CPT code 40843: Mouth reconstruction, extensive, with skin graft2026 Medicare rate & RVUs in Alabama
Reported for extensive mouth reconstruction using a skin graft to repair a substantial defect, with selection based on the reconstruction and graft documented.
In Alabama, Medicare pays $1,160.62 for 40843 in the office and $709.37 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 40843 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 40843 covers
This service reconstructs an extensive area of the mouth using a skin graft, including obtaining the graft. Oral and maxillofacial surgeons, plastic surgeons, or otolaryngologists may perform it to repair a substantial oral defect, such as one resulting from tumor removal or significant trauma. The operative report should describe the extent of reconstruction, the defect repaired, and the graft used.
Report this code when the documented service is extensive reconstruction with a skin graft; distinguish it from reconstruction with a free mucosal graft or split-thickness skin graft. Medicare coverage is restricted to specific circumstances. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% reduction. The code is priced as bilateral, so modifier 50 does not increase payment. An assistant at surgery may be paid; 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 Alabama compares for 40843
Across 109 of 109 payment localities, the office rate for 40843 runs from $1,143.86 in Arkansas to $1,657.87 in San Benito County, CA. Alabama pays $1,160.62. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Alabama · this page$1,160.62
- Los Angeles, CA · California$1,431.78+$271.16
- Washington, DC area · District of Columbia$1,467.98+$307.36
- Miami, FL · Florida$1,445.58+$284.96
- Chicago, IL · Illinois$1,401.55+$240.93
- Manhattan, NY · New York$1,496.00+$335.38
- Alaska · Alaska$1,519.76+$359.14
Other areas in Alabama first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $1,143.86 | $700.87 |
| ArizonaArizona | $1,258.32 | $758.59 |
| Bakersfield, CACalifornia | $1,348.73 | $783.51 |
| Chico, CACalifornia | $1,342.24 | $777.02 |
| El Centro, CACalifornia | $1,342.62 | $777.41 |
| Fresno, CACalifornia | $1,342.24 | $777.02 |
| Hanford, CACalifornia | $1,342.24 | $777.02 |
| Madera, CACalifornia | $1,342.24 | $777.02 |
| Merced, CACalifornia | $1,342.24 | $777.02 |
| Modesto, CACalifornia | $1,342.24 | $777.02 |
| Napa, CACalifornia | $1,536.89 | $857.18 |
| Oxnard, CACalifornia | $1,422.39 | $812.82 |
| Redding, CACalifornia | $1,342.24 | $777.02 |
| Rest of CaliforniaCalifornia | $1,342.24 | $777.02 |
| Riverside, CACalifornia | $1,367.22 | $802.00 |
| Sacramento, CACalifornia | $1,403.77 | $804.00 |
| Salinas, CACalifornia | $1,398.49 | $800.78 |
| San Diego, CACalifornia | $1,428.15 | $811.36 |
| Marin County, CACalifornia | $1,620.05 | $892.90 |
| San Francisco, CACalifornia | $1,617.41 | $890.26 |
| San Benito County, CACalifornia | $1,657.87 | $914.22 |
| Santa Clara County, CACalifornia | $1,647.10 | $903.45 |
| San Luis Obispo, CACalifornia | $1,376.65 | $789.26 |
| Santa Cruz, CACalifornia | $1,439.14 | $812.55 |
| Santa Maria, CACalifornia | $1,402.84 | $801.52 |
| Santa Rosa, CACalifornia | $1,453.29 | $820.00 |
| Stockton, CACalifornia | $1,342.24 | $777.02 |
| Vallejo, CACalifornia | $1,533.09 | $853.39 |
| Visalia, CACalifornia | $1,342.24 | $777.02 |
| Yuba City, CACalifornia | $1,342.24 | $777.02 |
| ColoradoColorado | $1,333.53 | $784.82 |
| ConnecticutConnecticut | $1,380.51 | $825.09 |
