Billing code 40814: Oral lesion excisionMedicare rate & RVUs
Report this service when a lesion of the mouth vestibule is excised and the resulting site requires complex repair.
Medicare pays $382.11 for 40814 nationally in the office and $264.54 in a hospital or facility. Local office rates run $339.33–$499.65.
Medicare rate · 40814
Oral lesion excision
Swap in your local Medicare rate.
- Work RVUs
- 3.43
- Total RVUs
- 11.44
- Global days
- 090
National rate · 2026
$382.11
Office setting, before claim adjustments.
See every locality for 40814 → · 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
What 40814 covers
Code 40814 describes excision of a lesion from the mucosa and submucosa of the mouth vestibule, followed by complex repair. The vestibule is the space between the lips or cheeks and the teeth or gums; examples include the inner lip or cheek lining. Oral and maxillofacial surgeons, otolaryngologists, and other surgeons may perform the procedure in an office, ambulatory surgery center, or hospital. A specimen may be sent for pathologic examination, but the operative service is selected by the excision and repair performed, not by the final diagnosis.
Choose this code when the operative report supports a complex repair, rather than no repair or simple repair. Document the lesion’s site, the excision performed, and the repair technique and complexity. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; 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.
Where 40814 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$339.33 to $499.65
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $344.12 | $241.25 |
| Alaska* | $449.23 | $324.01 |
| Arizona | $372.15 | $258.23 |
| Arkansas | $339.33 | $238.33 |
| Atlanta | $389.45 | $270.00 |
| Austin | $395.33 | $270.93 |
| Bakersfield | $402.81 | $273.95 |
| Baltimore/Surr. Cntys | $405.88 | $279.73 |
| Beaumont | $358.31 | $251.32 |
| Brazoria | $377.51 | $261.00 |
| Chicago | $403.20 | $285.05 |
| Chico | $401.51 | $272.65 |
| Colorado | $396.44 | $271.35 |
| Connecticut | $406.95 | $280.33 |
| Dallas | $380.04 | $262.94 |
| Dc + Md/Va Suburbs | $434.96 | $296.46 |
| Delaware | $378.16 | $262.00 |
| Detroit | $383.34 | $269.88 |
| East St. Louis | $376.78 | $268.62 |
| El Centro | $401.58 | $272.72 |
| Fort Lauderdale | $397.27 | $278.17 |
| Fort Worth | $377.70 | $261.78 |
| Fresno | $401.51 | $272.65 |
| Galveston | $378.73 | $261.98 |
| Hanford-Corcoran | $401.51 | $272.65 |
| Hawaii, Guam | $410.56 | $276.88 |
| Houston | $386.78 | $270.03 |
| Idaho | $354.13 | $245.97 |
| Indiana | $356.09 | $247.11 |
| Iowa | $351.75 | $244.17 |
| Kansas | $350.54 | $244.26 |
| Kentucky | $352.79 | $248.27 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $428.14 | $289.05 |
| Madera | $401.51 | $272.65 |
| Manhattan | $439.01 | $302.39 |
| Merced | $401.51 | $272.65 |
| Metropolitan Boston | $434.24 | $293.86 |
| Metropolitan Kansas City | $366.34 | $255.95 |
| Metropolitan Philadelphia | $397.37 | $274.98 |
| Metropolitan St. Louis | $370.00 | $258.07 |
| Miami | $414.94 | $292.55 |
| Minnesota | $379.09 | $258.11 |
| Mississippi | $343.13 | $241.90 |
| Modesto | $401.51 | $272.65 |
| Montana** | $382.08 | $264.51 |
| Napa | $462.50 | $307.54 |
| Nebraska | $353.50 | $244.98 |
| Nevada** | $379.90 | $262.22 |
| New Hampshire | $390.64 | $268.24 |
| New Mexico | $364.07 | $256.26 |
| New Orleans | $369.19 | $258.55 |
| North Carolina | $359.86 | $250.17 |
| North Dakota** | $373.38 | $255.81 |
| Northern Nj | $430.78 | $294.40 |
| Nyc Suburbs/Long Island | $449.82 | $310.03 |
| Ohio | $360.23 | $252.88 |
| Oklahoma | $351.77 | $246.78 |
| Oxnard-Thousand Oaks-Ventura | $425.79 | $286.82 |
| Portland | $408.24 | $277.62 |
| Poughkpsie/N Nyc Suburbs | $414.37 | $285.63 |
| Puerto Rico | $384.67 | $265.80 |
| Queens | $441.95 | $302.98 |
| Redding | $401.51 | $272.65 |
| Rest Of California | $401.51 | $272.65 |
| Rest Of Florida | $378.37 | $265.98 |
| Rest Of Georgia | $357.62 | $252.75 |
| Rest Of Illinois | $368.38 | $261.04 |
| Rest Of Louisiana | $352.41 | $248.36 |
| Rest Of Maine | $356.32 | $248.16 |
| Rest Of Maryland | $385.08 | $266.10 |
| Rest Of Massachusetts | $394.36 | $270.55 |
| Rest Of Michigan | $362.00 | $254.66 |
| Rest Of Missouri | $346.83 | $245.49 |
| Rest Of New Jersey | $411.38 | $282.99 |
| Rest Of New York | $365.10 | $253.41 |
| Rest Of Oregon | $376.73 | $259.63 |
| Rest Of Pennsylvania | $360.56 | $252.63 |
| Rest Of Texas | $367.79 | $256.21 |
| Rest Of Washington | $393.48 | $269.68 |
| Rhode Island | $391.04 | $269.59 |
| Riverside-San Bernardino-Ontario | $406.28 | $277.42 |
| Sacramento-Roseville-Folsom | $420.63 | $283.89 |
| Salinas | $419.04 | $282.78 |
| San Diego-Chula Vista-Carlsbad | $428.37 | $287.75 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $488.71 | $322.93 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $488.21 | $322.43 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $499.65 | $330.11 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $497.60 | $328.07 |
| San Luis Obispo-Paso Robles | $412.38 | $278.47 |
| Santa Cruz-Watsonville | $432.05 | $289.21 |
| Santa Maria-Santa Barbara | $420.47 | $283.38 |
| Santa Rosa-Petaluma | $436.37 | $292.00 |
| Seattle (King Cnty) | $442.54 | $298.28 |
| South Carolina | $360.69 | $252.05 |
| South Dakota** | $372.35 | $254.78 |
| Southern Maine | $374.41 | $257.89 |
| Stockton | $401.51 | $272.65 |
| Suburban Chicago | $401.08 | $280.34 |
| Tennessee | $352.29 | $245.42 |
| Utah | $365.44 | $254.92 |
| Vallejo | $461.78 | $306.82 |
| Vermont | $372.32 | $255.92 |
| Virgin Islands | $384.67 | $265.80 |
| Virginia | $373.49 | $257.91 |
| Visalia | $401.51 | $272.65 |
| West Virginia | $355.32 | $253.15 |
| Wisconsin | $361.32 | $248.68 |
| Wyoming** | $378.29 | $260.71 |
| Yuba City | $401.51 | $272.65 |
40814 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.
