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CMS RVU26D · Effective 2026-10-01

40805 in Delaware

Office / nonfacility

$288.74

Base rate per service

Facility setting

$182.48

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Oral surgery

About 40805: Complicated oral vestibule foreign body removal

Removal of an embedded foreign body from the oral vestibule when the retrieval is complicated, rather than a simple extraction.

This service removes an embedded object from the oral vestibule, the space between the lips or cheeks and the teeth or gums. The clinician exposes and retrieves the object using the additional work needed for a complicated removal. Oral and maxillofacial surgeons, dentists, and otolaryngologists may perform it in an office or another appropriate setting when an object is lodged in this tissue.

Choose this code rather than 40804 when the removal is complicated; document the object’s location and the work required to expose and retrieve it. A loose object that can be removed simply does not support the complicated level. The procedure has a 10-day global period, which includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 40805

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.72 · 31%
  • Practice expense (office) RVU5.71 · 65%
  • Malpractice RVU0.30 · 3%

33

Medicare services in 2024 · #5598 by national volume

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.

40805 compared with similar codes

Office rates for Delaware, from the same CMS release.

40804

Foreign body removal

Simple intraoral removal

$206.74

Use 40804 for simple removal of an embedded foreign body from the oral vestibule. Use 40805 when the retrieval is complicated, with documentation of the additional work.

40808

Mouth biopsy

Oral vestibule

$166.15

40808 is for sampling a lesion in the mouth for biopsy. It is not the code for retrieving an embedded foreign object.

40810

Mouth lesion excision

Without repair

$213.73

40810 describes excision of a mouth lesion. Choose 40805 when the target is an embedded foreign body, not tissue being excised as a lesion.

The same code, a different location

How does Delaware compare?

40805 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $288.74

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $326.85

    $38.11 higher than Delaware

  3. Dc + Md/Va Suburbs

    $331.58

    $42.84 higher than Delaware

  4. Miami

    $314.73

    $25.99 higher than Delaware

  5. Chicago

    $306.16

    $17.42 higher than Delaware

  6. Manhattan

    $334.17

    $45.43 higher than Delaware

  7. Alaska*

    $344.91

    $56.17 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 40805 ranges from $259.84 in Arkansas to $381.23 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 40805

    Office

    $263.40

    Facility

    $169.29

    $25.34 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 40805

    Office

    $259.84

    Facility

    $167.45

    $28.90 lower than Delaware for the office setting.

  • Arizona

    Arizona · 40805

    Office

    $284.23

    Facility

    $180.02

    $4.51 lower than Delaware for the office setting.

  • Bakersfield

    California · 40805

    Office

    $307.71

    Facility

    $189.83

    $18.97 higher than Delaware for the office setting.

  • Chico

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • El Centro

    California · 40805

    Office

    $306.84

    Facility

    $188.97

    $18.10 higher than Delaware for the office setting.

  • Fresno

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Madera

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Merced

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Modesto

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Napa

    California · 40805

    Office

    $353.03

    Facility

    $211.28

    $64.29 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 40805

    Office

    $325.07

    Facility

    $197.94

    $36.33 higher than Delaware for the office setting.

  • Redding

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Rest Of California

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 40805

    Office

    $310.06

    Facility

    $192.19

    $21.32 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 40805

    Office

    $321.30

    Facility

    $196.22

    $32.56 higher than Delaware for the office setting.

  • Salinas

    California · 40805

    Office

    $320.08

    Facility

    $195.43

    $31.34 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 40805

    Office

    $327.11

    Facility

    $198.48

    $38.37 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 40805

    Office

    $372.99

    Facility

    $221.35

    $84.25 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 40805

    Office

    $372.65

    Facility

    $221.01

    $83.91 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 40805

    Office

    $381.23

    Facility

    $226.14

    $92.49 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 40805

    Office

    $379.84

    Facility

    $224.75

    $91.10 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 40805

    Office

    $314.99

    Facility

    $192.49

    $26.25 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 40805

    Office

    $329.85

    Facility

    $199.18

    $41.11 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 40805

    Office

    $321.14

    Facility

    $195.74

    $32.40 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 40805

    Office

    $333.15

    Facility

    $201.08

    $44.41 higher than Delaware for the office setting.

  • Stockton

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Vallejo

    California · 40805

    Office

    $352.54

    Facility

    $210.79

    $63.80 higher than Delaware for the office setting.

  • Visalia

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Yuba City

    California · 40805

    Office

    $306.79

    Facility

    $188.92

    $18.05 higher than Delaware for the office setting.

  • Colorado

    Colorado · 40805

    Office

    $302.69

    Facility

    $188.26

    $13.95 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 40805

    Office

    $310.20

    Facility

    $194.36

    $21.46 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 40805

    Office

    $302.17

    Facility

    $193.22

    $13.43 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 40805

    Office

    $288.24

    Facility

    $185.42

    $0.50 lower than Delaware for the office setting.