| DelawareDelaware | $1,278.94 | $769.42 |
| Fort Lauderdale, FLFlorida | $1,367.30 | $844.89 |
| Rest of FloridaFlorida | $1,298.05 | $805.03 |
| Atlanta, GAGeorgia | $1,323.91 | $799.95 |
| Rest of GeorgiaGeorgia | $1,222.73 | $762.72 |
| Hawaii, Guam, HIHawaii | $1,371.30 | $784.94 |
| IowaIowa | $1,179.53 | $707.66 |
| IdahoIdaho | $1,189.42 | $714.97 |
| East St. Louis, ILIllinois | $1,308.84 | $834.38 |
| Rest of IllinoisIllinois | $1,268.29 | $797.44 |
| Suburban Chicago, ILIllinois | $1,378.63 | $849.00 |
| IndianaIndiana | $1,196.03 | $717.97 |
| KansasKansas | $1,179.02 | $712.82 |
| KentuckyKentucky | $1,198.87 | $740.40 |
| New Orleans, LALouisiana | $1,257.61 | $772.32 |
| Rest of LouisianaLouisiana | $1,199.00 | $742.59 |
| Metropolitan Boston, MAMassachusetts | $1,458.09 | $842.34 |
| Rest of MassachusettsMassachusetts | $1,327.63 | $784.59 |
| Baltimore area, MDMaryland | $1,377.74 | $824.38 |
| Rest of MarylandMaryland | $1,301.70 | $779.80 |
| Rest of MaineMaine | $1,200.97 | $726.52 |
| Southern Maine, MEMaine | $1,258.49 | $747.42 |
| Detroit, MIMichigan | $1,319.43 | $821.77 |
| Rest of MichiganMichigan | $1,234.66 | $763.81 |
| MinnesotaMinnesota | $1,262.94 | $732.27 |
| Metropolitan Kansas City, MOMissouri | $1,243.69 | $759.43 |
| Metropolitan St. Louis, MOMissouri | $1,256.03 | $765.07 |
| Rest of MissouriMissouri | $1,181.83 | $737.29 |
| MississippiMississippi | $1,162.82 | $718.79 |
| MontanaMontana | $1,294.13 | $778.42 |
| North CarolinaNorth Carolina | $1,212.69 | $731.53 |
| North DakotaNorth Dakota | $1,248.26 | $732.55 |
| NebraskaNebraska | $1,184.46 | $708.46 |
| New HampshireNew Hampshire | $1,317.41 | $780.56 |
| Northern New JerseyNew Jersey | $1,453.84 | $855.62 |
| Rest of New JerseyNew Jersey | $1,392.09 | $828.93 |
| New MexicoNew Mexico | $1,243.44 | $770.53 |
| NevadaNevada | $1,282.14 | $765.92 |
| NYC suburbs and Long Island, NYNew York | $1,538.60 | $925.43 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,405.33 | $840.63 |
| Queens, NYNew York | $1,500.84 | $891.27 |
| Rest of New YorkNew York | $1,231.26 | $741.33 |
| OhioOhio | $1,225.28 | $754.44 |
| OklahomaOklahoma | $1,191.37 | $730.85 |
| Portland, OROregon | $1,369.94 | $796.99 |
| Rest of OregonOregon | $1,268.07 | $754.42 |
| Metropolitan Philadelphia, PAPennsylvania | $1,349.55 | $812.70 |
| Rest of PennsylvaniaPennsylvania | $1,224.40 | $750.98 |
| Puerto RicoPuerto Rico | $1,301.93 | $780.54 |
| Rhode IslandRhode Island | $1,320.24 | $787.51 |
| South CarolinaSouth Carolina | $1,221.84 | $745.32 |
| South DakotaSouth Dakota | $1,242.83 | $727.12 |
| TennesseeTennessee | $1,185.58 | $716.80 |
| Austin, TXTexas | $1,332.70 | $787.08 |
| Beaumont, TXTexas | $1,216.76 | $747.46 |
| Brazoria, TXTexas | $1,273.37 | $762.30 |
| Dallas, TXTexas | $1,283.83 | $770.18 |
| Fort Worth, TXTexas | $1,276.83 | $768.34 |
| Galveston, TXTexas | $1,278.69 | $766.59 |
| Houston, TXTexas | $1,321.15 | $809.05 |
| Rest of TexasTexas | $1,245.95 | $756.55 |
| UtahUtah | $1,238.36 | $753.60 |
| VirginiaVirginia | $1,257.90 | $750.96 |
| Virgin Islands, VIUnited States Virgin Islands | $1,301.93 | $780.54 |
| VermontVermont | $1,248.00 | $737.45 |
| Rest of WashingtonWashington | $1,323.59 | $780.55 |
| King County, WAWashington | $1,482.59 | $849.82 |
| WisconsinWisconsin | $1,207.05 | $713.00 |
| West VirginiaWest Virginia | $1,222.85 | $774.69 |
| WyomingWyoming | $1,274.14 | $758.43 |
40843 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.
