22D |
| 2022-07-01 | $847.79 | $619.78 | RVU22C |
| 2022-04-01 | $847.79 | $619.78 | RVU22B |
| 2022-01-01 | $847.79 | $619.78 | RVU22A |
| 2021-10-01 | $831.45 | $611.26 | RVU21D |
| 2021-07-01 | $831.45 | $611.26 | RVU21C |
| 2021-04-01 | $831.45 | $611.26 | RVU21B |
| 2021-01-01 | $831.45 | $611.26 | RVU21A |
| 2020-10-01 | $818.48 | $620.12 | RVU20D |
| 2020-07-01 | $818.48 | $620.12 | RVU20C |
| 2020-04-01 | $818.48 | $620.12 | RVU20B |
| 2020-01-01 | $818.48 | $620.12 | RVU20A |
| 2019-10-01 | $801.00 | $617.47 | RVU19D |
| 2019-07-01 | $801.00 | $617.47 | RVU19C |
| 2019-04-01 | $801.00 | $617.47 | RVU19B |
| 2019-01-01 | $801.00 | $617.47 | RVU19A |
| 2018-10-01 | $790.74 | $615.45 | RVU18D |
| 2018-07-01 | $790.74 | $615.45 | RVU18C |
| 2018-04-01 | $790.74 | $615.45 | RVU18B |
| 2018-01-01 | $790.74 | $615.45 | RVU18AR1 |
| 2017-10-01 | $793.22 | $620.48 | RVU17D |
| 2017-07-01 | $793.22 | $620.48 | RVU17C |
| 2017-04-01 | $793.22 | $620.48 | RVU17B |
| 2017-01-01 | $793.22 | $620.48 | RVU17A |
| 2016-10-01 | $800.63 | $626.15 | RVU16D |
| 2016-07-01 | $800.63 | $626.15 | RVU16C |
| 2016-04-01 | $800.63 | $626.15 | RVU16B |
| 2016-01-01 | $800.63 | $626.15 | RVU16A |
| 2015-10-01 | $803.88 | $627.10 | RVU15D |
| 2015-07-01 | $803.88 | $627.10 | RVU15C |
| 2015-04-01 | $799.88 | $623.98 | RVU15B |
| 2015-01-01 | $799.88 | $623.98 | RVU15A |
| 2014-10-01 | $789.04 | $616.66 | RVU14D |
| 2014-07-01 | $789.04 | $616.66 | RVU14C |
| 2014-04-01 | $789.04 | $616.66 | RVU14B |
| 2014-01-01 | $789.04 | $616.66 | RVU14A |
| 2013-10-01 | $788.33 | $607.61 | RVU13D |
| 2013-07-01 | $788.33 | $607.61 | RVU13C |
| 2013-04-01 | $788.33 | $607.61 | RVU13B |
| 2013-01-01 | $788.33 | $607.61 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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