  • Atlanta

    Georgia · 40805

    Office

    $296.93

    Facility

    $187.66

    $8.19 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 40805

    Office

    $272.92

    Facility

    $176.98

    $15.82 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 40805

    Office

    $313.50

    Facility

    $191.21

    $24.76 higher than Delaware for the office setting.

  • Iowa

    Iowa · 40805

    Office

    $269.34

    Facility

    $170.93

    $19.40 lower than Delaware for the office setting.

  • Idaho

    Idaho · 40805

    Office

    $271.05

    Facility

    $172.10

    $17.69 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 40805

    Office

    $286.49

    Facility

    $187.55

    $2.25 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 40805

    Office

    $280.64

    Facility

    $182.44

    $8.10 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 40805

    Office

    $305.11

    Facility

    $194.66

    $16.37 higher than Delaware for the office setting.

  • Indiana

    Indiana · 40805

    Office

    $272.52

    Facility

    $172.82

    $16.22 lower than Delaware for the office setting.

  • Kansas

    Kansas · 40805

    Office

    $268.31

    Facility

    $171.08

    $20.43 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 40805

    Office

    $269.57

    Facility

    $173.96

    $19.17 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 40805

    Office

    $281.70

    Facility

    $180.49

    $7.04 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 40805

    Office

    $269.24

    Facility

    $174.05

    $19.50 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 40805

    Office

    $331.21

    Facility

    $202.80

    $42.47 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 40805

    Office

    $301.12

    Facility

    $187.87

    $12.38 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 40805

    Office

    $309.34

    Facility

    $193.94

    $20.60 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 40805

    Office

    $293.97

    Facility

    $185.12

    $5.23 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 40805

    Office

    $272.54

    Facility

    $173.60

    $16.20 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 40805

    Office

    $286.18

    Facility

    $179.59

    $2.56 lower than Delaware for the office setting.

  • Detroit

    Michigan · 40805

    Office

    $291.79

    Facility

    $188.00

    $3.05 higher than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 40805

    Office

    $276.29

    Facility

    $178.10

    $12.45 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 40805

    Office

    $290.07

    Facility

    $179.40

    $1.33 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 40805

    Office

    $279.73

    Facility

    $178.74

    $9.01 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 40805

    Office

    $282.46

    Facility

    $180.07

    $6.28 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 40805

    Office

    $265.01

    Facility

    $172.30

    $23.73 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 40805

    Office

    $262.46

    Facility

    $169.86

    $26.28 lower than Delaware for the office setting.

  • Montana**

    Montana · 40805

    Office

    $291.57

    Facility

    $184.02

    $2.83 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 40805

    Office

    $275.19

    Facility

    $174.85

    $13.55 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 40805

    Office

    $285.64

    Facility

    $178.09

    $3.10 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 40805

    Office

    $270.67

    Facility

    $171.40

    $18.07 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 40805

    Office

    $298.16

    Facility

    $186.20

    $9.42 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 40805

    Office

    $328.51

    Facility

    $203.75

    $39.77 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 40805

    Office

    $313.74

    Facility

    $196.30

    $25.00 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 40805

    Office

    $277.77

    Facility

    $179.15

    $10.97 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 40805

    Office

    $290.11

    Facility

    $182.45

    $1.37 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 40805

    Office

    $342.04

    Facility

    $214.16

    $53.30 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 40805

    Office

    $315.90

    Facility

    $198.13

    $27.16 higher than Delaware for the office setting.

  • Queens

    New York · 40805

    Office

    $336.54

    Facility

    $209.42

    $47.80 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 40805

    Office

    $279.08

    Facility

    $176.90

    $9.66 lower than Delaware for the office setting.

  • Ohio

    Ohio · 40805

    Office

    $275.08

    Facility

    $176.88

    $13.66 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 40805

    Office

    $268.95

    Facility

    $172.91

    $19.79 lower than Delaware for the office setting.

  • Portland

    Oregon · 40805

    Office

    $311.65

    Facility

    $192.16

    $22.91 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 40805

    Office

    $287.85

    Facility

    $180.73

    $0.89 lower than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 40805

    Office

    $302.98

    Facility

    $191.02

    $14.24 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 40805

    Office

    $275.40

    Facility

    $176.67

    $13.34 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 40805

    Office

    $293.54

    Facility

    $184.80

    $4.80 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 40805

    Office

    $298.53

    Facility

    $187.43

    $9.79 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 40805

    Office

    $275.59

    Facility

    $176.22

    $13.15 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 40805

    Office

    $284.94

    Facility

    $177.39

    $3.80 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 40805

    Office

    $269.60

    Facility

    $171.83

    $19.14 lower than Delaware for the office setting.

  • Austin

    Texas · 40805

    Office

    $301.69

    Facility

    $187.90

    $12.95 higher than Delaware for the office setting.

  • Beaumont

    Texas · 40805

    Office

    $273.71

    Facility

    $175.84

    $15.03 lower than Delaware for the office setting.

  • Brazoria

    Texas · 40805

    Office

    $288.40

    Facility

    $181.81

    $0.34 lower than Delaware for the office setting.