$1,143.86
$1,519.76
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 | $1,519.76 | 1 |
| AL | $1,160.62 | 1 |
| AR | $1,143.86 | 1 |
| AZ | $1,258.32 | 1 |
| CA | $1,342.24–$1,657.87 | 29 |
| CO | $1,333.53 | 1 |
| CT | $1,380.51 | 1 |
| DC | $1,467.98 | 1 |
| DE | $1,278.94 | 1 |
| FL | $1,298.05–$1,445.58 | 3 |
| GA | $1,222.73–$1,323.91 | 2 |
| GU | $1,371.30 | 1 |
| HI | $1,371.30 | 1 |
| IA | $1,179.53 | 1 |
| ID | $1,189.42 | 1 |
| IL | $1,268.29–$1,401.55 | 4 |
| IN | $1,196.03 | 1 |
| KS | $1,179.02 | 1 |
| KY | $1,198.87 | 1 |
| LA | $1,199.00–$1,257.61 | 2 |
| MA | $1,327.63–$1,458.09 | 2 |
| MD | $1,301.70–$1,467.98 | 3 |
| ME | $1,200.97–$1,258.49 | 2 |
| MI | $1,234.66–$1,319.43 | 2 |
| MN | $1,262.94 | 1 |
| MO | $1,181.83–$1,256.03 | 3 |
| MS | $1,162.82 | 1 |
| MT | $1,294.13 | 1 |
| NC | $1,212.69 | 1 |
| ND | $1,248.26 | 1 |
| NE | $1,184.46 | 1 |
| NH | $1,317.41 | 1 |
| NJ | $1,392.09–$1,453.84 | 2 |
| NM | $1,243.44 | 1 |
| NV | $1,282.14 | 1 |
| NY | $1,231.26–$1,538.60 | 5 |
| OH | $1,225.28 | 1 |
| OK | $1,191.37 | 1 |
| OR | $1,268.07–$1,369.94 | 2 |
| PA | $1,224.40–$1,349.55 | 2 |
| PR | $1,301.93 | 1 |
| RI | $1,320.24 | 1 |
| SC | $1,221.84 | 1 |
| SD | $1,242.83 | 1 |
| TN | $1,185.58 | 1 |
| TX | $1,216.76–$1,332.70 | 8 |
| UT | $1,238.36 | 1 |
| VA | $1,257.90–$1,467.98 | 2 |
| VI | $1,301.93 | 1 |
| VT | $1,248.00 | 1 |
| WA | $1,323.59–$1,482.59 | 2 |
| WI | $1,207.05 | 1 |
| WV | $1,222.85 | 1 |
| WY | $1,274.14 | 1 |
How the 40843 rate is calculated
Each of 40843’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 · 40843
RVUs × geographic indexes × conversion factor
Work12.47
12.47 RVUs× 1.000 GPCI
Practice expense23.96
23.96 RVUs× 1.000 GPCI
Malpractice2.32
2.32 RVUs× 1.000 GPCI
Adjusted RVUs
38.7500
Conversion factor
$33.4009
Medicare rate
$1,294.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Alabama inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,874
- Code
- 40843
- Physician work
- 12.47
- Practice expense
- 23.96
- Malpractice
- 2.32
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.47 | × 1.000 | 12.4700 |
| Practice expense | 23.96 | × 0.875 | 20.9650 |
| Malpractice | 2.32 | × 0.566 | 1.3131 |
| Total RVUs | 34.7481 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Alabama$1160.62
Office: (12.47 × 1 + 23.96 × 0.875 + 2.32 × 0.566) × $33.4009 = $1160.62
Facility: (12.47 × 1 + 8.52 × 0.875 + 2.32 × 0.566) × $33.4009 = $709.37
Payment rules and modifiers for 40843
40843 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 40843
Mouth reconstruction, extensive, with skin graft
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| 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 · 40843
Mouth reconstruction, extensive, with skin graft
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
40843 without 51 · national office
$1,294.28
Mouth reconstruction, extensive, with skin graft
40843-51 · Second procedure: 50%
$647.14
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 40843 has changed in Alabama
40843 · Office / nonfacility
$1160.62
Effective 2026-10-01
The base rate is $111.31 higher than on 2025-10-01, moving from $1049.31 to $1160.62 (10.6%).
