Billing code 40510: Lip excisionMedicare rate & RVUs in Oklahoma
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.
Medicare pays $459.14 for 40510 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 40510 covers
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.
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 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $459.14 | $297.48 |
How the 40510 rate is calculated
Each of 40510’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 40510
RVUs × geographic indexes × conversion factor
Work4.70
4.70 RVUs× 1.000 GPCI
Practice expense9.53
9.53 RVUs× 1.000 GPCI
Malpractice0.69
0.69 RVUs× 1.000 GPCI
Adjusted RVUs
14.9200
Conversion factor
$33.4009
Medicare rate
$498.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 40510
40510 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 40510
Lip excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 40510
Lip excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
40510 without 51 · national office
$498.34
Lip excision
40510-51 · Second procedure: 50%
$249.17
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
40510 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 40500Lip excision
- 40500 addresses a vermilion-focused shave with mucosal advancement. Choose 40510 for partial resection through the full thickness of the lip with direct closure.
- 40520Lip excision
- Both involve partial full-thickness lip excision, but 40520 includes local-flap reconstruction; 40510 is for direct closure.
- 40525Lip reconstruction
- 40525 represents a more extensive, radical resection with reconstruction and direct closure. 40510 is for partial full-thickness excision.
- 40530Lip excision
- 40530 is for complete lip removal with reconstruction. 40510 is limited to partial full-thickness removal with direct closure.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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