  • Dallas

    Texas · 40805

    Office

    $290.22

    Facility

    $183.10

    $1.48 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 40805

    Office

    $288.44

    Facility

    $182.40

    $0.30 lower than Delaware for the office setting.

  • Galveston

    Texas · 40805

    Office

    $289.26

    Facility

    $182.46

    $0.52 higher than Delaware for the office setting.

  • Houston

    Texas · 40805

    Office

    $294.75

    Facility

    $187.95

    $6.01 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 40805

    Office

    $280.89

    Facility

    $178.83

    $7.85 lower than Delaware for the office setting.

  • Utah

    Utah · 40805

    Office

    $279.12

    Facility

    $178.03

    $9.62 lower than Delaware for the office setting.

  • Virginia

    Virginia · 40805

    Office

    $285.40

    Facility

    $179.68

    $3.34 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 40805

    Office

    $293.54

    Facility

    $184.80

    $4.80 higher than Delaware for the office setting.

  • Vermont

    Vermont · 40805

    Office

    $284.73

    Facility

    $178.26

    $4.01 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 40805

    Office

    $300.48

    Facility

    $187.23

    $11.74 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 40805

    Office

    $337.59

    Facility

    $205.63

    $48.85 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 40805

    Office

    $276.65

    Facility

    $173.61

    $12.09 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 40805

    Office

    $270.92

    Facility

    $177.46

    $17.82 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 40805

    Office

    $288.98

    Facility

    $181.43

    $0.24 higher than Delaware for the office setting.

See how rates vary across the country

40805 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$259.84

$344.91

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$344.911
AL$263.401
AR$259.841
AZ$284.231
CA$306.79–$381.2329
CO$302.691
CT$310.201
DC$331.581
DE$288.741
FL$288.24–$314.733
GA$272.92–$296.932
GU$313.501
HI$313.501
IA$269.341
ID$271.051
IL$280.64–$306.164
IN$272.521
KS$268.311
KY$269.571
LA$269.24–$281.702
MA$301.12–$331.212
MD$293.97–$331.583
ME$272.54–$286.182
MI$276.29–$291.792
MN$290.071
MO$265.01–$282.463
MS$262.461
MT$291.571
NC$275.191
ND$285.641
NE$270.671
NH$298.161
NJ$313.74–$328.512
NM$277.771
NV$290.111
NY$279.08–$342.045
OH$275.081
OK$268.951
OR$287.85–$311.652
PA$275.40–$302.982
PR$293.541
RI$298.531
SC$275.591
SD$284.941
TN$269.601
TX$273.71–$301.698
UT$279.121
VA$285.40–$331.582
VI$293.541
VT$284.731
WA$300.48–$337.592
WI$276.651
WV$270.921
WY$288.981

Explore 40805 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Delaware →

Why are the office and facility amounts different?

For 40805 in Delaware, the physician’s office rate is $288.74 and the facility-setting rate is $182.48: a difference of $106.26.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 40805 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$317.61

$288.74 × 110% = $317.61

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 40805 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

4,860

Code
40805
Physician work
2.72
Practice expense
5.71
Malpractice
0.30

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 40805 in Delaware
ComponentRVULocality factorAdjusted
Physician work2.72× 1.0052.7336
Practice expense5.71× 0.9885.6415
Malpractice0.30× 0.8990.2697
Total RVUs8.6448
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$288.74

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 40805 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.721.005
Practice expense5.710.988
Malpractice0.30.899

(2.72 × 1.005 + 5.71 × 0.988 + 0.3 × 0.899) × $33.4009 = $288.74

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.721.005
Practice expense2.490.988
Malpractice0.30.899

(2.72 × 1.005 + 2.49 × 0.988 + 0.3 × 0.899) × $33.4009 = $182.48

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

40805 · Office / nonfacility

$288.74

Effective 2026-10-01

The base rate is $10.02 higher than on 2025-10-01, moving from $278.72 to $288.74 (3.6%).

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

    $278.72changed to$288.74

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.79 changed to 2.72
    • Practice expense RVU 5.59 changed to 5.71
    • Malpractice RVU 0.27 changed to 0.30
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $278.72

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$288.74$182.48RVU26D
2026-07-01$288.74$182.48RVU26C
2026-04-01$288.74$182.48RVU26B
2026-01-01$288.74$182.48RVU26A
2025-10-01$278.72$195.93RVU25D
2025-07-01$278.72$195.93RVU25C
2025-04-01$278.72$195.93RVU25B
2025-01-01$278.72$195.93RVU25A

40805 billing questions

How does this differ from 40804?

40805 is for a complicated removal of an embedded foreign body in the oral vestibule; 40804 represents the simple removal. Document the factors that made retrieval complicated.

Does this code cover removal of a loose object?

No. This code describes a complicated removal of an embedded object. A loose object removed simply does not support this level.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure.

Should modifier 50 be appended for objects on both sides?

No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Can an assistant surgeon be reported?

Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

What documentation supports the complicated level?

Record the foreign body’s specific oral vestibule location and the additional work needed to expose and retrieve it, distinguishing the service from simple removal.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 40805PPRRVU2026_Oct_nonQPP.csv, line 4,860 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet