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CMS RVU26D · Effective 2026-10-01

40652 in Modesto

Office / nonfacility

$601.08

Base rate per service

Facility setting

$370.09

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.

Facial surgery

About 40652: Full-thickness lip repair below half height

Repair a full-thickness lip injury extending through the lip but involving less than half its vertical height, with extent and tissue involvement documented.

This code describes repair of a full-thickness lip injury that extends through the lip but involves less than half its vertical height. The injury may involve the external skin, lip muscle, and inner oral lining. A physician or other qualified surgeon typically performs the repair in an emergency department, operating room, or other setting where the injury is treated. Precise alignment of the lip edges, including the vermilion border when involved, helps restore the lip’s contour.

Choose the code based on the injury’s depth and vertical extent, and document the involved layers and proportion of lip height affected. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 40652

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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 RVU4.32 · 25%
  • Practice expense (office) RVU12.01 · 70%
  • Malpractice RVU0.82 · 5%

249

Medicare services in 2024 · #4142 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.

40652 compared with similar codes

Office rates for Modesto, from the same CMS release.

40650

Lip repair

Vermilion only

$603.47

Choose 40650 when the full-thickness repair is limited to the vermilion. This code describes a full-thickness injury involving less than half the lip’s vertical height.

40654

Lip repair

Full thickness, over half height

$645.60

Choose 40654 when the full-thickness repair involves more than half the lip’s vertical height or is complex; this code is for the less-than-half-height repair.

12011

Wound repair

Face, 2.5 cm or less

$145.97

12011 describes repair of qualifying superficial facial wounds, including lip wounds. It is not the choice for a full-thickness injury extending through the lip.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 40652 is $603.37—$2.29 higher than the $601.08 rate in Modesto. Both use the same code, release and participation basis.

40652 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $601.08

  2. Bakersfield

    $603.37

    $2.29 higher than Modesto

  3. Chico

    $601.08

    The same base rate than Modesto

  4. El Centro

    $601.22

    $0.14 higher than Modesto

  5. Fresno

    $601.08

    The same base rate than Modesto

  6. Hanford-Corcoran

    $601.08

    The same base rate than Modesto

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

    $642.95

    $41.87 higher than Modesto

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, 40652 ranges from $502.98 in Arkansas to $753.30 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 · 40652

    Office

    $601.08

    Facility

    $370.09

    The same base rate than Modesto for the office setting.

  • Merced

    California · 40652

    Office

    $601.08

    Facility

    $370.09

    The same base rate than Modesto for the office setting.

  • Napa

    California · 40652

    Office

    $696.00

    Facility

    $418.22

    $94.92 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 40652

    Office

    $639.55

    Facility

    $390.43

    $38.47 higher than Modesto for the office setting.

  • Redding

    California · 40652

    Office

    $601.08

    Facility

    $370.09

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 40652

    Office

    $601.08

    Facility

    $370.09

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 40652

    Office

    $609.91

    Facility

    $378.91

    $8.83 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 40652

    Office

    $630.70

    Facility

    $385.58

    $29.62 higher than Modesto for the office setting.

  • Salinas

    California · 40652

    Office

    $628.37

    Facility

    $384.10

    $27.29 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 40652

    Office

    $643.23

    Facility

    $391.17

    $42.15 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 40652

    Office

    $736.19

    Facility

    $439.01

    $135.11 higher than Modesto for the office setting.

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

    California · 40652

    Office

    $735.25

    Facility

    $438.08

    $134.17 higher than Modesto for the office setting.

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

    California · 40652

    Office

    $753.30

    Facility

    $449.38

    $152.22 higher than Modesto for the office setting.

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

    California · 40652

    Office

    $749.49

    Facility

    $445.57

    $148.41 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 40652

    Office

    $618.33

    Facility

    $378.27

    $17.25 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 40652

    Office

    $649.39

    Facility

    $393.32

    $48.31 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 40652

    Office

    $630.75

    Facility

    $385.00

    $29.67 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 40652

    Office

    $655.91

    Facility

    $397.09

    $54.83 higher than Modesto for the office setting.

