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CMS RVU26D · Effective 2026-10-01

40800 in Merced

Office / nonfacility

$223.74

Base rate per service

Facility setting

$120.87

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 40800: Simple oral vestibule lesion drainage

Reports simple drainage of a localized collection in the mouth’s vestibule, such as an abscess along the inner lip or cheek near the teeth.

CPT 40800 covers a simple procedure to open and empty a localized fluid collection in the oral vestibule, the space between the lips or cheeks and the teeth and gums. A typical case is a small abscess along the inner lip or cheek beside the dental arch. An oral and maxillofacial surgeon or another clinician treating oral disease may perform the service in an office or facility. This is drainage, not diagnostic tissue sampling, foreign-body removal, or excision of a lesion.

Select 40800 when the documented work supports simple drainage; 40801 is the related code for complicated drainage. Document the collection’s precise vestibular location and the drainage performed. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.

CMS billing rules for 40800

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
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.20 · 19%
  • Practice expense (office) RVU4.92 · 78%
  • Malpractice RVU0.16 · 3%

1.5K

Medicare services in 2024 · #2688 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.

40800 compared with similar codes

Office rates for Merced, from the same CMS release.

40801

Mouth drainage

Complicated vestibular collection

$323.67

Both address drainage in the oral vestibule. Choose 40800 for simple drainage and 40801 when the documented procedure is complicated.

40808

Mouth biopsy

Oral vestibule

$178.83

40808 describes tissue sampling of a vestibular lesion; 40800 describes draining a fluid collection.

40810

Mouth lesion excision

Without repair

$229.97

40810 is for excising a vestibular lesion. Use 40800 when the service opens and drains a collection instead.

40804

Foreign body removal

Simple intraoral removal

$222.26

40804 is for simple removal of a foreign body from the vestibule, not drainage of an abscess or other collection.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 40800 is $224.21—$0.47 higher than the $223.74 rate in Merced. Both use the same code, release and participation basis.

40800 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $223.74

  2. Bakersfield

    $224.21

    $0.47 higher than Merced

  3. Chico

    $223.74

    The same base rate than Merced

  4. El Centro

    $223.76

    $0.02 higher than Merced

  5. Fresno

    $223.74

    The same base rate than Merced

  6. Hanford-Corcoran

    $223.74

    The same base rate than Merced

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

    $239.68

    $15.94 higher than Merced

Other payment areas listed in California 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, 40800 ranges from $183.99 in Arkansas to $284.32 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

  • Madera

    California · 40800

    Office

    $223.74

    Facility

    $120.87

    The same base rate than Merced for the office setting.

  • Modesto

    California · 40800

    Office

    $223.74

    Facility

    $120.87

    The same base rate than Merced for the office setting.

  • Napa

    California · 40800

    Office

    $261.91

    Facility

    $138.21

    $38.17 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 40800

    Office

    $238.77

    Facility

    $127.84

    $15.03 higher than Merced for the office setting.

  • Redding

    California · 40800

    Office

    $223.74

    Facility

    $120.87

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 40800

    Office

    $223.74

    Facility

    $120.87

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 40800

    Office

    $225.47

    Facility

    $122.60

    $1.73 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 40800

    Office

    $235.51

    Facility

    $126.35

    $11.77 higher than Merced for the office setting.

  • Salinas

    California · 40800

    Office

    $234.65

    Facility

    $125.87

    $10.91 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 40800

    Office

    $240.72

    Facility

    $128.47

    $16.98 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 40800

    Office

    $278.05

    Facility

    $145.71

    $54.31 higher than Merced for the office setting.

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

    California · 40800

    Office

    $277.87

    Facility

    $145.53

    $54.13 higher than Merced for the office setting.

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

    California · 40800

    Office

    $284.32

    Facility

    $148.98

    $60.58 higher than Merced for the office setting.

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

    California · 40800

    Office

    $283.58

    Facility

    $148.24

    $59.84 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 40800

    Office

    $230.80

    Facility

    $123.90

    $7.06 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 40800

    Office

    $243.45

    Facility

    $129.42

    $19.71 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 40800

    Office

    $235.68

    Facility

    $126.24

    $11.94 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 40800

    Office

    $245.95

    Facility

    $130.69

    $22.21 higher than Merced for the office setting.

