FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

40490 in Vallejo

Office / nonfacility

$144.90

Base rate per service

Facility setting

$60.38

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.

Surgical procedure

About 40490: Lip lesion biopsy

Reports a biopsy of lip tissue to obtain a specimen from a suspicious lip lesion for diagnostic examination.

A clinician removes a tissue sample from a lip lesion for diagnostic evaluation. This service is commonly performed by dermatologists, otolaryngologists, oral surgeons, and other clinicians who evaluate lip abnormalities in an office or facility setting. The target must be on the lip; a lesion elsewhere in the mouth has a site-specific biopsy code. A biopsy obtains a diagnostic sample rather than removing a lesion as definitive treatment.

Select the code from the documented biopsy site and procedure, and retain the operative note describing the lip location, lesion, and tissue sampled. The specimen may be sent for separate pathology evaluation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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 code. CMS does not pay for an assistant at surgery, co-surgeons, or team surgery for this service.

CMS billing rules for 40490

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU1.19 · 33%
  • Practice expense (office) RVU2.29 · 64%
  • Malpractice RVU0.12 · 3%

26.4K

Medicare services in 2024 · #1026 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.

40490 compared with similar codes

Office rates for Vallejo, from the same CMS release.

40808

Mouth biopsy

Oral vestibule

$208.73

40490 is for lip tissue; 40808 is for a lesion in the vestibule of the mouth. Base selection on the documented biopsy site.

41100

Tongue biopsy

Anterior two-thirds

$230.64

Use 41100 when the sampled lesion is on the tongue. A lip lesion is reported with 40490.

11104

Punch biopsy

Single skin lesion

$150.32

11104 describes a punch biopsy of a skin lesion. Consider it for a skin target outside the lip, rather than a biopsy of lip tissue.

The same code, a different location

How does Vallejo compare?

In Bakersfield, the office rate for 40490 is $126.77—$18.13 lower than the $144.90 rate in Vallejo. Both use the same code, release and participation basis.

40490 across payment areas

Same release and payment basis · bars start at $0

  1. Vallejo · This locality

    $144.90

  2. Bakersfield

    $126.77

    $18.13 lower than Vallejo

  3. Chico

    $126.40

    $18.50 lower than Vallejo

  4. El Centro

    $126.42

    $18.48 lower than Vallejo

  5. Fresno

    $126.40

    $18.50 lower than Vallejo

  6. Hanford-Corcoran

    $126.40

    $18.50 lower than Vallejo

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

    $134.52

    $10.38 lower than Vallejo

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, 40490 ranges from $107.51 in Arkansas to $156.56 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 · 40490

    Office

    $126.40

    Facility

    $56.12

    $18.50 lower than Vallejo for the office setting.

  • Merced

    California · 40490

    Office

    $126.40

    Facility

    $56.12

    $18.50 lower than Vallejo for the office setting.

  • Modesto

    California · 40490

    Office

    $126.40

    Facility

    $56.12

    $18.50 lower than Vallejo for the office setting.

  • Napa

    California · 40490

    Office

    $145.10

    Facility

    $60.58

    $0.20 higher than Vallejo for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 40490

    Office

    $133.77

    Facility

    $57.96

    $11.13 lower than Vallejo for the office setting.

  • Redding

    California · 40490

    Office

    $126.40

    Facility

    $56.12

    $18.50 lower than Vallejo for the office setting.

  • Rest Of California

    California · 40490

    Office

    $126.40

    Facility

    $56.12

    $18.50 lower than Vallejo for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 40490

    Office

    $127.71

    Facility

    $57.43

    $17.19 lower than Vallejo for the office setting.

  • Sacramento-Roseville-Folsom

    California · 40490

    Office

    $132.28

    Facility

    $57.70

    $12.62 lower than Vallejo for the office setting.

  • Salinas

    California · 40490

    Office

    $131.78

    Facility

    $57.45

    $13.12 lower than Vallejo for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 40490

    Office

    $134.59

    Facility

    $57.89

    $10.31 lower than Vallejo for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 40490

    Office

    $153.21

    Facility

    $62.79

    $8.31 higher than Vallejo for the office setting.

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

    California · 40490

    Office

    $153.07

    Facility

    $62.65

    $8.17 higher than Vallejo for the office setting.

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

    California · 40490

    Office

    $156.56

    Facility

    $64.09

    $11.66 higher than Vallejo for the office setting.

