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

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 Vermont, Medicare pays $1,248.00 for 40843 in the office and $737.45 when it’s performed in a hospital or facility.

$1,248.00Office (non-facility)
$737.45Hospital or facility
−3.6%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.

We’ll open 40843 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 40843 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 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 Vermont 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. Vermont pays $1,248.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

40843 in Vermont vs other payment areas
  1. Vermont · this page$1,248.00
  2. Los Angeles, CA · California$1,431.78+$183.78
  3. Washington, DC area · District of Columbia$1,467.98+$219.98
  4. Miami, FL · Florida$1,445.58+$197.58
  5. Chicago, IL · Illinois$1,401.55+$153.55
  6. Manhattan, NY · New York$1,496.00+$248.00
  7. Alaska · Alaska$1,519.76+$271.76

Other areas in Vermont first, then benchmark localities. Bars start at $0.

Every other payment area

40843 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,160.62$709.37
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

40843 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.

$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 / territoryOffice rate rangeLocalities
AK$1,519.761
AL$1,160.621
AR$1,143.861
AZ$1,258.321
CA$1,342.24–$1,657.8729
CO$1,333.531
CT$1,380.511
DC$1,467.981
DE$1,278.941
FL$1,298.05–$1,445.583
GA$1,222.73–$1,323.912
GU$1,371.301
HI$1,371.301
IA$1,179.531
ID$1,189.421
IL$1,268.29–$1,401.554
IN$1,196.031
KS$1,179.021
KY$1,198.871
LA$1,199.00–$1,257.612
MA$1,327.63–$1,458.092
MD$1,301.70–$1,467.983
ME$1,200.97–$1,258.492
MI$1,234.66–$1,319.432
MN$1,262.941
MO$1,181.83–$1,256.033
MS$1,162.821
MT$1,294.131
NC$1,212.691
ND$1,248.261
NE$1,184.461
NH$1,317.411
NJ$1,392.09–$1,453.842
NM$1,243.441
NV$1,282.141
NY$1,231.26–$1,538.605
OH$1,225.281
OK$1,191.371
OR$1,268.07–$1,369.942
PA$1,224.40–$1,349.552
PR$1,301.931
RI$1,320.241
SC$1,221.841
SD$1,242.831
TN$1,185.581
TX$1,216.76–$1,332.708
UT$1,238.361
VA$1,257.90–$1,467.982
VI$1,301.931
VT$1,248.001
WA$1,323.59–$1,482.592
WI$1,207.051
WV$1,222.851
WY$1,274.141

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?

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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 40843 in Vermont
ComponentRVULocality factorAdjusted
Physician work12.47× 1.00012.4700
Practice expense23.96× 0.99023.7204
Malpractice2.32× 0.5061.1739
Total RVUs37.3643
Conversion factor× 33.4009

Office rate, Vermont$1248.00

Office: (12.47 × 1 + 23.96 × 0.99 + 2.32 × 0.506) × $33.4009 = $1248.00

Facility: (12.47 × 1 + 8.52 × 0.99 + 2.32 × 0.506) × $33.4009 = $737.45

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

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)2Already bilateral by definition: paid once at 100%.
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 · 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.

  • 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
CodeHow it relatesOffice range, Vermont
Same family
40840Mouth reconstruction, anterior vestibuloplastyLimited mouth reconstruction, unlike this code's extensive graft-based service.$855.61
40842Mouth reconstruction, extensive reconstructionExtensive mouth reconstruction without a specified graft type.$811.13
40844Mouth reconstruction, mucosal graft includedExtensive mouth reconstruction with a free mucosal graft.$1,562.05
40845Mouth reconstruction, with bone graftExtensive mouth reconstruction with a split-thickness skin graft.$1,424.07

How 40843 has changed in Vermont

40843 · Office / nonfacility

$1248.00

Effective 2026-10-01

The base rate is $118.48 higher than on 2025-10-01, moving from $1129.52 to $1248.00 (10.5%).

