CPT code 40843: Mouth reconstruction, extensive, with skin graft2026 Medicare rate & RVUs in Washington, DC area

Reported for extensive mouth reconstruction using a skin graft to repair a substantial defect, with selection based on the reconstruction and graft documented.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Washington, DC area, Medicare pays $1,467.98 for 40843 in the office and $860.48 when it’s performed in a hospital or facility.

$1,467.98Office (non-facility)

$860.48Hospital or facility

+13.4%vs the national office rate ($1,294.28)

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

Rate in Washington, DC area
What 40843 covers
Compared with other areas
Rate map
How it’s calculated
Payment rules
Related codes
Rate history
Where it applies
Billing questions
Sources

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 Washington, DC area 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. Washington, DC area pays $1,467.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

40843 in Washington, DC area vs other payment areas

Washington, DC area · this page$1,467.98
Los Angeles, CA · California$1,431.78−$36.20
Miami, FL · Florida$1,445.58−$22.40
Chicago, IL · Illinois$1,401.55−$66.43
Manhattan, NY · New York$1,496.00+$28.02
Alaska · Alaska$1,519.76+$51.78
Alabama · Alabama$1,160.62−$307.36

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

Every other payment area

40843 in every other Medicare payment locality
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.

ME WI VT NH MT ND MN MI NY MA RI WA ID WY SD IA IL IN OH PA NJ CT OR NV UT CO NE MO KY WV VA MD DE CA AZ NM KS OK AR TN NC SC DC TX LA MS AL GA FL AK HI

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

40843 office rate range by state
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

See 40843 in every payment locality

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

Office or facility?

Your ZIP

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 Washington, DC area 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

Locality: Washington, DC area
Physician work: 1.054
Practice expense: 1.178
Malpractice: 1.113

Office calculation for 40843 in Washington, DC area
Component	RVU	Locality factor	Adjusted
Physician work	12.47	× 1.054	13.1434
Practice expense	23.96	× 1.178	28.2249
Malpractice	2.32	× 1.113	2.5822
Total RVUs			43.9504
Conversion factor			× 33.4009

Office rate, Washington, DC area$1467.98

Office: (12.47 × 1.054 + 23.96 × 1.178 + 2.32 × 1.113) × $33.4009 = $1467.98

Facility: (12.47 × 1.054 + 8.52 × 1.178 + 2.32 × 1.113) × $33.4009 = $860.48

Open 40843 in the RVU calculator

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

Date of surgery

Date of a later visit

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

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%).

When to use modifier 51

Codes related to 40843

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

Codes related to 40843
Code	How it relates	Office range, Washington, DC area
Same family
40840	Mouth reconstruction, anterior vestibuloplastyLimited mouth reconstruction, unlike this code's extensive graft-based service.	$1,000.81
40842	Mouth reconstruction, extensive reconstructionExtensive mouth reconstruction without a specified graft type.	$947.37
40844	Mouth reconstruction, mucosal graft includedExtensive mouth reconstruction with a free mucosal graft.	$1,836.21
40845	Mouth reconstruction, with bone graftExtensive mouth reconstruction with a split-thickness skin graft.	$1,655.73

How 40843 has changed in Washington, DC area

40843 · Office / nonfacility

$1467.98

Effective 2026-10-01

Compare with release effective

The base rate is $130.26 higher than on 2025-10-01, moving from $1337.72 to $1467.98 (9.7%).