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

    California · 40490

    Office

    $156.01

    Facility

    $63.53

    $11.11 higher than Vallejo for the office setting.

  • San Luis Obispo-Paso Robles

    California · 40490

    Office

    $129.69

    Facility

    $56.65

    $15.21 lower than Vallejo for the office setting.

  • Santa Cruz-Watsonville

    California · 40490

    Office

    $135.66

    Facility

    $57.75

    $9.24 lower than Vallejo for the office setting.

  • Santa Maria-Santa Barbara

    California · 40490

    Office

    $132.19

    Facility

    $57.42

    $12.71 lower than Vallejo for the office setting.

  • Santa Rosa-Petaluma

    California · 40490

    Office

    $137.02

    Facility

    $58.26

    $7.88 lower than Vallejo for the office setting.

  • Stockton

    California · 40490

    Office

    $126.40

    Facility

    $56.12

    $18.50 lower than Vallejo for the office setting.

  • Visalia

    California · 40490

    Office

    $126.40

    Facility

    $56.12

    $18.50 lower than Vallejo for the office setting.

  • Yuba City

    California · 40490

    Office

    $126.40

    Facility

    $56.12

    $18.50 lower than Vallejo for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 40490

    Office

    $136.46

    Facility

    $60.91

    $8.44 lower than Vallejo for the office setting.

  • Miami

    Florida · 40490

    Office

    $129.51

    Facility

    $62.75

    $15.39 lower than Vallejo for the office setting.

  • Chicago

    Illinois · 40490

    Office

    $126.09

    Facility

    $61.64

    $18.81 lower than Vallejo for the office setting.

  • Manhattan

    New York · 40490

    Office

    $137.53

    Facility

    $63.01

    $7.37 lower than Vallejo for the office setting.

  • Alaska*

    Alaska · 40490

    Office

    $143.29

    Facility

    $74.99

    $1.61 lower than Vallejo for the office setting.

  • Alabama

    Alabama · 40490

    Office

    $108.94

    Facility

    $52.83

    $35.96 lower than Vallejo for the office setting.

  • Arkansas

    Arkansas · 40490

    Office

    $107.51

    Facility

    $52.43

    $37.39 lower than Vallejo for the office setting.

  • Arizona

    Arizona · 40490

    Office

    $117.29

    Facility

    $55.15

    $27.61 lower than Vallejo for the office setting.

  • Colorado

    Colorado · 40490

    Office

    $124.74

    Facility

    $56.50

    $20.16 lower than Vallejo for the office setting.

  • Connecticut

    Connecticut · 40490

    Office

    $127.77

    Facility

    $58.70

    $17.13 lower than Vallejo for the office setting.

  • Delaware

    Delaware · 40490

    Office

    $119.12

    Facility

    $55.76

    $25.78 lower than Vallejo for the office setting.

  • Fort Lauderdale

    Florida · 40490

    Office

    $124.48

    Facility

    $59.51

    $20.42 lower than Vallejo for the office setting.

  • Rest Of Florida

    Florida · 40490

    Office

    $118.89

    Facility

    $57.59

    $26.01 lower than Vallejo for the office setting.

  • Atlanta

    Georgia · 40490

    Office

    $122.39

    Facility

    $57.24

    $22.51 lower than Vallejo for the office setting.

  • Rest Of Georgia

    Georgia · 40490

    Office

    $112.75

    Facility

    $55.55

    $32.15 lower than Vallejo for the office setting.

  • Hawaii, Guam

    Hawaii · 40490

    Office

    $129.03

    Facility

    $56.12

    $15.87 lower than Vallejo for the office setting.

  • Iowa

    Iowa · 40490

    Office

    $111.32

    Facility

    $52.65

    $33.58 lower than Vallejo for the office setting.

  • Idaho

    Idaho · 40490

    Office

    $112.01

    Facility

    $53.01

    $32.89 lower than Vallejo for the office setting.

  • East St. Louis

    Illinois · 40490

    Office

    $118.19

    Facility

    $59.19

    $26.71 lower than Vallejo for the office setting.

  • Rest Of Illinois

    Illinois · 40490

    Office

    $115.85

    Facility

    $57.29

    $29.05 lower than Vallejo for the office setting.

  • Suburban Chicago

    Illinois · 40490

    Office

    $125.68

    Facility

    $59.82

    $19.22 lower than Vallejo for the office setting.

  • Indiana

    Indiana · 40490

    Office

    $112.60

    Facility

    $53.15

    $32.30 lower than Vallejo for the office setting.

