$521.34–$571.73
40500 addresses a vermilion-focused shave with mucosal advancement. Choose 40510 for partial resection through the full thickness of the lip with direct closure.
On this page
CMS RVU26D · Effective 2026-10-01
40510 Lip excision Medicare reimbursement rates in Florida
Reports removal of a partial, full-thickness lip segment with direct closure, such as excision of a localized lesion that requires through-and-through resection. Compare 40510 office and facility rates across CMS payment localities in Florida.
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.
What does Medicare pay for 40510 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$495.93–$546.63
3 of 3 localities have a supported rate.
Facility setting
$322.86–$358.18
3 of 3 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 40510 pays more and less in Florida
3 payment localities
$495.93 to $546.63
Plastic surgery
About 40510: Partial full-thickness lip excision with closure
Reports removal of a partial, full-thickness lip segment with direct closure, such as excision of a localized lesion that requires through-and-through resection.
The surgeon removes a portion of the lip through its full thickness and closes the resulting defect directly. This approach may be used to excise a localized lip lesion, including a malignancy, when the planned resection is partial and the edges can be brought together without a reconstructive flap. Otolaryngologists, plastic surgeons, and other surgeons performing lip procedures may report the service in an operating room or an appropriate outpatient surgical setting.
Select this code when the operative report supports partial full-thickness removal and direct closure; document the site, extent of resection, and closure method. It carries 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
CMS billing rules for 40510
- 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
- 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 RVU4.70 · 32%
- Practice expense (office) RVU9.53 · 64%
- Malpractice RVU0.69 · 5%
542
Medicare services in 2024 · #3483 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.
40510 compared with similar codes
Office rates for Florida, from the same CMS release.
$516.55–$570.07
Both involve partial full-thickness lip excision, but 40520 includes local-flap reconstruction; 40510 is for direct closure.
No office rate
40525 represents a more extensive, radical resection with reconstruction and direct closure. 40510 is for partial full-thickness excision.
$564.56–$624.36
40530 is for complete lip removal with reconstruction. 40510 is limited to partial full-thickness removal with direct closure.
Compare 40510 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
$521.10
Facility
$337.71
Miami →
Office / nonfacility
$546.63
Facility
$358.18
Rest Of Florida →
Office / nonfacility
$495.93
Facility
$322.86
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40510 billing questions
How does 40510 differ from 40500?
40510 is for removal through the full thickness of a partial lip segment. 40500 is used for a vermilion-focused lip shave with mucosal advancement, rather than full-thickness resection.
When would 40520 be more appropriate?
Use 40520 when the partial full-thickness defect is reconstructed with a local flap. 40510 describes direct closure of the defect.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple procedure reduction.
Should modifier 50 be used for both sides of the lip?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 40510. 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.
4,8204049F,,Doc order given stop antibio,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,82140500,,Partial excision of lip,A,,4.36,10.87,,5.04,,0.57,15.80,9.97,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,8224050F,,Ht care plan doc,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,82340510,,Partial excision of lip,A,,4.70,9.53,,4.11,,0.69,14.92,9.50,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,8244051F,,Referred for an av fistula,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,82540520,,Partial excision of lip,A,,4.67,10.16,,4.40,,0.72,15.55,9.79,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,82640525,,Reconstruct lip with flap,A,,7.53,6.18,NA,6.18,,1.20,14.91,14.91,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00