  • Stockton

    California · 40652

    Office

    $601.08

    Facility

    $370.09

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 40652

    Office

    $694.66

    Facility

    $416.88

    $93.58 higher than Modesto for the office setting.

  • Visalia

    California · 40652

    Office

    $601.08

    Facility

    $370.09

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 40652

    Office

    $601.08

    Facility

    $370.09

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 40652

    Office

    $655.12

    Facility

    $406.84

    $54.04 higher than Modesto for the office setting.

  • Miami

    Florida · 40652

    Office

    $631.15

    Facility

    $411.75

    $30.07 higher than Modesto for the office setting.

  • Chicago

    Illinois · 40652

    Office

    $611.31

    Facility

    $399.50

    $10.23 higher than Modesto for the office setting.

  • Manhattan

    New York · 40652

    Office

    $663.10

    Facility

    $418.19

    $62.02 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 40652

    Office

    $658.75

    Facility

    $434.29

    $57.67 higher than Modesto for the office setting.

  • Alabama

    Alabama · 40652

    Office

    $510.80

    Facility

    $326.38

    $90.28 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 40652

    Office

    $502.98

    Facility

    $321.94

    $98.10 lower than Modesto for the office setting.

  • Arizona

    Arizona · 40652

    Office

    $556.45

    Facility

    $352.22

    $44.63 lower than Modesto for the office setting.

  • Colorado

    Colorado · 40652

    Office

    $594.23

    Facility

    $369.98

    $6.85 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 40652

    Office

    $612.35

    Facility

    $385.36

    $11.27 higher than Modesto for the office setting.

  • Delaware

    Delaware · 40652

    Office

    $565.97

    Facility

    $357.74

    $35.11 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 40652

    Office

    $600.17

    Facility

    $386.67

    $0.91 lower than Modesto for the office setting.

  • Rest Of Florida

    Florida · 40652

    Office

    $568.95

    Facility

    $367.47

    $32.13 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 40652

    Office

    $585.18

    Facility

    $371.05

    $15.90 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 40652

    Office

    $534.76

    Facility

    $346.76

    $66.32 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 40652

    Office

    $616.25

    Facility

    $376.62

    $15.17 higher than Modesto for the office setting.

  • Iowa

    Iowa · 40652

    Office

    $522.21

    Facility

    $329.37

    $78.87 lower than Modesto for the office setting.

  • Idaho

    Idaho · 40652

    Office

    $526.30

    Facility

    $332.40

    $74.78 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 40652

    Office

    $568.51

    Facility

    $374.61

    $32.57 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 40652

    Office

    $553.35

    Facility

    $360.92

    $47.73 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 40652

    Office

    $605.81

    Facility

    $389.36

    $4.73 higher than Modesto for the office setting.

  • Indiana

    Indiana · 40652

    Office

    $529.46

    Facility

    $334.09

    $71.62 lower than Modesto for the office setting.

  • Kansas

    Kansas · 40652

    Office

    $520.73

    Facility

    $330.20

    $80.35 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 40652

    Office

    $525.97

    Facility

    $338.60

    $75.11 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 40652

    Office

    $552.88

    Facility

    $354.56

    $48.20 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 40652

    Office

    $525.54

    Facility

    $339.02

    $75.54 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 40652

    Office

    $653.55

    Facility

    $401.90

    $52.47 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 40652

    Office

    $590.83

    Facility

    $368.90

    $10.25 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 40652

    Office

    $610.91

    Facility

    $384.76

    $9.83 higher than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 40652

    Office

    $576.84

    Facility

    $363.55

    $24.24 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 40652

    Office

    $530.38

    Facility

    $336.48

    $70.70 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 40652

    Office

    $559.11

    Facility

    $350.25

    $41.97 lower than Modesto for the office setting.

  • Detroit

    Michigan · 40652

    Office

    $577.57

    Facility

    $374.19

    $23.51 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 40652

    Office

    $541.46

    Facility

    $349.04

    $59.62 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 40652

    Office

    $565.18

    Facility

    $348.31

    $35.90 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 40652

    Office

    $547.73

    Facility

    $349.82

    $53.35 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 40652

    Office

    $553.63

    Facility

    $352.98

    $47.45 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 40652

    Office

    $516.76

    Facility

    $335.08

    $84.32 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 40652

    Office

    $509.92

    Facility

    $328.45

    $91.16 lower than Modesto for the office setting.

