Billing code 40831: Laceration repairMedicare rate & RVUs in Utah
Repair a complicated traumatic laceration of the mouth vestibule when the wound requires more involved closure than a simple repair.
Medicare pays $298.43 for 40831 in the office in Utah (Utah). 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 40831 covers
This service repairs a complicated traumatic wound in 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, otolaryngologist, plastic surgeon, or emergency physician in an office, emergency department, or other appropriate setting. The procedure closes the injured tissue; it is not removal of a mouth lesion or drainage of an abscess.
Choose this code rather than 40830 when the documented laceration requires complicated repair. Record the site, wound extent and tissue involvement, and the repair performed to support that distinction. Medicare assigns a 10-day global period, so related postoperative visits during that period are 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% reduction. Do not use modifier 50 for this service. An assistant is paid only when medical necessity is documented; 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.
40831 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $298.43 | $186.34 |
How the 40831 rate is calculated
Each of 40831’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 · 40831
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.51Practice expense 6.51Malpractice 0.34
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 40831
40831 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 40831
Laceration repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0 | Not paid without supporting documentation. |
| 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 40831
Laceration repair
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
40831 without 51 · national office
$312.63
Laceration repair
40831-51 · Second procedure: 50%
$156.32
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%).
40831 compared with similar codes
Compare codes
40831 vs 40830 vs 40812 vs 40840: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 40830Mouth laceration repair
- This code is for complicated repair; 40830 is for simple repair of a mouth vestibule laceration.
- 40812Oral lesion excision
- 40812 concerns excision and repair of a mouth lesion. Use 40831 for repair of a traumatic laceration, not a lesion excision.
- 40840Reconstruction of mouth
- 40840 describes reconstruction of the mouth. Choose 40831 when the service is closure of a complicated laceration rather than mouth reconstruction.
40831 billing questions
How do I distinguish 40831 from 40830?
Use 40831 for a complicated vestibular laceration repair and 40830 for a simple repair. Document the wound and the work that supports the level selected.
Can I report modifier 50 for wounds on both sides of the mouth?
No. Modifier 50 is inappropriate for this service under the CMS bilateral rule.
Are related postoperative visits separately payable during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
How does the multiple-procedure reduction affect this code?
For procedures performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. 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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