  • Stockton

    California · 40800

    Office

    $223.74

    Facility

    $120.87

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 40800

    Office

    $261.65

    Facility

    $137.95

    $37.91 higher than Merced for the office setting.

  • Visalia

    California · 40800

    Office

    $223.74

    Facility

    $120.87

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 40800

    Office

    $223.74

    Facility

    $120.87

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 40800

    Office

    $241.78

    Facility

    $131.21

    $18.04 higher than Merced for the office setting.

  • Miami

    Florida · 40800

    Office

    $224.67

    Facility

    $126.96

    $0.93 higher than Merced for the office setting.

  • Chicago

    Illinois · 40800

    Office

    $217.78

    Facility

    $123.45

    $5.96 lower than Merced for the office setting.

  • Manhattan

    New York · 40800

    Office

    $242.08

    Facility

    $133.02

    $18.34 higher than Merced for the office setting.

  • Alaska*

    Alaska · 40800

    Office

    $238.08

    Facility

    $138.12

    $14.34 higher than Merced for the office setting.

  • Alabama

    Alabama · 40800

    Office

    $186.90

    Facility

    $104.77

    $36.84 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 40800

    Office

    $183.99

    Facility

    $103.37

    $39.75 lower than Merced for the office setting.

  • Arizona

    Arizona · 40800

    Office

    $203.89

    Facility

    $112.95

    $19.85 lower than Merced for the office setting.

  • Colorado

    Colorado · 40800

    Office

    $219.59

    Facility

    $119.72

    $4.15 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 40800

    Office

    $224.34

    Facility

    $123.25

    $0.60 higher than Merced for the office setting.

  • Delaware

    Delaware · 40800

    Office

    $207.45

    Facility

    $114.72

    $16.29 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 40800

    Office

    $216.21

    Facility

    $121.14

    $7.53 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 40800

    Office

    $205.22

    Facility

    $115.49

    $18.52 lower than Merced for the office setting.

  • Atlanta

    Georgia · 40800

    Office

    $213.58

    Facility

    $118.22

    $10.16 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 40800

    Office

    $193.04

    Facility

    $109.32

    $30.70 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 40800

    Office

    $230.02

    Facility

    $123.31

    $6.28 higher than Merced for the office setting.

  • Iowa

    Iowa · 40800

    Office

    $192.57

    Facility

    $106.69

    $31.17 lower than Merced for the office setting.

  • Idaho

    Idaho · 40800

    Office

    $193.79

    Facility

    $107.45

    $29.95 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 40800

    Office

    $202.03

    Facility

    $115.68

    $21.71 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 40800

    Office

    $198.47

    Facility

    $112.78

    $25.27 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 40800

    Office

    $218.60

    Facility

    $122.21

    $5.14 lower than Merced for the office setting.

  • Indiana

    Indiana · 40800

    Office

    $195.01

    Facility

    $108.01

    $28.73 lower than Merced for the office setting.

  • Kansas

    Kansas · 40800

    Office

    $191.33

    Facility

    $106.48

    $32.41 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 40800

    Office

    $191.06

    Facility

    $107.62

    $32.68 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 40800

    Office

    $200.79

    Facility

    $112.47

    $22.95 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 40800

    Office

    $190.63

    Facility

    $107.57

    $33.11 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 40800

    Office

    $242.69

    Facility

    $130.63

    $18.95 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 40800

    Office

    $218.02

    Facility

    $119.19

    $5.72 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 40800

    Office

    $223.66

    Facility

    $122.95

    $0.08 lower than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 40800

    Office

    $211.69

    Facility

    $116.71

    $12.05 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 40800

    Office

    $194.59

    Facility

    $108.24

    $29.15 lower than Merced for the office setting.

  • Southern Maine

    Maine · 40800

    Office

    $206.31

    Facility

    $113.29

    $17.43 lower than Merced for the office setting.

