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CPT code 41008: Tongue drainage, intraoral approach2026 Medicare rate & RVUs in Iowa

Reports incision and drainage of a collection involving the tongue when the surgeon reaches the site through the mouth.

CMS RVU26DEffective Oct 1, 2026One payment locality220 Medicare services in 2024

In Iowa, Medicare pays $380.36 for 41008 in the office and $225.11 when it’s performed in a hospital or facility.

$380.36Office (non-facility)
$225.11Hospital or facility
−8.2%vs the national office rate ($414.51)

Check a contract rate as a % of Medicare · 41008 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 41008 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 41008 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 41008 covers

This procedure drains a localized collection, such as an abscess, cyst, or hematoma, involving the tongue through an incision made from inside the mouth. Oral and maxillofacial surgeons and other qualified surgeons may perform it in an operating room or another setting equipped for the procedure. The operative note should identify the tongue as the treated site and describe the intraoral route and drainage performed.

Choose this code when the collection is in the tongue and is accessed intraorally; a different site or an external approach points to a different code. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. 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 Iowa compares for 41008

Across 109 of 109 payment localities, the office rate for 41008 runs from $366.30 in Arkansas to $545.52 in San Benito County, CA. Iowa pays $380.36. The RVUs are the same everywhere; the geographic indexes change the dollars.

41008 in Iowa vs other payment areas
  1. Iowa · this page$380.36
  2. Los Angeles, CA · California$465.88+$85.52
  3. Washington, DC area · District of Columbia$473.27+$92.91
  4. Miami, FL · Florida$451.24+$70.88
  5. Chicago, IL · Illinois$437.92+$57.56
  6. Manhattan, NY · New York$477.56+$97.20
  7. Alaska · Alaska$482.00+$101.64

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

Every other payment area

41008 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$371.70$223.24
ArkansasArkansas$366.30$220.55
ArizonaArizona$403.30$238.88
Bakersfield, CACalifornia$437.66$251.69
Chico, CACalifornia$436.24$250.27
El Centro, CACalifornia$436.32$250.36
Fresno, CACalifornia$436.24$250.27
Hanford, CACalifornia$436.24$250.27

41008 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.

$366.30

$490.88

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

View every state and territory as a table
41008 office rate range by state
State / territoryOffice rate rangeLocalities
AK$482.001
AL$371.701
AR$366.301
AZ$403.301
CA$436.24–$545.5229
CO$430.551
CT$442.181
DC$473.271
DE$409.991
FL$410.17–$451.243
GA$386.81–$422.702
GU$446.741
HI$446.741
IA$380.361
ID$383.031
IL$398.87–$437.924
IN$385.251
KS$378.971
KY$381.411
LA$380.98–$399.882
MA$428.12–$472.722
MD$417.72–$473.273
ME$385.47–$405.902
MI$391.77–$415.742
MN$411.261
MO$374.67–$400.833
MS$370.541
MT$414.471
NC$389.461
ND$404.781
NE$382.341
NH$424.171
NJ$446.87–$468.402
NM$394.091
NV$412.061
NY$395.37–$489.715
OH$389.791
OK$380.301
OR$408.50–$443.822
PA$390.19–$431.402
PR$417.401
RI$424.301
SC$390.351
SD$403.641
TN$380.941
TX$387.64–$429.438
UT$395.701
VA$404.84–$473.272
VI$417.401
VT$403.561
WA$427.19–$481.962
WI$391.191
WV$384.151
WY$410.251

See 41008 in every payment locality

How the 41008 rate is calculated

Each of 41008’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 · 41008

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.37

3.37 RVUs× 1.000 GPCI

Practice expense8.55

8.55 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

12.4100

Conversion factor

$33.4009

Medicare rate

$414.51

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,886

Code
41008
Physician work
3.37
Practice expense
8.55
Malpractice
0.49

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 41008 in Iowa
ComponentRVULocality factorAdjusted
Physician work3.37× 1.0003.3700
Practice expense8.55× 0.9157.8233
Malpractice0.49× 0.3970.1945
Total RVUs11.3878
Conversion factor× 33.4009

Office rate, Iowa$380.36

Office: (3.37 × 1 + 8.55 × 0.915 + 0.49 × 0.397) × $33.4009 = $380.36

Facility: (3.37 × 1 + 3.47 × 0.915 + 0.49 × 0.397) × $33.4009 = $225.11

Open 41008 in the RVU calculator

Payment rules and modifiers for 41008

41008 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41008

Tongue drainage, intraoral approach

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 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)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 41008

Tongue drainage, intraoral approach

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

41008 without 51 · national office

$414.51

Tongue drainage, intraoral approach

41008-51 · Second procedure: 50%

$207.26

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 41008

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

Codes related to 41008
CodeHow it relatesOffice range, Iowa
Same family
41009Abscess drainage, intraoral pharyngeal spaceRelated tongue-drainage code for an external approach.$398.05
Used instead
41000Oral abscess drainage, floor of mouthUsed for drainage involving dentoalveolar structures rather than the tongue.$146.41
41005Oral drainage, mouth vestibuleAddresses drainage at the floor of the mouth by a sublingual approach.$212.35
41006Mouth lesion drainage, floor of mouth, extraoralAddresses drainage at the floor of the mouth by a submental approach.$322.05
41007Mouth lesion drainage, floor of mouth, intraoralAddresses drainage at the floor of the mouth by a submandibular approach.$310.69

How 41008 has changed in Iowa

41008 · Office / nonfacility

$380.36

Effective 2026-10-01

The base rate is $22.13 higher than on 2025-10-01, moving from $358.23 to $380.36 (6.2%).

