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

In Tennessee, Medicare pays $212.00 for 41005 in the office and $103.61 when it’s performed in a hospital or facility.

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.

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 Tennessee 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. Tennessee pays $212.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

41005 rates by state

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

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.

Payment rules and modifiers for 41005

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

What modifiers do to the payment

When to use modifier 51

Codes related to 41005

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

How 41005 has changed in Tennessee

Price 41005 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

• Adams
• Adamsville
• Alamo
• Alcoa
• Alexandria
• Algood
• Allardt
• Altamont

Browse all communities in Tennessee

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

Open CMS sourceHow we calculate rates