  • Kansas

    Kansas · 40490

    Office

    $110.91

    Facility

    $52.94

    $33.99 lower than Vallejo for the office setting.

  • Kentucky

    Kentucky · 40490

    Office

    $111.41

    Facility

    $54.40

    $33.49 lower than Vallejo for the office setting.

  • New Orleans

    Louisiana · 40490

    Office

    $116.28

    Facility

    $55.93

    $28.62 lower than Vallejo for the office setting.

  • Rest Of Louisiana

    Louisiana · 40490

    Office

    $111.28

    Facility

    $54.52

    $33.62 lower than Vallejo for the office setting.

  • Metropolitan Boston

    Massachusetts · 40490

    Office

    $136.27

    Facility

    $59.70

    $8.63 lower than Vallejo for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 40490

    Office

    $124.12

    Facility

    $56.59

    $20.78 lower than Vallejo for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 40490

    Office

    $127.41

    Facility

    $58.60

    $17.49 lower than Vallejo for the office setting.

  • Rest Of Maryland

    Maryland · 40490

    Office

    $121.23

    Facility

    $56.33

    $23.67 lower than Vallejo for the office setting.

  • Rest Of Maine

    Maine · 40490

    Office

    $112.61

    Facility

    $53.61

    $32.29 lower than Vallejo for the office setting.

  • Southern Maine

    Maine · 40490

    Office

    $118.08

    Facility

    $54.52

    $26.82 lower than Vallejo for the office setting.

  • Detroit

    Michigan · 40490

    Office

    $120.32

    Facility

    $58.43

    $24.58 lower than Vallejo for the office setting.

  • Rest Of Michigan

    Michigan · 40490

    Office

    $114.11

    Facility

    $55.56

    $30.79 lower than Vallejo for the office setting.

  • Minnesota

    Minnesota · 40490

    Office

    $119.64

    Facility

    $53.65

    $25.26 lower than Vallejo for the office setting.

  • Metropolitan Kansas City

    Missouri · 40490

    Office

    $115.49

    Facility

    $55.27

    $29.41 lower than Vallejo for the office setting.

  • Metropolitan St. Louis

    Missouri · 40490

    Office

    $116.58

    Facility

    $55.53

    $28.32 lower than Vallejo for the office setting.

  • Rest Of Missouri

    Missouri · 40490

    Office

    $109.58

    Facility

    $54.30

    $35.32 lower than Vallejo for the office setting.

  • Mississippi

    Mississippi · 40490

    Office

    $108.57

    Facility

    $53.35

    $36.33 lower than Vallejo for the office setting.

  • Montana**

    Montana · 40490

    Office

    $120.24

    Facility

    $56.11

    $24.66 lower than Vallejo for the office setting.

  • North Carolina

    North Carolina · 40490

    Office

    $113.67

    Facility

    $53.84

    $31.23 lower than Vallejo for the office setting.

  • North Dakota**

    North Dakota · 40490

    Office

    $117.86

    Facility

    $53.73

    $27.04 lower than Vallejo for the office setting.

  • Nebraska

    Nebraska · 40490

    Office

    $111.86

    Facility

    $52.67

    $33.04 lower than Vallejo for the office setting.

  • New Hampshire

    New Hampshire · 40490

    Office

    $122.88

    Facility

    $56.12

    $22.02 lower than Vallejo for the office setting.

  • Northern Nj

    New Jersey · 40490

    Office

    $135.26

    Facility

    $60.87

    $9.64 lower than Vallejo for the office setting.

  • Rest Of New Jersey

    New Jersey · 40490

    Office

    $129.26

    Facility

    $59.23

    $15.64 lower than Vallejo for the office setting.

  • New Mexico

    New Mexico · 40490

    Office

    $114.70

    Facility

    $55.89

    $30.20 lower than Vallejo for the office setting.

  • Nevada**

    Nevada · 40490

    Office

    $119.65

    Facility

    $55.46

    $25.25 lower than Vallejo for the office setting.

  • Nyc Suburbs/Long Island

    New York · 40490

    Office

    $140.68

    Facility

    $64.43

    $4.22 lower than Vallejo for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 40490

    Office

    $130.14

    Facility

    $59.92

    $14.76 lower than Vallejo for the office setting.

  • Queens

    New York · 40490

    Office

    $138.48

    Facility

    $62.68

    $6.42 lower than Vallejo for the office setting.