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
$1049.31changed to$1160.62
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 12.79 changed to 12.47
- Practice expense RVU 21.07 changed to 23.96
- Malpractice RVU 2.33 changed to 2.32
- Practice expense GPCI 0.869 changed to 0.875
- Malpractice GPCI 0.575 changed to 0.566
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1077.22changed to$1049.31
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 20.96 changed to 21.07
- Malpractice RVU 2.36 changed to 2.33
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1059.64changed to$1077.22
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1116.53changed to$1059.64
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 21.00 changed to 20.96
- Malpractice RVU 2.30 changed to 2.36
- Practice expense GPCI 0.878 changed to 0.869
- Malpractice GPCI 0.748 changed to 0.575
January 1, 2023
RVU23A
$1151.76changed to$1116.53
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 20.66 changed to 21.00
- Malpractice RVU 2.33 changed to 2.30
- Practice expense GPCI 0.888 changed to 0.878
- Malpractice GPCI 0.921 changed to 0.748
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1153.80changed to$1151.76
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 20.49 changed to 20.66
- Malpractice RVU 2.26 changed to 2.33
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$1132.76changed to$1153.80
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 19.13 changed to 20.49
- Malpractice RVU 2.25 changed to 2.26
- Practice expense GPCI 0.889 changed to 0.888
- Malpractice GPCI 0.707 changed to 0.921
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$985.38changed to$1132.76
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 15.14 changed to 19.13
- Malpractice RVU 2.19 changed to 2.25
- Practice expense GPCI 0.890 changed to 0.889
- Malpractice GPCI 0.492 changed to 0.707
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$1006.77changed to$985.38
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 15.88 changed to 15.14
- Malpractice RVU 2.12 changed to 2.19
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$1006.77
Held through RVU18C, RVU18D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $1,160.62 | $709.37 | RVU26D |
| 2026-07-01 | $1,160.62 | $709.37 | RVU26C |
| 2026-04-01 | $1,160.62 | $709.37 | RVU26B |
| 2026-01-01 | $1,160.62 | $709.37 | RVU26A |
| 2025-10-01 | $1,049.31 | $774.12 | RVU25D |
| 2025-07-01 | $1,049.31 | $774.12 | RVU25C |
| 2025-04-01 | $1,049.31 | $774.12 | RVU25B |
| 2025-01-01 | $1,049.31 | $774.12 | RVU25A |
| 2024-10-01 | $1,077.22 | $789.40 | RVU24D |
| 2024-07-01 | $1,077.22 | $789.40 | RVU24C |
| 2024-04-01 | $1,077.22 | $789.40 | RVU24B |
| 2024-03-09 | $1,077.22 | $789.40 | RVU24AR |
| 2024-01-01 | $1,059.64 | $776.52 | RVU24A |
| 2023-10-01 | $1,116.53 | $818.11 | RVU23D |
| 2023-07-01 | $1,116.53 | $818.11 | RVU23C |
| 2023-04-01 | $1,116.53 | $818.11 | RVU23B |
| 2023-01-01 | $1,116.53 | $818.11 | RVU23A |
| 2022-10-01 | $1,151.76 | $844.15 | RVU22D |
| 2022-07-01 | $1,151.76 | $844.15 | RVU22C |
| 2022-04-01 | $1,151.76 | $844.15 | RVU22B |
| 2022-01-01 | $1,151.76 | $844.15 | RVU22A |
| 2021-10-01 | $1,153.80 | $847.04 | RVU21D |
| 2021-07-01 | $1,153.80 | $847.04 | RVU21C |
| 2021-04-01 | $1,153.80 | $847.04 | RVU21B |
| 2021-01-01 | $1,153.80 | $847.04 | RVU21A |
| 2020-10-01 | $1,132.76 | $851.38 | RVU20D |
| 2020-07-01 | $1,132.76 | $851.38 | RVU20C |
| 2020-04-01 | $1,132.76 | $851.38 | RVU20B |
| 2020-01-01 | $1,132.76 | $851.38 | RVU20A |
| 2019-10-01 | $985.38 | $777.22 | RVU19D |
| 2019-07-01 | $985.38 | $777.22 | RVU19C |
| 2019-04-01 | $985.38 | $777.22 | RVU19B |
| 2019-01-01 | $985.38 | $777.22 | RVU19A |
| 2018-10-01 | $1,006.77 | $797.55 | RVU18D |
| 2018-07-01 | $1,006.77 | $797.55 | RVU18C |
| 2018-04-01 | $1,006.77 | $797.55 | RVU18B |
| 2018-01-01 | Rate data unavailable | Rate data unavailable | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Rate data unavailable | RVU17D |
| 2017-07-01 | Rate data unavailable | Rate data unavailable | RVU17C |
| 2017-04-01 | Rate data unavailable | Rate data unavailable | RVU17B |
| 2017-01-01 | Rate data unavailable | Rate data unavailable | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Alabama rate applies
Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.
- Abanda
- Abbeville
- Adamsville
- Addison
- Akron
- Alabaster
- Albertville
- Alexander City
40843 billing questions
How is this code distinguished from 40842?
40843 is for extensive mouth reconstruction with a skin graft. 40842 describes extensive reconstruction without specifying a graft type.
When should 40844 or 40845 be considered instead?
40844 is for extensive reconstruction with a free mucosal graft, and 40845 is for extensive reconstruction with a split-thickness skin graft. Select based on the graft used and documented.
Can graft harvesting be reported separately?
No. The service includes obtaining the skin graft, so do not separately report graft acquisition.
Can modifier 50 increase payment?
No. CMS prices this code as bilateral, and modifier 50 does not increase payment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or another surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code under the CMS rules provided.
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
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