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

    $1129.52changed to$1248.00

    • 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 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1159.26changed to$1129.52

    • 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.

  3. March 9, 2024

    RVU24AR

    $1140.34changed to$1159.26

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1185.24changed to$1140.34

    • 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 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $1204.17changed to$1185.24

    • 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 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1206.83changed to$1204.17

    • 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.

  7. January 1, 2021

    RVU21A

    $1204.76changed to$1206.83

    • 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 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1061.72changed to$1204.76

    • 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 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1086.09changed to$1061.72

    • 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.

  10. January 1, 2018

    RVU18AR1

    $1104.23changed to$1086.09

    • 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
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1105.73changed to$1104.23

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 16.56 changed to 16.44
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1114.52changed to$1105.73

    • 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.

  13. July 1, 2015

    RVU15C

    $1108.98changed to$1114.52

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1118.04changed to$1108.98

    • 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
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$1118.04

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,248.00$737.45RVU26D
2026-07-01$1,248.00$737.45RVU26C
2026-04-01$1,248.00$737.45RVU26B
2026-01-01$1,248.00$737.45RVU26A
2025-10-01$1,129.52$815.07RVU25D
2025-07-01$1,129.52$815.07RVU25C
2025-04-01$1,129.52$815.07RVU25B
2025-01-01$1,129.52$815.07RVU25A
2024-10-01$1,159.26$830.37RVU24D
2024-07-01$1,159.26$830.37RVU24C
2024-04-01$1,159.26$830.37RVU24B
2024-03-09$1,159.26$830.37RVU24AR
2024-01-01$1,140.34$816.82RVU24A
2023-10-01$1,185.24$846.37RVU23D
2023-07-01$1,185.24$846.37RVU23C
2023-04-01$1,185.24$846.37RVU23B
2023-01-01$1,185.24$846.37RVU23A
2022-10-01$1,204.17$857.42RVU22D
2022-07-01$1,204.17$857.42RVU22C
2022-04-01$1,204.17$857.42RVU22B
2022-01-01$1,204.17$857.42RVU22A
2021-10-01$1,206.83$861.04RVU21D
2021-07-01$1,206.83$861.04RVU21C
2021-04-01$1,206.83$861.04RVU21B
2021-01-01$1,206.83$861.04RVU21A
2020-10-01$1,204.76$885.72RVU20D
2020-07-01$1,204.76$885.72RVU20C
2020-04-01$1,204.76$885.72RVU20B
2020-01-01$1,204.76$885.72RVU20A
2019-10-01$1,061.72$824.32RVU19D
2019-07-01$1,061.72$824.32RVU19C
2019-04-01$1,061.72$824.32RVU19B
2019-01-01$1,061.72$824.32RVU19A
2018-10-01$1,086.09$847.49RVU18D
2018-07-01$1,086.09$847.49RVU18C
2018-04-01$1,086.09$847.49RVU18B
2018-01-01$1,086.09$847.49RVU18AR1
2017-10-01$1,104.23$867.90RVU17D
2017-07-01$1,104.23$867.90RVU17C
2017-04-01$1,104.23$867.90RVU17B
2017-01-01$1,104.23$867.90RVU17A
2016-10-01$1,105.73$866.68RVU16D
2016-07-01$1,105.73$866.68RVU16C
2016-04-01$1,105.73$866.68RVU16B
2016-01-01$1,105.73$866.68RVU16A
2015-10-01$1,114.52$879.66RVU15D
2015-07-01$1,114.52$879.66RVU15C
2015-04-01$1,108.98$875.28RVU15B
2015-01-01$1,108.98$875.28RVU15A
2014-10-01$1,118.04$885.24RVU14D
2014-07-01$1,118.04$885.24RVU14C
2014-04-01$1,118.04$885.24RVU14B
2014-01-01$1,118.04$885.24RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 40843 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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