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

January 1, 2026
RVU26A
$1337.72changed to$1467.98
- 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
- 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.
January 1, 2025
RVU25A
$1373.44changed to$1337.72
- 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
$1351.02changed to$1373.44
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1417.55changed to$1351.02
- 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
- 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
January 1, 2023
RVU23A
$1454.55changed to$1417.55
- 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
- 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.
January 1, 2022
RVU22A
$1456.11changed to$1454.55
- 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
$1430.87changed to$1456.11
- 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
- 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.
January 1, 2020
RVU20A
$1238.69changed to$1430.87
- 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
- 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.
January 1, 2019
RVU19A
$1266.26changed to$1238.69
- 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.
January 1, 2018
RVU18AR1
$1290.08changed to$1266.26
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 16.44 changed to 15.88
- Malpractice RVU 2.15 changed to 2.12
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$1294.29changed to$1290.08
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 16.56 changed to 16.44
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$1304.57changed to$1294.29
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 16.70 changed to 16.56
- Malpractice RVU 2.14 changed to 2.15
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$1298.07changed to$1304.57
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$1309.80changed to$1298.07
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 16.83 changed to 16.70
- Malpractice RVU 2.41 changed to 2.14
- 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.
January 1, 2014
RVU14A
$1285.81changed to$1309.80
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 17.97 changed to 16.83
- Malpractice RVU 2.52 changed to 2.41
- 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.
January 1, 2013
RVU13AR
Earliest loaded release: $1285.81
Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective from	Office	Facility	CMS release
2026-10-01	$1,467.98	$860.48	RVU26D
2026-07-01	$1,467.98	$860.48	RVU26C
2026-04-01	$1,467.98	$860.48	RVU26B
2026-01-01	$1,467.98	$860.48	RVU26A
2025-10-01	$1,337.72	$960.25	RVU25D
2025-07-01	$1,337.72	$960.25	RVU25C
2025-04-01	$1,337.72	$960.25	RVU25B
2025-01-01	$1,337.72	$960.25	RVU25A
2024-10-01	$1,373.44	$978.63	RVU24D
2024-07-01	$1,373.44	$978.63	RVU24C
2024-04-01	$1,373.44	$978.63	RVU24B
2024-03-09	$1,373.44	$978.63	RVU24AR
2024-01-01	$1,351.02	$962.66	RVU24A
2023-10-01	$1,417.55	$1,004.93	RVU23D
2023-07-01	$1,417.55	$1,004.93	RVU23C
2023-04-01	$1,417.55	$1,004.93	RVU23B
2023-01-01	$1,417.55	$1,004.93	RVU23A
2022-10-01	$1,454.55	$1,026.39	RVU22D
2022-07-01	$1,454.55	$1,026.39	RVU22C
2022-04-01	$1,454.55	$1,026.39	RVU22B
2022-01-01	$1,454.55	$1,026.39	RVU22A
2021-10-01	$1,456.11	$1,029.15	RVU21D
2021-07-01	$1,456.11	$1,029.15	RVU21C
2021-04-01	$1,456.11	$1,029.15	RVU21B
2021-01-01	$1,456.11	$1,029.15	RVU21A
2020-10-01	$1,430.87	$1,044.42	RVU20D
2020-07-01	$1,430.87	$1,044.42	RVU20C
2020-04-01	$1,430.87	$1,044.42	RVU20B
2020-01-01	$1,430.87	$1,044.42	RVU20A
2019-10-01	$1,238.69	$956.85	RVU19D
2019-07-01	$1,238.69	$956.85	RVU19C
2019-04-01	$1,238.69	$956.85	RVU19B
2019-01-01	$1,238.69	$956.85	RVU19A
2018-10-01	$1,266.26	$982.99	RVU18D
2018-07-01	$1,266.26	$982.99	RVU18C
2018-04-01	$1,266.26	$982.99	RVU18B
2018-01-01	$1,266.26	$982.99	RVU18AR1
2017-10-01	$1,290.08	$1,008.12	RVU17D
2017-07-01	$1,290.08	$1,008.12	RVU17C
2017-04-01	$1,290.08	$1,008.12	RVU17B
2017-01-01	$1,290.08	$1,008.12	RVU17A
2016-10-01	$1,294.29	$1,007.38	RVU16D
2016-07-01	$1,294.29	$1,007.38	RVU16C
2016-04-01	$1,294.29	$1,007.38	RVU16B
2016-01-01	$1,294.29	$1,007.38	RVU16A
2015-10-01	$1,304.57	$1,022.68	RVU15D
2015-07-01	$1,304.57	$1,022.68	RVU15C
2015-04-01	$1,298.07	$1,017.59	RVU15B
2015-01-01	$1,298.07	$1,017.59	RVU15A
2014-10-01	$1,309.80	$1,031.64	RVU14D
2014-07-01	$1,309.80	$1,031.64	RVU14C
2014-04-01	$1,309.80	$1,031.64	RVU14B
2014-01-01	$1,309.80	$1,031.64	RVU14A
2013-10-01	$1,285.81	$996.82	RVU13D
2013-07-01	$1,285.81	$996.82	RVU13C
2013-04-01	$1,285.81	$996.82	RVU13B
2013-01-01	$1,285.81	$996.82	RVU13AR

Price 40843 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.

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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

RVUs for 40843PPRRVU2026_Oct_nonQPP.csv, line 4,874 (RVU26D)

4,87140831,,[CPT descriptor omitted],A,,2.51,6.51,,2.94,,0.34,9.36,5.79,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

4,87240840,,[CPT descriptor omitted],R,,8.92,16.17,,6.58,,1.36,26.45,16.86,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

4,87340842,,[CPT descriptor omitted],R,,8.92,14.84,,6.05,,1.33,25.09,16.30,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

4,87440843,,[CPT descriptor omitted],R,,12.47,23.96,,8.52,,2.32,38.75,23.31,0,090,0.09,0.81,0.10,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

4,87540844,,[CPT descriptor omitted],R,,16.38,29.14,,12.31,,3.04,48.56,31.73,0,090,0.09,0.81,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

4,87640845,,[CPT descriptor omitted],R,,18.88,22.59,,9.78,,2.75,44.22,31.41,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

4,8774084F,,[CPT descriptor omitted],I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00

Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536

3704112,CO,01,COLORADO,1.012,1.064,0.781

3813102,CT,00,CONNECTICUT,1.020,1.077,1.210

3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113

4012102,DE,01,DELAWARE,1.005,0.988,0.899

4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808

4209102,FL,04,MIAMI,1.000,1.041,2.529

Open CMS source How we calculate rates

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What 40843 covers

How Washington, DC area compares for 40843

Every other payment area

40843 rates by state

How the 40843 rate is calculated

Payment rules and modifiers for 40843

What modifiers do to the payment

Codes related to 40843

How 40843 has changed in Washington, DC area

Where the Washington, DC area rate applies

40843 billing questions

How is this code distinguished from 40842?

When should 40844 or 40845 be considered instead?

Can graft harvesting be reported separately?

Can modifier 50 increase payment?

What postoperative care is included?

Can an assistant or another surgeon be reported?

Where these rates come from

Did this answer your question about what 40843 pays in Washington, DC area?

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