  • Montana**

    Montana · 40652

    Office

    $572.77

    Facility

    $362.01

    $28.31 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 40652

    Office

    $536.06

    Facility

    $339.42

    $65.02 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 40652

    Office

    $556.56

    Facility

    $345.80

    $44.52 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 40652

    Office

    $524.90

    Facility

    $330.37

    $76.18 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 40652

    Office

    $585.85

    Facility

    $366.45

    $15.23 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 40652

    Office

    $647.96

    Facility

    $403.48

    $46.88 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 40652

    Office

    $618.16

    Facility

    $388.01

    $17.08 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 40652

    Office

    $545.04

    Facility

    $351.77

    $56.04 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 40652

    Office

    $568.65

    Facility

    $357.68

    $32.43 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 40652

    Office

    $681.35

    Facility

    $430.76

    $80.27 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 40652

    Office

    $623.18

    Facility

    $392.40

    $22.10 higher than Modesto for the office setting.

  • Queens

    New York · 40652

    Office

    $667.17

    Facility

    $418.06

    $66.09 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 40652

    Office

    $544.63

    Facility

    $344.41

    $56.45 lower than Modesto for the office setting.

  • Ohio

    Ohio · 40652

    Office

    $538.14

    Facility

    $345.72

    $62.94 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 40652

    Office

    $523.80

    Facility

    $335.59

    $77.28 lower than Modesto for the office setting.

  • Portland

    Oregon · 40652

    Office

    $612.65

    Facility

    $378.50

    $11.57 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 40652

    Office

    $563.09

    Facility

    $353.17

    $37.99 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 40652

    Office

    $597.16

    Facility

    $377.75

    $3.92 lower than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 40652

    Office

    $538.43

    Facility

    $344.95

    $62.65 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 40652

    Office

    $576.83

    Facility

    $363.75

    $24.25 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 40652

    Office

    $585.85

    Facility

    $368.13

    $15.23 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 40652

    Office

    $538.23

    Facility

    $343.49

    $62.85 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 40652

    Office

    $554.64

    Facility

    $343.88

    $46.44 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 40652

    Office

    $523.64

    Facility

    $332.06

    $77.44 lower than Modesto for the office setting.

  • Austin

    Texas · 40652

    Office

    $593.26

    Facility

    $370.27

    $7.82 lower than Modesto for the office setting.

  • Beaumont

    Texas · 40652

    Office

    $534.78

    Facility

    $342.99

    $66.30 lower than Modesto for the office setting.

  • Brazoria

    Texas · 40652

    Office

    $564.34

    Facility

    $355.48

    $36.74 lower than Modesto for the office setting.

  • Dallas

    Texas · 40652

    Office

    $568.63

    Facility

    $358.71

    $32.45 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 40652

    Office

    $564.97

    Facility

    $357.17

    $36.11 lower than Modesto for the office setting.

  • Galveston

    Texas · 40652

    Office

    $566.46

    Facility

    $357.18

    $34.62 lower than Modesto for the office setting.

  • Houston

    Texas · 40652

    Office

    $581.47

    Facility

    $372.19

    $19.61 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 40652

    Office

    $549.71

    Facility

    $349.70

    $51.37 lower than Modesto for the office setting.

  • Utah

    Utah · 40652

    Office

    $545.96

    Facility

    $347.85

    $55.12 lower than Modesto for the office setting.

  • Virginia

    Virginia · 40652

    Office

    $557.95

    Facility

    $350.78

    $43.13 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 40652

    Office

    $576.83

    Facility

    $363.75

    $24.25 lower than Modesto for the office setting.

  • Vermont

    Vermont · 40652

    Office

    $555.28

    Facility

    $346.63

    $45.80 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 40652

    Office

    $589.42

    Facility

    $367.49

    $11.66 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 40652

    Office

    $666.09

    Facility

    $407.49

    $65.01 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 40652

    Office

    $537.02

    Facility

    $335.12

    $64.06 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 40652

    Office

    $532.08

    Facility

    $348.93

    $69.00 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 40652

    Office

    $565.70

    Facility

    $354.94

    $35.38 lower than Modesto for the office setting.

