40845 Reconstruction of mouth
Also known as: complex free flap reconstruction, maximal oral reconstruction, extensive flap surgery
Surgical reconstruction of the oral cavity and lips with the most extensive tissue transfer including free flaps with complex microvascular repairs.
In Plain Language
extensive mouth surgery with complex tissue transfer; major mouth rebuilding procedure; complex oral reconstruction
Clinical Context
Used for the most extensive oral defects involving multiple structures requiring complex free flap reconstruction with microvascular anastomosis. Common in massive cancer resection, extensive trauma, and severe burns.
RVU Breakdown
| Work RVU | 18.88 |
| Total RVU | 18.88 |
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 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 18.88, this code ranks in the 80th percentile among Surgery codes — 2.4x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 40845?
CPT 40845 (Reconstruction of mouth) is a Surgery code. Surgical reconstruction of the oral cavity and lips with the most extensive tissue transfer including free flaps with complex microvascular repairs.
What is the wRVU value for CPT 40845?
The work RVU for CPT 40845 is 18.88. This code is primarily used by Oral and Maxillofacial Surgery, Plastic Surgery, Head and Neck Surgery. It has a 90-day global period.
When is CPT 40845 used?
Used for the most extensive oral defects involving multiple structures requiring complex free flap reconstruction with microvascular anastomosis. Common in massive cancer resection, extensive trauma, and severe burns.
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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.