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

    $358.23changed to$380.36

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.46 changed to 3.37
    • Practice expense RVU 8.10 changed to 8.55
    • Malpractice RVU 0.48 changed to 0.49
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $362.87changed to$358.23

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.94 changed to 8.10
    • Malpractice RVU 0.42 changed to 0.48

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $356.95changed to$362.87

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $367.15changed to$356.95

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.91 changed to 7.94
    • Malpractice RVU 0.40 changed to 0.42
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $369.50changed to$367.15

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.77 changed to 7.91
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $374.17changed to$369.50

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.83 changed to 7.77
    • Malpractice RVU 0.38 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $365.25changed to$374.17

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.18 changed to 7.83
    • Malpractice RVU 0.35 changed to 0.38
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $364.01changed to$365.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.06 changed to 7.18
    • Malpractice RVU 0.56 changed to 0.35
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $359.69changed to$364.01

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.94 changed to 7.06

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $360.79changed to$359.69

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.02 changed to 6.94
    • Malpractice RVU 0.57 changed to 0.56
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $360.11changed to$360.79

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.05 changed to 7.02
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $361.70changed to$360.11

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.07 changed to 7.05
    • Malpractice RVU 0.55 changed to 0.57

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $359.90changed to$361.70

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $355.73changed to$359.90

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.03 changed to 7.07
    • Malpractice RVU 0.42 changed to 0.55
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $355.71changed to$355.73

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.66 changed to 7.03
    • Malpractice RVU 0.44 changed to 0.42
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $355.71

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$380.36$225.11RVU26D
2026-07-01$380.36$225.11RVU26C
2026-04-01$380.36$225.11RVU26B
2026-01-01$380.36$225.11RVU26A
2025-10-01$358.23$238.62RVU25D
2025-07-01$358.23$238.62RVU25C
2025-04-01$358.23$238.62RVU25B
2025-01-01$358.23$238.62RVU25A
2024-10-01$362.87$239.79RVU24D
2024-07-01$362.87$239.79RVU24C
2024-04-01$362.87$239.79RVU24B
2024-03-09$362.87$239.79RVU24AR
2024-01-01$356.95$235.87RVU24A
2023-10-01$367.15$240.72RVU23D
2023-07-01$367.15$240.72RVU23C
2023-04-01$367.15$240.72RVU23B
2023-01-01$367.15$240.72RVU23A
2022-10-01$369.50$240.19RVU22D
2022-07-01$369.50$240.19RVU22C
2022-04-01$369.50$240.19RVU22B
2022-01-01$369.50$240.19RVU22A
2021-10-01$374.17$243.15RVU21D
2021-07-01$374.17$243.15RVU21C
2021-04-01$374.17$243.15RVU21B
2021-01-01$374.17$243.15RVU21A
2020-10-01$365.25$249.37RVU20D
2020-07-01$365.25$249.37RVU20C
2020-04-01$365.25$249.37RVU20B
2020-01-01$365.25$249.37RVU20A
2019-10-01$364.01$254.83RVU19D
2019-07-01$364.01$254.83RVU19C
2019-04-01$364.01$254.83RVU19B
2019-01-01$364.01$254.83RVU19A
2018-10-01$359.69$257.16RVU18D
2018-07-01$359.69$257.16RVU18C
2018-04-01$359.69$257.16RVU18B
2018-01-01$359.69$257.16RVU18AR1
2017-10-01$360.79$259.47RVU17D
2017-07-01$360.79$259.47RVU17C
2017-04-01$360.79$259.47RVU17B
2017-01-01$360.79$259.47RVU17A
2016-10-01$360.11$259.38RVU16D
2016-07-01$360.11$259.38RVU16C
2016-04-01$360.11$259.38RVU16B
2016-01-01$360.11$259.38RVU16A
2015-10-01$361.70$259.64RVU15D
2015-07-01$361.70$259.64RVU15C
2015-04-01$359.90$258.35RVU15B
2015-01-01$359.90$258.35RVU15A
2014-10-01$355.73$257.63RVU14D
2014-07-01$355.73$257.63RVU14C
2014-04-01$355.73$257.63RVU14B
2014-01-01$355.73$257.63RVU14A
2013-10-01$355.71$251.90RVU13D
2013-07-01$355.71$251.90RVU13C
2013-04-01$355.71$251.90RVU13B
2013-01-01$355.71$251.90RVU13AR

Price 41008 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

41008 billing questions

When should this code be chosen over 41009?

Use 41008 for drainage of a tongue collection reached through the mouth. Code 41009 is the related alternative for an external approach.

Does this code cover drainage of a tooth-related abscess?

No. When the treated collection is in dentoalveolar structures rather than the tongue, consider 41000.

What should the operative note identify?

Document the tongue as the site, the intraoral route, and the incision and drainage performed. This supports distinguishing the service from drainage at another oral site or by an external approach.

Can modifier 50 be used?

No. The code's descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.

How does the global period affect postoperative billing?

The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.

When is assistant-at-surgery payment allowed?

Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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 41008PPRRVU2026_Oct_nonQPP.csv, line 4,886 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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