Billing code 40830: Mouth laceration repairMedicare rate & RVUs

Medicare pays $231.80 for 40830 nationally in the office and $138.61 in a hospital or facility. Local office rates run $204.81–$307.67.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 40830 covers

This code describes simple repair of a traumatic cut in the oral vestibule—the space between the inner lip or cheek and the teeth or gums. A clinician may use it for an uncomplicated mucosal laceration, such as one caused by a fall or impact. Oral and maxillofacial surgeons, dentists, otolaryngologists, and emergency clinicians may perform the repair in an office, emergency department, or operating room. The key distinction from 40831 is that 40830 is for a simple repair; the record should identify the wound’s location and describe the repair performed.

Report one unit for the repair and document the injury, vestibular site, and basis for selecting the simple repair code. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. Assistant-at-surgery payment requires documentation of medical necessity; 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 40830 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

40830 rates by state

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

How the 40830 rate is calculated

Each of 40830’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.

Payment rules and modifiers for 40830

40830 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

40830 compared with similar codes

How to choose

40831Laceration repair

Both address mouth vestibule lacerations; choose 40830 for a simple repair and 40831 when the repair is complicated.

40812Oral lesion excision

40812 describes excision of a mouth lesion with repair. 40830 is for repair of a traumatic laceration, without lesion excision as the service.

40808Mouth biopsy

40808 is for biopsy of a mouth lesion. It is not a repair code for a traumatic vestibular cut.

Codes related to 40830

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

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

Open CMS sourceHow we calculate rates