CPT code 41005: Oral drainage, mouth vestibule2026 Medicare rate & RVUs in Vallejo, CA

Reports intraoral incision and drainage of a collection in the mouth vestibule, the space between the cheeks or lips and the gums.

CMS RVU26DEffective Oct 1, 2026One payment locality145 Medicare services in 2024

In Vallejo, CA, Medicare pays $289.14 for 41005 in the office and $131.98 when it’s performed in a hospital or facility.

$289.14Office (non-facility)
$131.98Hospital or facility
+25.1%vs the national office rate ($231.13)

Check a contract rate as a % of Medicare · 41005 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 41005 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vallejo, CA
  2. What 41005 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 41005 covers

This service opens and drains a localized collection in the oral vestibule through an incision made inside the mouth. The vestibule is the space between the inner cheek or lip and the gum. A typical situation is an infection that has spread into this soft-tissue space; the target is the vestibular collection, rather than drainage confined to the tooth-bearing alveolar structures. Oral and maxillofacial surgeons, dentists, and other physicians who treat oral infections may perform it in an office, clinic, or facility setting.

Select the code based on the collection’s documented location and the intraoral approach. The record should identify the vestibular site, the incision and drainage performed, and relevant findings such as the collection’s contents. Related postoperative visits are included in the 10-day global period. 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 multiple-procedure reduction. Modifier 50 is not appropriate for this descriptor and anatomy. Assistant-at-surgery payment requires documented medical necessity; 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.

How Vallejo, CA compares for 41005

Across 109 of 109 payment localities, the office rate for 41005 runs from $202.73 in Arkansas to $314.26 in San Benito County, CA. Vallejo, CA pays $289.14. The RVUs are the same everywhere; the geographic indexes change the dollars.

41005 in Vallejo, CA vs other payment areas
  1. Vallejo, CA · this page$289.14
  2. Bakersfield, CA · California$247.43−$41.71
  3. Chico, CA · California$246.95−$42.19
  4. El Centro, CA · California$246.98−$42.16
  5. Fresno, CA · California$246.95−$42.19
  6. Hanford, CA · California$246.95−$42.19
  7. Los Angeles, CA · California$264.59−$24.55

Other areas in California first, then benchmark localities. Bars start at $0.

Every other payment area

41005 in every other Medicare payment locality
Payment localityOfficeFacility
Madera, CACalifornia$246.95$116.26
Merced, CACalifornia$246.95$116.26
Modesto, CACalifornia$246.95$116.26
Napa, CACalifornia$289.40$132.24
Oxnard, CACalifornia$263.63$122.69
Redding, CACalifornia$246.95$116.26
Rest of CaliforniaCalifornia$246.95$116.26
Riverside, CACalifornia$248.69$118.00

41005 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$202.73

$280.61

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
41005 office rate range by state
State / territoryOffice rate rangeLocalities
AK$262.011
AL$205.941
AR$202.731
AZ$224.691
CA$246.95–$314.2629
CO$242.191
CT$247.211
DC$266.631
DE$228.611
FL$225.77–$246.813
GA$212.39–$235.272
GU$253.961
HI$253.961
IA$212.351
ID$213.671
IL$218.22–$240.504
IN$215.031
KS$210.911
KY$210.361
LA$209.86–$221.062
MA$240.43–$267.812
MD$233.32–$266.633
ME$214.47–$227.512
MI$215.90–$228.392
MN$232.681
MO$205.74–$222.363
MS$204.301
MT$231.121
NC$216.941
ND$227.961
NE$213.721
NH$237.971
NJ$250.20–$263.482
NM$217.021
NV$230.421
NY$220.40–$273.045
OH$215.251
OK$210.361
OR$228.81–$250.772
PA$215.83–$240.442
PR$233.071
RI$237.411
SC$216.421
SD$227.591
TN$212.001
TX$214.28–$241.238
UT$219.611
VA$226.45–$266.632
VI$233.071
VT$226.661
WA$240.11–$273.842
WI$219.751
WV$209.461
WY$229.741

See 41005 in every payment locality

How the 41005 rate is calculated

Each of 41005’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 · 41005

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.28

1.28 RVUs× 1.000 GPCI

Practice expense5.48

5.48 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

6.9200

Conversion factor

$33.4009

Medicare rate

$231.13

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Vallejo, CA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,883

Code
41005
Physician work
1.28
Practice expense
5.48
Malpractice
0.16

GPCI2026.csv

33

Locality
Vallejo, CA
Physician work
1.063
Practice expense
1.318
Malpractice
0.459
Office calculation for 41005 in Vallejo, CA
ComponentRVULocality factorAdjusted
Physician work1.28× 1.0631.3606
Practice expense5.48× 1.3187.2226
Malpractice0.16× 0.4590.0734
Total RVUs8.6567
Conversion factor× 33.4009

Office rate, Vallejo, CA$289.14

Office: (1.28 × 1.063 + 5.48 × 1.318 + 0.16 × 0.459) × $33.4009 = $289.14

Facility: (1.28 × 1.063 + 1.91 × 1.318 + 0.16 × 0.459) × $33.4009 = $131.98

Open 41005 in the RVU calculator

Payment rules and modifiers for 41005

41005 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41005

Oral drainage, mouth vestibule

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 41005

Oral drainage, mouth vestibule

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

41005 without 51 · national office

$231.13

Oral drainage, mouth vestibule

41005-51 · Second procedure: 50%

$115.57

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%).