  • Rest Of New York

    New York · 40490

    Office

    $115.23

    Facility

    $54.31

    $29.67 lower than Vallejo for the office setting.

  • Ohio

    Ohio · 40490

    Office

    $113.62

    Facility

    $55.07

    $31.28 lower than Vallejo for the office setting.

  • Oklahoma

    Oklahoma · 40490

    Office

    $111.17

    Facility

    $53.90

    $33.73 lower than Vallejo for the office setting.

  • Portland

    Oregon · 40490

    Office

    $128.34

    Facility

    $57.10

    $16.56 lower than Vallejo for the office setting.

  • Rest Of Oregon

    Oregon · 40490

    Office

    $118.75

    Facility

    $54.87

    $26.15 lower than Vallejo for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 40490

    Office

    $124.87

    Facility

    $58.11

    $20.03 lower than Vallejo for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 40490

    Office

    $113.75

    Facility

    $54.88

    $31.15 lower than Vallejo for the office setting.

  • Puerto Rico

    Puerto Rico · 40490

    Office

    $121.02

    Facility

    $56.19

    $23.88 lower than Vallejo for the office setting.

  • Rhode Island

    Rhode Island · 40490

    Office

    $123.09

    Facility

    $56.84

    $21.81 lower than Vallejo for the office setting.

  • South Carolina

    South Carolina · 40490

    Office

    $113.83

    Facility

    $54.57

    $31.07 lower than Vallejo for the office setting.

  • South Dakota**

    South Dakota · 40490

    Office

    $117.58

    Facility

    $53.45

    $27.32 lower than Vallejo for the office setting.

  • Tennessee

    Tennessee · 40490

    Office

    $111.43

    Facility

    $53.13

    $33.47 lower than Vallejo for the office setting.

  • Austin

    Texas · 40490

    Office

    $124.30

    Facility

    $56.45

    $20.60 lower than Vallejo for the office setting.

  • Beaumont

    Texas · 40490

    Office

    $113.07

    Facility

    $54.72

    $31.83 lower than Vallejo for the office setting.

  • Brazoria

    Texas · 40490

    Office

    $118.99

    Facility

    $55.44

    $25.91 lower than Vallejo for the office setting.

  • Dallas

    Texas · 40490

    Office

    $119.73

    Facility

    $55.85

    $25.17 lower than Vallejo for the office setting.

  • Fort Worth

    Texas · 40490

    Office

    $119.01

    Facility

    $55.78

    $25.89 lower than Vallejo for the office setting.

  • Galveston

    Texas · 40490

    Office

    $119.34

    Facility

    $55.66

    $25.56 lower than Vallejo for the office setting.

  • Houston

    Texas · 40490

    Office

    $121.53

    Facility

    $57.85

    $23.37 lower than Vallejo for the office setting.

  • Rest Of Texas

    Texas · 40490

    Office

    $115.95

    Facility

    $55.09

    $28.95 lower than Vallejo for the office setting.

  • Utah

    Utah · 40490

    Office

    $115.25

    Facility

    $54.96

    $29.65 lower than Vallejo for the office setting.

  • Virginia

    Virginia · 40490

    Office

    $117.76

    Facility

    $54.73

    $27.14 lower than Vallejo for the office setting.

  • Virgin Islands

    United States Virgin Islands · 40490

    Office

    $121.02

    Facility

    $56.19

    $23.88 lower than Vallejo for the office setting.

  • Vermont

    Vermont · 40490

    Office

    $117.50

    Facility

    $54.01

    $27.40 lower than Vallejo for the office setting.

  • Rest Of Washington

    Washington · 40490

    Office

    $123.86

    Facility

    $56.33

    $21.04 lower than Vallejo for the office setting.

  • Seattle (King Cnty)

    Washington · 40490

    Office

    $138.86

    Facility

    $60.17

    $6.04 lower than Vallejo for the office setting.

  • Wisconsin

    Wisconsin · 40490

    Office

    $114.26

    Facility

    $52.82

    $30.64 lower than Vallejo for the office setting.

  • West Virginia

    West Virginia · 40490

    Office

    $111.95

    Facility

    $56.22

    $32.95 lower than Vallejo for the office setting.

  • Wyoming**

    Wyoming · 40490

    Office

    $119.20

    Facility

    $55.07

    $25.70 lower than Vallejo for the office setting.

See how rates vary across the country

40490 · 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.

