40490 Biopsy of lip
Also known as: lip biopsy, lip punch biopsy
Biopsy of the lip, sampling tissue to diagnose pathology such as infection, dysplasia, or malignancy. A small tissue sample is obtained and examined microscopically.
In Plain Language
taking a small sample from the lip
Clinical Context
Used for suspicious lip lesions, persistent ulcers, or pigmented changes. Important for ruling out oral cancer and infectious diseases.
RVU Breakdown
| Work RVU | 1.19 |
| Total RVU | 1.19 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 0-day global period, meaning pre- and post-operative E&M visits are billable separately on the same day. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 1.19, this code ranks in the 6th percentile among Surgery codes — 6.7x below the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 40490?
CPT 40490 (Biopsy of lip) is a Surgery code. Biopsy of the lip, sampling tissue to diagnose pathology such as infection, dysplasia, or malignancy. A small tissue sample is obtained and examined microscopically.
What is the wRVU value for CPT 40490?
The work RVU for CPT 40490 is 1.19. This code is primarily used by Oral Surgery, General Surgery, Dermatology.
When is CPT 40490 used?
Used for suspicious lip lesions, persistent ulcers, or pigmented changes. Important for ruling out oral cancer and infectious diseases.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.