See how rates vary across the country

40652 · 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.

$502.98

$677.19

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$658.751
AL$510.801
AR$502.981
AZ$556.451
CA$601.08–$753.3029
CO$594.231
CT$612.351
DC$655.121
DE$565.971
FL$568.95–$631.153
GA$534.76–$585.182
GU$616.251
HI$616.251
IA$522.211
ID$526.301
IL$553.35–$611.314
IN$529.461
KS$520.731
KY$525.971
LA$525.54–$552.882
MA$590.83–$653.552
MD$576.84–$655.123
ME$530.38–$559.112
MI$541.46–$577.572
MN$565.181
MO$516.76–$553.633
MS$509.921
MT$572.771
NC$536.061
ND$556.561
NE$524.901
NH$585.851
NJ$618.16–$647.962
NM$545.041
NV$568.651
NY$544.63–$681.355
OH$538.141
OK$523.801
OR$563.09–$612.652
PA$538.43–$597.162
PR$576.831
RI$585.851
SC$538.231
SD$554.641
TN$523.641
TX$534.78–$593.268
UT$545.961
VA$557.95–$655.122
VI$576.831
VT$555.281
WA$589.42–$666.092
WI$537.021
WV$532.081
WY$565.701

Explore 40652 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 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 40652 in Modesto, the physician’s office rate is $601.08 and the facility-setting rate is $370.09: a difference of $230.99.

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 40652 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$661.19

$601.08 × 110% = $661.19

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 40652 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

4,840

Code
40652
Physician work
4.32
Practice expense
12.01
Malpractice
0.82

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 40652 in Modesto
ComponentRVULocality factorAdjusted
Physician work4.32× 1.0174.3934
Practice expense12.01× 1.09613.1630
Malpractice0.82× 0.5360.4395
Total RVUs17.9959
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$601.08

Open 40652 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.321.017
Practice expense12.011.096
Malpractice0.820.536

(4.32 × 1.017 + 12.01 × 1.096 + 0.82 × 0.536) × $33.4009 = $601.08

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.321.017
Practice expense5.71.096
Malpractice0.820.536

(4.32 × 1.017 + 5.7 × 1.096 + 0.82 × 0.536) × $33.4009 = $370.09

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

40652 · Office / nonfacility

$601.08

Effective 2026-10-01

The base rate is $70.25 higher than on 2025-10-01, moving from $530.83 to $601.08 (13.2%).

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

    $530.83changed to$601.08

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.43 changed to 4.32
    • Practice expense RVU 10.51 changed to 12.01
    • Malpractice RVU 0.77 changed to 0.82
    • 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: $530.83

    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$601.08$370.09RVU26D
2026-07-01$601.08$370.09RVU26C
2026-04-01$601.08$370.09RVU26B
2026-01-01$601.08$370.09RVU26A
2025-10-01$530.83$367.49RVU25D
2025-07-01$530.83$367.49RVU25C
2025-04-01$530.83$367.49RVU25B
2025-01-01$530.83$367.49RVU25A

40652 billing questions

How does this differ from 40650?

40652 is for a full-thickness injury involving less than half the lip’s vertical height. 40650 is for a full-thickness repair limited to the vermilion.

When is 40654 the better choice?

Use 40654 for a full-thickness repair involving more than half the lip’s vertical height or a complex repair. Document the extent and complexity supporting that selection.

What should the operative note document?

Document that the injury is full thickness, the lip layers involved, and how much of the lip’s vertical height is affected. Include the repair details and any complexity relevant to code selection.

Can modifier 50 be used for a repair on both sides?

No. CMS identifies modifier 50 as inappropriate for this code because of its descriptor or anatomy.

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 surgeon be paid?

CMS assistant-at-surgery payment is allowed only when medical necessity is documented. 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 40652PPRRVU2026_Oct_nonQPP.csv, line 4,840 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet