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Billing code 40702: Cleft lip repairMedicare rate & RVUs

Reports secondary surgical repair of a bilateral cleft lip and associated nasal deformity in an infant, rather than primary repair or later revision.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $899.49 for 40702 nationally in a facility.

Medicare rate · 40702

Cleft lip repair

Swap in your local Medicare rate.

Work RVUs
13.91
Total RVUs
26.93
Global days
090

National rate · 2026

$899.49

Facility setting, before claim adjustments.

See every locality for 40702 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 40702 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 40702 covers

This code describes secondary repair of a bilateral cleft lip and associated nasal deformity in infancy, before age four. A plastic, craniofacial, or other appropriately trained surgeon typically performs the reconstruction in an operating room, often at a children’s hospital. The service addresses residual deformity after an earlier repair; it is distinct from the initial repair of the cleft.

Select the code based on the secondary nature of the operation, the patient’s age, and bilateral involvement. The operative report should establish the prior repair and describe the lip and nasal deformities treated. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. The code is priced bilaterally, so modifier 50 does not increase payment. Assistant-at-surgery payment may be made; co-surgeon and team-surgery payment 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.

Where 40702 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

40702 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$818.50
Alaska*Unavailable$1,115.76
ArizonaUnavailable$876.27
ArkansasUnavailable$808.52
AtlantaUnavailable$923.78
AustinUnavailable$910.82
BakersfieldUnavailable$908.10
Baltimore/Surr. CntysUnavailable$952.80
BeaumontUnavailable$861.98
BrazoriaUnavailable$881.11

40702 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
40702 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 40702 rate is calculated

Each of 40702’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 · 40702

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.91Practice expense 10.44Malpractice 2.58

26.9300 adjusted RVUs×$33.4009 conversion factor=$899.49

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 40702

40702 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 40702

Cleft lip repair

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 · 40702

Cleft lip repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

40702 without 51 · national facility

$899.49

Cleft lip repair

40702-51 · Second procedure: 50%

$449.75

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

40702 compared with similar codes

Compare codes

40702 vs 40701 vs 40700 vs 40720: national Medicare rates

Swap in your local Medicare rate.

  • 40702
    Cleft lip repair · 13.91 wRVU
    —
  • 40701
    Cleft lip repair · 16.8 wRVU
    —
  • 40700
    Cleft lip repair · 13.82 wRVU
    —
  • 40720
    Cleft repair · 14.35 wRVU
    —

How to choose

40701Cleft lip repair
40701 is for primary bilateral repair. This code is for secondary repair in infancy after an earlier cleft repair.
40700Cleft lip repair
40700 describes primary unilateral repair; this code describes secondary bilateral repair in infancy.
40720Cleft repair
Both describe secondary repair, but 40720 is for an older child or adult; this code is for infancy.

Codes related to 40702

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

Codes related to 40702
CodeHow it relatesNational office range
Same family
40700Cleft lip repairPrimary repair of a unilateral cleft lip and associated nasal deformity.No office rate
40701Cleft lip repairPrimary repair of a bilateral cleft lip and associated nasal deformity.No office rate
40720Cleft repairSecondary repair for an older child or adult rather than an infant.No office rate
Used instead
40761Cleft repairCleft lip repair using a cross-lip flap when that operative method is performed.No office rate

40702 billing questions

When should this code be chosen instead of 40701?

Use this code for secondary repair in infancy. Code 40701 describes primary bilateral repair, not revision after an earlier repair.

Should modifier 50 be appended for bilateral repair?

The code is already priced as bilateral. Modifier 50 does not increase its payment.

Does the global period include related postoperative care?

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?

Assistant-at-surgery payment may be made. CMS does not permit co-surgeon or team-surgery payment for this code.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to 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
RVUs for 40702PPRRVU2026_Oct_nonQPP.csv, line 4,848 (RVU26D)

Open CMS sourceHow we calculate rates

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