$339.33
$450.58
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 | $449.23 | 1 |
| AL | $344.12 | 1 |
| AR | $339.33 | 1 |
| AZ | $372.15 | 1 |
| CA | $401.51–$499.65 | 29 |
| CO | $396.44 | 1 |
| CT | $406.95 | 1 |
| DC | $434.96 | 1 |
| DE | $378.16 | 1 |
| FL | $378.37–$414.94 | 3 |
| GA | $357.62–$389.45 | 2 |
| GU | $410.56 | 1 |
| HI | $410.56 | 1 |
| IA | $351.75 | 1 |
| ID | $354.13 | 1 |
| IL | $368.38–$403.20 | 4 |
| IN | $356.09 | 1 |
| KS | $350.54 | 1 |
| KY | $352.79 | 1 |
| LA | $352.41–$369.19 | 2 |
| MA | $394.36–$434.24 | 2 |
| MD | $385.08–$434.96 | 3 |
| ME | $356.32–$374.41 | 2 |
| MI | $362.00–$383.34 | 2 |
| MN | $379.09 | 1 |
| MO | $346.83–$370.00 | 3 |
| MS | $343.13 | 1 |
| MT | $382.08 | 1 |
| NC | $359.86 | 1 |
| ND | $373.38 | 1 |
| NE | $353.50 | 1 |
| NH | $390.64 | 1 |
| NJ | $411.38–$430.78 | 2 |
| NM | $364.07 | 1 |
| NV | $379.90 | 1 |
| NY | $365.10–$449.82 | 5 |
| OH | $360.23 | 1 |
| OK | $351.77 | 1 |
| OR | $376.73–$408.24 | 2 |
| PA | $360.56–$397.37 | 2 |
| PR | $384.67 | 1 |
| RI | $391.04 | 1 |
| SC | $360.69 | 1 |
| SD | $372.35 | 1 |
| TN | $352.29 | 1 |
| TX | $358.31–$395.33 | 8 |
| UT | $365.44 | 1 |
| VA | $373.49–$434.96 | 2 |
| VI | $384.67 | 1 |
| VT | $372.32 | 1 |
| WA | $393.48–$442.54 | 2 |
| WI | $361.32 | 1 |
| WV | $355.32 | 1 |
| WY | $378.29 | 1 |
How the 40814 rate is calculated
Each of 40814’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 · 40814
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.43Practice expense 7.57Malpractice 0.44
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 40814
40814 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 40814
Oral lesion excision
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 40814
Oral lesion excision
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
40814 without 51 · national office
$382.11
Oral lesion excision
40814-51 · Second procedure: 50%
$191.06
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%).
40814 compared with similar codes
Compare codes
40814 vs 40812 vs 40810 vs 40816 vs 40808: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 40812Oral lesion excision
- Both involve excision of a vestibular mouth lesion and repair. The repair documented for 40814 must be complex; 40812 describes simple repair.
- 40810Mouth lesion excision
- 40810 is for excision without repair. Choose 40814 when the site is closed with a complex repair.
- 40816Mouth lesion excision
- 40816 describes full-thickness excision and closure. 40814 applies to mucosa and submucosa excision with complex repair.
- 40808Mouth biopsy
- 40808 is for biopsy of a mouth lesion. 40814 is for lesion excision with complex repair, rather than sampling alone.
40814 billing questions
How does 40814 differ from 40812?
Both describe vestibular lesion excision with repair. Use 40814 when the documentation supports complex repair; 40812 is for simple repair.
When is 40810 a better choice?
40810 describes excision without repair. Use 40814 when the excision site receives a complex repair.
Should 40814 be reported for a biopsy?
Use 40814 for excision with complex repair, not for a diagnostic sample alone. Code 40808 describes biopsy of a mouth lesion.
Can modifier 50 be appended for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
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 co-surgeon be paid?
Assistant-at-surgery payment is restricted for this code. Co-surgeons and team surgery 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
Show the CMS file lines behind this rate
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