When to use modifier 51

How 41005 has changed in Vallejo, CA

41005 · Office / nonfacility

$289.14

Effective 2026-10-01

The base rate is $14.90 higher than on 2025-10-01, moving from $274.24 to $289.14 (5.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $274.24changed to$289.14

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.31 changed to 1.28
    • Practice expense RVU 5.36 changed to 5.48
    • Malpractice RVU 0.15 changed to 0.16
    • Work GPCI 1.058 changed to 1.063
    • Practice expense GPCI 1.310 changed to 1.318
    • Malpractice GPCI 0.470 changed to 0.459

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $283.80changed to$274.24

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.40 changed to 5.36
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $279.17changed to$283.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $295.95changed to$279.17

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.75 changed to 5.40
    • Malpractice RVU 0.17 changed to 0.14
    • Work GPCI 1.051 changed to 1.058
    • Practice expense GPCI 1.265 changed to 1.310
    • Malpractice GPCI 0.487 changed to 0.470
  5. January 1, 2023

    RVU23A

    $261.61changed to$295.95

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.03 changed to 5.75
    • Malpractice RVU 0.11 changed to 0.17
    • Work GPCI 1.044 changed to 1.051
    • Practice expense GPCI 1.220 changed to 1.265
    • Malpractice GPCI 0.504 changed to 0.487

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $265.84changed to$261.61

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.07 changed to 5.03
    • Malpractice RVU 0.13 changed to 0.11

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $265.13changed to$265.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.78 changed to 5.07
    • Malpractice RVU 0.11 changed to 0.13
    • Work GPCI 1.049 changed to 1.044
    • Practice expense GPCI 1.238 changed to 1.220
    • Malpractice GPCI 0.496 changed to 0.504

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $271.16changed to$265.13

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.81 changed to 4.78
    • Malpractice RVU 0.22 changed to 0.11
    • Work GPCI 1.055 changed to 1.049
    • Practice expense GPCI 1.256 changed to 1.238
    • Malpractice GPCI 0.458 changed to 0.496

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $273.29changed to$271.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.86 changed to 4.81
    • Malpractice RVU 0.23 changed to 0.22

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $283.30changed to$273.29

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.05 changed to 4.86
    • Malpractice RVU 0.19 changed to 0.23
    • Work GPCI 1.057 changed to 1.055
    • Practice expense GPCI 1.271 changed to 1.256
    • Malpractice GPCI 0.477 changed to 0.458

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$283.30

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$289.14$131.98RVU26D
2026-07-01$289.14$131.98RVU26C
2026-04-01$289.14$131.98RVU26B
2026-01-01$289.14$131.98RVU26A
2025-10-01$274.24$136.94RVU25D
2025-07-01$274.24$136.94RVU25C
2025-04-01$274.24$136.94RVU25B
2025-01-01$274.24$136.94RVU25A
2024-10-01$283.80$137.72RVU24D
2024-07-01$283.80$137.72RVU24C
2024-04-01$283.80$137.72RVU24B
2024-03-09$283.80$137.72RVU24AR
2024-01-01$279.17$135.47RVU24A
2023-10-01$295.95$139.91RVU23D
2023-07-01$295.95$139.91RVU23C
2023-04-01$295.95$139.91RVU23B
2023-01-01$295.95$139.91RVU23A
2022-10-01$261.61$124.40RVU22D
2022-07-01$261.61$124.40RVU22C
2022-04-01$261.61$124.40RVU22B
2022-01-01$261.61$124.40RVU22A
2021-10-01$265.84$126.63RVU21D
2021-07-01$265.84$126.63RVU21C
2021-04-01$265.84$126.63RVU21B
2021-01-01$265.84$126.63RVU21A
2020-10-01$265.13$135.56RVU20D
2020-07-01$265.13$135.56RVU20C
2020-04-01$265.13$135.56RVU20B
2020-01-01$265.13$135.56RVU20A
2019-10-01$271.16$144.42RVU19D
2019-07-01$271.16$144.42RVU19C
2019-04-01$271.16$144.42RVU19B
2019-01-01$271.16$144.42RVU19A
2018-10-01$273.29$151.21RVU18D
2018-07-01$273.29$151.21RVU18C
2018-04-01$273.29$151.21RVU18B
2018-01-01$273.29$151.21RVU18AR1
2017-10-01$283.30$150.11RVU17D
2017-07-01$283.30$150.11RVU17C
2017-04-01$283.30$150.11RVU17B
2017-01-01$283.30$150.11RVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 41005 for an earlier date of service

Where the Vallejo, CA rate applies

Vallejo, CA is a Medicare payment area, not a city. Our Census mapping connects it to 11 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

  • Vallejo
  • Allendale
  • Benicia
  • Dixon
  • Elmira
  • Fairfield
  • Green Valley
  • Hartley

Browse all communities in California

41005 billing questions

How is this different from 41000?

41005 is for a collection in the mouth vestibule, between the cheek or lip and the gum. 41000 is used for drainage involving dentoalveolar structures.

Does the incision have to be made inside the mouth?

Yes. This code describes drainage of a vestibular collection by an intraoral approach.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure.

Can modifier 50 be used for drainage on both sides?

No. The descriptor and anatomy make modifier 50 inappropriate for this code.

When can an assistant-at-surgery be paid?

Assistant-at-surgery payment is allowed only when the documentation supports medical necessity. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction.

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
RVUs for 41005PPRRVU2026_Oct_nonQPP.csv, line 4,883 (RVU26D)
Geographic factors for Vallejo, CAGPCI2026.csv, line 33 (RVU26D)

Open CMS sourceHow we calculate rates

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