$107.51

$143.29

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$143.291
AL$108.941
AR$107.511
AZ$117.291
CA$126.40–$156.5629
CO$124.741
CT$127.771
DC$136.461
DE$119.121
FL$118.89–$129.513
GA$112.75–$122.392
GU$129.031
HI$129.031
IA$111.321
ID$112.011
IL$115.85–$126.094
IN$112.601
KS$110.911
KY$111.411
LA$111.28–$116.282
MA$124.12–$136.272
MD$121.23–$136.463
ME$112.61–$118.082
MI$114.11–$120.322
MN$119.641
MO$109.58–$116.583
MS$108.571
MT$120.241
NC$113.671
ND$117.861
NE$111.861
NH$122.881
NJ$129.26–$135.262
NM$114.701
NV$119.651
NY$115.23–$140.685
OH$113.621
OK$111.171
OR$118.75–$128.342
PA$113.75–$124.872
PR$121.021
RI$123.091
SC$113.831
SD$117.581
TN$111.431
TX$113.07–$124.308
UT$115.251
VA$117.76–$136.462
VI$121.021
VT$117.501
WA$123.86–$138.862
WI$114.261
WV$111.951
WY$119.201

Explore 40490 on the national rate map →

Where does this rate apply?

Vallejo is a Medicare payment area. Our Census mapping connects it to 11 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 40490 in Vallejo, the physician’s office rate is $144.90 and the facility-setting rate is $60.38: a difference of $84.52.

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 40490 in Vallejo. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$159.39

$144.90 × 110% = $159.39

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 40490 in Vallejo.

PPRRVU2026_Oct_nonQPP.csv

4,819

Code
40490
Physician work
1.19
Practice expense
2.29
Malpractice
0.12

GPCI2026.csv

33

Locality
Vallejo
Physician work
1.063
Practice expense
1.318
Malpractice
0.459
Office / nonfacility calculation for 40490 in Vallejo
ComponentRVULocality factorAdjusted
Physician work1.19× 1.0631.2650
Practice expense2.29× 1.3183.0182
Malpractice0.12× 0.4590.0551
Total RVUs4.3383
Conversion factor× 33.4009

Office / nonfacility rate, Vallejo$144.90

Open 40490 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.191.063
Practice expense2.291.318
Malpractice0.120.459

(1.19 × 1.063 + 2.29 × 1.318 + 0.12 × 0.459) × $33.4009 = $144.90

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.191.063
Practice expense0.371.318
Malpractice0.120.459

(1.19 × 1.063 + 0.37 × 1.318 + 0.12 × 0.459) × $33.4009 = $60.38

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

40490 · Office / nonfacility

$144.90

Effective 2026-10-01

The base rate is $3.29 higher than on 2025-10-01, moving from $141.61 to $144.90 (2.3%).

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

    $141.61changed to$144.90

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.22 changed to 1.19
    • Practice expense RVU 2.31 changed to 2.29
    • Malpractice RVU 0.13 changed to 0.12
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $141.61

    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$144.90$60.38RVU26D
2026-07-01$144.90$60.38RVU26C
2026-04-01$144.90$60.38RVU26B
2026-01-01$144.90$60.38RVU26A
2025-10-01$141.61$74.66RVU25D
2025-07-01$141.61$74.66RVU25C
2025-04-01$141.61$74.66RVU25B
2025-01-01$141.61$74.66RVU25A

40490 billing questions

How is 40490 distinguished from a biopsy elsewhere in the mouth?

Use 40490 when the sampled tissue is on the lip. Biopsies of the tongue, floor of mouth, palate, or oral vestibule have site-specific codes.

Is 40490 a biopsy or an excision?

It reports obtaining a diagnostic tissue sample from the lip. If the procedure removes a lesion rather than sampling it for diagnosis, evaluate the applicable excision code instead.

Can modifier 50 be used when both lips are sampled?

No. CMS bilateral adjustment does not apply to 40490, and modifier 50 is inappropriate for this descriptor and anatomy.

What same-day care is included?

The 0-day global period includes the related preoperative and postoperative care furnished on the procedure date.

How does CMS handle 40490 with another procedure in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

What documentation supports reporting 40490?

Document that the sampled lesion is on the lip, its location and clinical description, and the tissue obtained. Include the procedure details and specimen disposition.

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 40490PPRRVU2026_Oct_nonQPP.csv, line 4,819 (RVU26D)
Geographic factors for VallejoGPCI2026.csv, line 33 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet