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

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 Connecticut, Medicare pays $247.21 for 41005 in the office and $118.78 when it’s performed in a hospital or facility.

$247.21Office (non-facility)
$118.78Hospital or facility
+7.0%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 Connecticut
  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 Connecticut 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. Connecticut pays $247.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

41005 in Connecticut vs other payment areas
  1. Connecticut · this page$247.21
  2. Los Angeles, CA · California$264.59+$17.38
  3. Washington, DC area · District of Columbia$266.63+$19.42
  4. Miami, FL · Florida$246.81−$0.40
  5. Chicago, IL · Illinois$239.27−$7.94
  6. Manhattan, NY · New York$266.65+$19.44
  7. Alaska · Alaska$262.01+$14.80

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

Every other payment area

41005 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$205.94$101.60
ArkansasArkansas$202.73$100.31
ArizonaArizona$224.69$109.15
Bakersfield, CACalifornia$247.43$116.74
Chico, CACalifornia$246.95$116.26
El Centro, CACalifornia$246.98$116.29
Fresno, CACalifornia$246.95$116.26
Hanford, CACalifornia$246.95$116.26

41005 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Connecticut 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

38

Locality
Connecticut
Physician work
1.020
Practice expense
1.077
Malpractice
1.210
Office calculation for 41005 in Connecticut
ComponentRVULocality factorAdjusted
Physician work1.28× 1.0201.3056
Practice expense5.48× 1.0775.9020
Malpractice0.16× 1.2100.1936
Total RVUs7.4012
Conversion factor× 33.4009

Office rate, Connecticut$247.21

Office: (1.28 × 1.02 + 5.48 × 1.077 + 0.16 × 1.21) × $33.4009 = $247.21

Facility: (1.28 × 1.02 + 1.91 × 1.077 + 0.16 × 1.21) × $33.4009 = $118.78

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

Codes related to 41005

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 41005
CodeHow it relatesOffice range, Connecticut
Same family
41000Oral abscess drainage, floor of mouthDrainage is directed at dentoalveolar structures rather than the mouth vestibule.$169.88
41006Mouth lesion drainage, floor of mouth, extraoralDrainage targets the floor-of-mouth spaces rather than the vestibule.$371.40
41007Mouth lesion drainage, floor of mouth, intraoralDrainage targets a collection within the tongue.$358.26
41008Tongue drainage, intraoral approachDrainage targets a peritonsillar collection.$442.18
41015Mouth lesion drainage, extraoral floor-of-mouth approachDrainage involves sublingual, submental, or submandibular spaces by an extraoral approach.$436.53

How 41005 has changed in Connecticut

41005 · Office / nonfacility

$247.21

Effective 2026-10-01

The base rate is $8.89 higher than on 2025-10-01, moving from $238.32 to $247.21 (3.7%).

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

    $238.32changed to$247.21

    • 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 1.022 changed to 1.020
    • Practice expense GPCI 1.091 changed to 1.077
    • Malpractice GPCI 1.207 changed to 1.210

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $246.30changed to$238.32

    • 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

    $242.28changed to$246.30

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $266.61changed to$242.28

    • 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 1.030 changed to 1.022
    • Practice expense GPCI 1.102 changed to 1.091
    • Malpractice GPCI 1.070 changed to 1.207

  5. January 1, 2023

    RVU23A

    $244.48changed to$266.61

    • 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 1.037 changed to 1.030
    • Practice expense GPCI 1.114 changed to 1.102
    • Malpractice GPCI 0.934 changed to 1.070

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $248.71changed to$244.48

    • 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

    $244.99changed to$248.71

    • 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 1.029 changed to 1.037
    • Practice expense GPCI 1.113 changed to 1.114
    • Malpractice GPCI 1.094 changed to 0.934

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $250.92changed to$244.99

    • 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 1.021 changed to 1.029
    • Practice expense GPCI 1.112 changed to 1.113
    • Malpractice GPCI 1.255 changed to 1.094

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $253.09changed to$250.92

    • 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

    $259.02changed to$253.09

    • 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 1.023 changed to 1.021
    • Practice expense GPCI 1.117 changed to 1.112
    • Malpractice GPCI 1.244 changed to 1.255

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $262.31changed to$259.02

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.13 changed to 5.05
    • Work GPCI 1.024 changed to 1.023
    • Practice expense GPCI 1.121 changed to 1.117
    • Malpractice GPCI 1.232 changed to 1.244

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $261.65changed to$262.31

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.09 changed to 5.13

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $260.34changed to$261.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $260.97changed to$260.34

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.16 changed to 5.09
    • Malpractice RVU 0.15 changed to 0.19
    • Practice expense GPCI 1.116 changed to 1.121
    • Malpractice GPCI 1.234 changed to 1.232

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $269.51changed to$260.97

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.75 changed to 5.16
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 1.110 changed to 1.116
    • Malpractice GPCI 1.235 changed to 1.234

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $269.51

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$247.21$118.78RVU26D
2026-07-01$247.21$118.78RVU26C
2026-04-01$247.21$118.78RVU26B
2026-01-01$247.21$118.78RVU26A
2025-10-01$238.32$123.98RVU25D
2025-07-01$238.32$123.98RVU25C
2025-04-01$238.32$123.98RVU25B
2025-01-01$238.32$123.98RVU25A
2024-10-01$246.30$124.64RVU24D
2024-07-01$246.30$124.64RVU24C
2024-04-01$246.30$124.64RVU24B
2024-03-09$246.30$124.64RVU24AR
2024-01-01$242.28$122.61RVU24A
2023-10-01$266.61$130.68RVU23D
2023-07-01$266.61$130.68RVU23C
2023-04-01$266.61$130.68RVU23B
2023-01-01$266.61$130.68RVU23A
2022-10-01$244.48$119.19RVU22D
2022-07-01$244.48$119.19RVU22C
2022-04-01$244.48$119.19RVU22B
2022-01-01$244.48$119.19RVU22A
2021-10-01$248.71$121.61RVU21D
2021-07-01$248.71$121.61RVU21C
2021-04-01$248.71$121.61RVU21B
2021-01-01$248.71$121.61RVU21A
2020-10-01$244.99$128.51RVU20D
2020-07-01$244.99$128.51RVU20C
2020-04-01$244.99$128.51RVU20B
2020-01-01$244.99$128.51RVU20A
2019-10-01$250.92$138.70RVU19D
2019-07-01$250.92$138.70RVU19C
2019-04-01$250.92$138.70RVU19B
2019-01-01$250.92$138.70RVU19A
2018-10-01$253.09$145.01RVU18D
2018-07-01$253.09$145.01RVU18C
2018-04-01$253.09$145.01RVU18B
2018-01-01$253.09$145.01RVU18AR1
2017-10-01$259.02$141.96RVU17D
2017-07-01$259.02$141.96RVU17C
2017-04-01$259.02$141.96RVU17B
2017-01-01$259.02$141.96RVU17A
2016-10-01$262.31$143.51RVU16D
2016-07-01$262.31$143.51RVU16C
2016-04-01$262.31$143.51RVU16B
2016-01-01$262.31$143.51RVU16A
2015-10-01$261.65$143.62RVU15D
2015-07-01$261.65$143.62RVU15C
2015-04-01$260.34$142.91RVU15B
2015-01-01$260.34$142.91RVU15A
2014-10-01$260.97$142.24RVU14D
2014-07-01$260.97$142.24RVU14C
2014-04-01$260.97$142.24RVU14B
2014-01-01$260.97$142.24RVU14A
2013-10-01$269.51$144.13RVU13D
2013-07-01$269.51$144.13RVU13C
2013-04-01$269.51$144.13RVU13B
2013-01-01$269.51$144.13RVU13AR

Price 41005 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

  • Ansonia
  • Ball Pond
  • Baltic
  • Bantam
  • Bethel
  • Bethlehem Village
  • Bigelow Corners
  • Blue Hills

Browse all communities in Connecticut

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 ConnecticutGPCI2026.csv, line 38 (RVU26D)

Open CMS sourceHow we calculate rates

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