  • Detroit

    Michigan · 40800

    Office

    $207.67

    Facility

    $117.10

    $16.07 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 40800

    Office

    $196.15

    Facility

    $110.46

    $27.59 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 40800

    Office

    $210.76

    Facility

    $114.18

    $12.98 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 40800

    Office

    $199.61

    Facility

    $111.48

    $24.13 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 40800

    Office

    $201.88

    Facility

    $112.53

    $21.86 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 40800

    Office

    $186.94

    Facility

    $106.04

    $36.80 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 40800

    Office

    $185.52

    Facility

    $104.71

    $38.22 lower than Merced for the office setting.

  • Montana**

    Montana · 40800

    Office

    $209.75

    Facility

    $115.89

    $13.99 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 40800

    Office

    $196.82

    Facility

    $109.25

    $26.92 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 40800

    Office

    $206.58

    Facility

    $112.73

    $17.16 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 40800

    Office

    $193.78

    Facility

    $107.15

    $29.96 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 40800

    Office

    $215.83

    Facility

    $118.12

    $7.91 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 40800

    Office

    $238.94

    Facility

    $130.07

    $15.20 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 40800

    Office

    $227.00

    Facility

    $124.51

    $3.26 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 40800

    Office

    $197.19

    Facility

    $111.13

    $26.55 lower than Merced for the office setting.

  • Nevada**

    Nevada · 40800

    Office

    $209.03

    Facility

    $115.08

    $14.71 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 40800

    Office

    $247.96

    Facility

    $136.37

    $24.22 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 40800

    Office

    $228.30

    Facility

    $125.52

    $4.56 higher than Merced for the office setting.

  • Queens

    New York · 40800

    Office

    $244.59

    Facility

    $133.66

    $20.85 higher than Merced for the office setting.

  • Rest Of New York

    New York · 40800

    Office

    $199.95

    Facility

    $110.79

    $23.79 lower than Merced for the office setting.

  • Ohio

    Ohio · 40800

    Office

    $195.50

    Facility

    $109.81

    $28.24 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 40800

    Office

    $190.98

    Facility

    $107.17

    $32.76 lower than Merced for the office setting.

  • Portland

    Oregon · 40800

    Office

    $227.27

    Facility

    $123.00

    $3.53 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 40800

    Office

    $207.51

    Facility

    $114.03

    $16.23 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 40800

    Office

    $218.25

    Facility

    $120.54

    $5.49 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 40800

    Office

    $195.99

    Facility

    $109.83

    $27.75 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 40800

    Office

    $211.49

    Facility

    $116.60

    $12.25 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 40800

    Office

    $215.36

    Facility

    $118.41

    $8.38 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 40800

    Office

    $196.47

    Facility

    $109.74

    $27.27 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 40800

    Office

    $206.21

    Facility

    $112.35

    $17.53 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 40800

    Office

    $192.33

    Facility

    $107.01

    $31.41 lower than Merced for the office setting.

  • Austin

    Texas · 40800

    Office

    $218.76

    Facility

    $119.46

    $4.98 lower than Merced for the office setting.

  • Beaumont

    Texas · 40800

    Office

    $194.59

    Facility

    $109.18

    $29.15 lower than Merced for the office setting.

  • Brazoria

    Texas · 40800

    Office

    $207.42

    Facility

    $114.41

    $16.32 lower than Merced for the office setting.

  • Dallas

    Texas · 40800

    Office

    $208.70

    Facility

    $115.22

    $15.04 lower than Merced for the office setting.

  • Fort Worth

    Texas · 40800

    Office

    $207.13

    Facility

    $114.59

    $16.61 lower than Merced for the office setting.

  • Galveston

    Texas · 40800

    Office

    $208.01

    Facility

    $114.81

    $15.73 lower than Merced for the office setting.

  • Houston

    Texas · 40800

    Office

    $210.94

    Facility

    $117.74

    $12.80 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 40800

    Office

    $200.86

    Facility

    $111.79

    $22.88 lower than Merced for the office setting.

  • Utah

    Utah · 40800

    Office

    $199.35

    Facility

    $111.13

    $24.39 lower than Merced for the office setting.

  • Virginia

    Virginia · 40800

    Office

    $205.39

    Facility

    $113.13

    $18.35 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 40800

    Office

    $211.49

    Facility

    $116.60

    $12.25 lower than Merced for the office setting.

