$155.14
40808 describes biopsy of a mouth lesion. Choose 40810 when the documented service is excision of a lesion from the oral vestibule without repair.
On this page
CMS RVU26D · Effective 2026-10-01
40810 Mouth lesion excision Medicare reimbursement rates in Nebraska
Reports removal of a lesion from the mucosa and submucosa of the mouth vestibule when the excision is performed without repair. Compare 40810 office and facility rates across CMS payment localities in Nebraska.
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 40810 in Nebraska?
Nebraska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$199.61
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$106.20
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
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.
Oral surgery
About 40810: Vestibular oral lesion excision without repair
Reports removal of a lesion from the mucosa and submucosa of the mouth vestibule when the excision is performed without repair.
This service removes a lesion from the lining and underlying tissue of the oral vestibule, the space between the lips or cheeks and the teeth or gums. It may be performed by an oral and maxillofacial surgeon, dentist, or other qualified clinician in an office or surgical setting. A persistent or suspicious inner-lip or cheek lesion may be excised for treatment or tissue diagnosis; the specimen can be submitted for pathologic examination.
Choose this code when the documented work is excision in the vestibule and no repair is performed. If the operative note describes repair, compare the repair-specific codes in this family rather than reporting this code. Document the precise site, lesion and extent removed, and whether repair was performed. The service 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% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 40810
- 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 RVU1.33 · 21%
- Practice expense (office) RVU4.96 · 77%
- Malpractice RVU0.18 · 3%
2K
Medicare services in 2024 · #2479 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.
40810 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$260.24
40812 is the related vestibular lesion excision code when simple repair is performed; 40810 is for excision without repair.
$353.50
40814 is used for vestibular lesion excision involving complex repair, unlike 40810, which is reported when no repair is performed.
$193.78
40800 describes drainage of a mouth lesion. Use 40810 when the lesion is excised rather than drained.
Compare 40810 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.
1 of 1 payment localities
Nebraska →
Office / nonfacility
$199.61
Facility
$106.20
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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 40810 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
4,863
- Code
- 40810
- Physician work
- 1.33
- Practice expense
- 4.96
- Malpractice
- 0.18
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.33 | × 1.000 | 1.3300 |
| Practice expense | 4.96 | × 0.923 | 4.5781 |
| Malpractice | 0.18 | × 0.378 | 0.0680 |
| Total RVUs | 5.9761 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$199.61
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.33 | 1 |
| Practice expense | 4.96 | 0.923 |
| Malpractice | 0.18 | 0.378 |
(1.33 × 1 + 4.96 × 0.923 + 0.18 × 0.378) × $33.4009 = $199.61
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.33 | 1 |
| Practice expense | 1.93 | 0.923 |
| Malpractice | 0.18 | 0.378 |
(1.33 × 1 + 1.93 × 0.923 + 0.18 × 0.378) × $33.4009 = $106.20
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.
40810 billing questions
When should this code be used instead of 40808?
Use 40810 when the lesion is excised from the oral vestibule. Code 40808 describes biopsy rather than this excision service.
Does this code include closure of the excision site?
No repair is included in this code. If the operative note documents repair, compare the repair-specific vestibular lesion excision codes.
Can modifier 50 be reported for lesions on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Are postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
Is examination of the removed tissue included?
The code represents removal of the lesion, not the pathologist's examination. A pathology service may be reported separately when performed.
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.
4,86040805,,Removal foreign body mouth,A,,2.72,5.71,,2.49,,0.30,8.73,5.51,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,86140806,,Incision of lip fold,A,,0.30,2.67,,0.50,,0.06,3.03,0.86,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,86240808,,Biopsy of mouth lesion,A,,1.02,3.87,,1.31,,0.14,5.03,2.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,86340810,,Excision of mouth lesion,A,,1.33,4.96,,1.93,,0.18,6.47,3.44,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,86440812,,Excise/repair mouth lesion,A,,2.31,5.82,,2.44,,0.29,8.42,5.04,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,86540814,,Excise/repair mouth lesion,A,,3.43,7.57,,4.05,,0.44,11.44,7.92,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,86640816,,Excision of mouth lesion,A,,3.68,8.06,,4.21,,0.49,12.23,8.38,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068