CPT code 40844: Mouth reconstruction, mucosal graft included2026 Medicare rate & RVUs in Missouri
Reports reconstruction of the oral vestibule using a mucous membrane graft, including obtaining the graft, to address tissue loss or scarring.
Medicare pays $1,484.99–$1,575.43 for 40844 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 40844 covers
This procedure rebuilds the oral vestibule—the space between the cheek or lip and the gum—using a mucous membrane graft, including obtaining the graft. Oral and maxillofacial surgeons and other qualified surgeons may perform it when tissue loss or scar contracture has reduced vestibular depth, such as after trauma or prior surgery. The reconstruction may restore the oral lining and improve the area’s shape for function or prosthetic support.
Select the code that matches the documented reconstructive technique and graft work; distinguish this service from vestibular reconstruction using another graft type or a different approach. The operative report should identify the affected site, reason for reconstruction, graft type and source, whether the graft was obtained during the procedure, and the reconstructive work performed. CMS lists restricted coverage, so payment is limited to specific circumstances. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Assistant-at-surgery payment may be made; co-surgeon and team-surgery billing are not permitted. Modifier 50 is inappropriate for this descriptor and anatomy.
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.
Where 40844 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$1484.99 to $1575.43
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $1,560.24 | $1,032.39 |
| Metropolitan St. Louis, MO | $1,575.43 | $1,040.28 |
| Rest of Missouri | $1,484.99 | $1,000.43 |
How the 40844 rate is calculated
Each of 40844’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 · 40844
RVUs × geographic indexes × conversion factor
Work16.38
16.38 RVUs× 1.000 GPCI
Practice expense29.14
29.14 RVUs× 1.000 GPCI
Malpractice3.04
3.04 RVUs× 1.000 GPCI
Adjusted RVUs
48.5600
Conversion factor
$33.4009
Medicare rate
$1,621.95
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 40844
40844 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 40844
Mouth reconstruction, mucosal graft included
| 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 · 40844
Mouth reconstruction, mucosal graft included
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
40844 without 51 · national office
$1,621.95
Mouth reconstruction, mucosal graft included
40844-51 · Second procedure: 50%
$810.98
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%).
40844 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 40842Mouth reconstructionExtensive reconstruction
- Both are in the oral vestibule reconstruction family. For 40844, the documented service includes a mucous membrane graft and obtaining it; compare the complete descriptors and operative work.
- 40843Mouth reconstructionExtensive, with skin graft
- This is a sibling vestibule reconstruction code. Use the code whose listed graft and technique match the operative report rather than relying on the general reconstruction label.
- 40845Mouth reconstructionWith bone graft
- This is another oral vestibule reconstruction code. Distinguish it from 40844 by matching the specific listed scope and technique to the operative documentation.
40844 billing questions
How is 40844 distinguished from other vestibule reconstruction codes?
40844 describes reconstruction with a mucous membrane graft, including obtaining the graft. Choose among related codes according to the graft and reconstructive work documented in the operative report.
What documentation supports reporting 40844?
Document the vestibular site and defect, the reason for reconstruction, the graft type and source, whether it was obtained during the procedure, and the reconstructive steps. CMS payment is restricted to specific circumstances.
Are routine postoperative visits separately reported?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.
Can another procedure be reported during the same session?
A separately performed procedure may be reported when supported by the record. CMS applies the standard multiple-procedure reduction to other procedures performed in the same session.
Can modifier 50 be used for reconstruction on both sides?
No. CMS identifies modifier 50 as inappropriate for this descriptor and anatomy.
Can an assistant surgeon be reported?
CMS indicates assistant-at-surgery payment may be made. Co-surgeon and team-surgery billing are not permitted.
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
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