  • Vermont

    Vermont · 40800

    Office

    $205.47

    Facility

    $112.56

    $18.27 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 40800

    Office

    $217.71

    Facility

    $118.88

    $6.03 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 40800

    Office

    $248.09

    Facility

    $132.93

    $24.35 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 40800

    Office

    $199.16

    Facility

    $109.24

    $24.58 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 40800

    Office

    $190.53

    Facility

    $108.97

    $33.21 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 40800

    Office

    $208.37

    Facility

    $114.51

    $15.37 lower than Merced for the office setting.

See how rates vary across the country

40800 · 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.

$183.99

$254.03

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$238.081
AL$186.901
AR$183.991
AZ$203.891
CA$223.74–$284.3229
CO$219.591
CT$224.341
DC$241.781
DE$207.451
FL$205.22–$224.673
GA$193.04–$213.582
GU$230.021
HI$230.021
IA$192.571
ID$193.791
IL$198.47–$218.604
IN$195.011
KS$191.331
KY$191.061
LA$190.63–$200.792
MA$218.02–$242.692
MD$211.69–$241.783
ME$194.59–$206.312
MI$196.15–$207.672
MN$210.761
MO$186.94–$201.883
MS$185.521
MT$209.751
NC$196.821
ND$206.581
NE$193.781
NH$215.831
NJ$227.00–$238.942
NM$197.191
NV$209.031
NY$199.95–$247.965
OH$195.501
OK$190.981
OR$207.51–$227.272
PA$195.99–$218.252
PR$211.491
RI$215.361
SC$196.471
SD$206.211
TN$192.331
TX$194.59–$218.768
UT$199.351
VA$205.39–$241.782
VI$211.491
VT$205.471
WA$217.71–$248.092
WI$199.161
WV$190.531
WY$208.371

Explore 40800 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, 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 California →

Why are the office and facility amounts different?

For 40800 in Merced, the physician’s office rate is $223.74 and the facility-setting rate is $120.87: a difference of $102.87.

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 40800 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$246.11

$223.74 × 110% = $246.11

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.

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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 40800 in Merced.

PPRRVU2026_Oct_nonQPP.csv

4,857

Code
40800
Physician work
1.20
Practice expense
4.92
Malpractice
0.16

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 40800 in Merced
ComponentRVULocality factorAdjusted
Physician work1.20× 1.0171.2204
Practice expense4.92× 1.0965.3923
Malpractice0.16× 0.5360.0858
Total RVUs6.6985
Conversion factor× 33.4009

Office / nonfacility rate, Merced$223.74

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

Open 40800 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.21.017
Practice expense4.921.096
Malpractice0.160.536

(1.2 × 1.017 + 4.92 × 1.096 + 0.16 × 0.536) × $33.4009 = $223.74

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.21.017
Practice expense2.111.096
Malpractice0.160.536

(1.2 × 1.017 + 2.11 × 1.096 + 0.16 × 0.536) × $33.4009 = $120.87

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

40800 · Office / nonfacility

$223.74

Effective 2026-10-01

The base rate is $12.75 higher than on 2025-10-01, moving from $210.99 to $223.74 (6.0%).

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

    $210.99changed to$223.74

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.23 changed to 1.20
    • Practice expense RVU 4.76 changed to 4.92
    • Malpractice RVU 0.13 changed to 0.16
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $210.99

    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$223.74$120.87RVU26D
2026-07-01$223.74$120.87RVU26C
2026-04-01$223.74$120.87RVU26B
2026-01-01$223.74$120.87RVU26A
2025-10-01$210.99$123.66RVU25D
2025-07-01$210.99$123.66RVU25C
2025-04-01$210.99$123.66RVU25B
2025-01-01$210.99$123.66RVU25A

40800 billing questions

How is 40800 distinguished from 40801?

40800 is for simple drainage in the oral vestibule; 40801 is for complicated drainage. The procedure note should support the level selected.

When is a biopsy code more appropriate?

Use 40808 when the service is a biopsy of a vestibular lesion for tissue diagnosis, rather than simple drainage of a collection.

Can modifier 50 be used for collections on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Are related postoperative visits separately payable during the global period?

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

Can an assistant or co-surgeon be paid for this procedure?

Assistant-at-surgery services are not paid 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 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 40800PPRRVU2026_Oct_nonQPP.csv, line 4,857 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet