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40816 Excision of mouth lesion

Surgery Global 90d

Also known as: oral lesion excision, intraoral excision

Excision of mouth lesion, likely with intermediate complexity reconstruction between 40814 and simpler excisions.

In Plain Language

removing a growth in the mouth

Clinical Context

Used for moderate-sized intraoral lesions. May involve standard closure techniques beyond simple primary closure.

RVU Breakdown

Work RVU3.68
Total RVU3.68

Est. Medicare Payment

$122.91

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 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.

How This Code Compares

With a work RVU of 3.68, this code ranks in the 25th percentile among Surgery codes — 2.2x below the median (8.00). The highest wRVU in this category is 106.19.

Specialties

Oral SurgeryGeneral SurgeryENT

Frequently Asked Questions

What is CPT code 40816?

CPT 40816 (Excision of mouth lesion) is a Surgery code. Excision of mouth lesion, likely with intermediate complexity reconstruction between 40814 and simpler excisions.

What is the wRVU value for CPT 40816?

The work RVU for CPT 40816 is 3.68. This code is primarily used by Oral Surgery, General Surgery, ENT. It has a 90-day global period.

When is CPT 40816 used?

Used for moderate-sized intraoral lesions. May involve standard closure techniques beyond simple primary closure.

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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.