CPT code 41009: Abscess drainage, intraoral pharyngeal space2026 Medicare rate & RVUs in Nebraska

Reports surgical drainage through the mouth for a deep infection involving the retropharyngeal or parapharyngeal space.

CMS RVU26DEffective Oct 1, 2026One payment locality102 Medicare services in 2024

In Nebraska, Medicare pays $400.12 for 41009 in the office and $244.43 when it’s performed in a hospital or facility.

$400.12Office (non-facility)
$244.43Hospital or facility
−7.6%vs the national office rate ($432.88)

Check a contract rate as a % of Medicare · 41009 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 41009 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nebraska
  2. What 41009 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 41009 covers

This service drains a deep collection in the retropharyngeal or parapharyngeal space through an intraoral approach. It is typically performed by an oral and maxillofacial surgeon or another surgeon treating a deep head-and-neck infection, often in an operating-room setting. A common clinical context is spread of an odontogenic infection into a deep pharyngeal space; the documented space and surgical route distinguish this service from drainage of an oral vestibule or floor-of-mouth collection.

Report the code when the operative record supports drainage of the specified deep space by the intraoral route. Document the involved anatomy, approach, and findings. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures receive the standard multiple-procedure reduction. Modifier 50 is inappropriate. 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 Nebraska compares for 41009

Across 109 of 109 payment localities, the office rate for 41009 runs from $383.37 in Arkansas to $569.54 in San Benito County, CA. Nebraska pays $400.12. The RVUs are the same everywhere; the geographic indexes change the dollars.

41009 in Nebraska vs other payment areas
  1. Nebraska · this page$400.12
  2. Los Angeles, CA · California$486.60+$86.48
  3. Washington, DC area · District of Columbia$493.89+$93.77
  4. Miami, FL · Florida$469.52+$69.40
  5. Chicago, IL · Illinois$455.96+$55.84
  6. Manhattan, NY · New York$497.95+$97.83
  7. Alaska · Alaska$505.37+$105.25

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

Every other payment area

41009 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$388.93$241.34
ArkansasArkansas$383.37$238.48
ArizonaArizona$421.39$257.95
Bakersfield, CACalifornia$457.31$272.45
Chico, CACalifornia$455.90$271.03
El Centro, CACalifornia$455.98$271.11
Fresno, CACalifornia$455.90$271.03
Hanford, CACalifornia$455.90$271.03

41009 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.

$383.37

$512.72

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

View every state and territory as a table
41009 office rate range by state
State / territoryOffice rate rangeLocalities
AK$505.371
AL$388.931
AR$383.371
AZ$421.391
CA$455.90–$569.5429
CO$449.761
CT$461.451
DC$493.891
DE$428.311
FL$427.92–$469.523
GA$403.99–$441.202
GU$466.671
HI$466.671
IA$398.051
ID$400.751
IL$416.16–$455.964
IN$403.031
KS$396.511
KY$398.661
LA$398.17–$417.602
MA$447.24–$493.482
MD$436.32–$493.893
ME$403.14–$424.302
MI$409.20–$433.522
MN$430.171
MO$391.62–$418.703
MS$387.561
MT$432.841
NC$407.261
ND$423.351
NE$400.121
NH$443.001
NJ$466.49–$488.932
NM$411.541
NV$430.491
NY$413.32–$510.285
OH$407.261
OK$397.641
OR$426.93–$463.552
PA$407.73–$450.282
PR$435.891
RI$443.211
SC$407.981
SD$422.231
TN$398.521
TX$405.10–$448.458
UT$413.481
VA$423.13–$493.892
VI$435.891
VT$422.001
WA$446.30–$503.162
WI$409.351
WV$401.021
WY$428.711

See 41009 in every payment locality

How the 41009 rate is calculated

Each of 41009’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 · 41009

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.62

3.62 RVUs× 1.000 GPCI

Practice expense8.86

8.86 RVUs× 1.000 GPCI

Malpractice0.48

0.48 RVUs× 1.000 GPCI

Adjusted RVUs

12.9600

Conversion factor

$33.4009

Medicare rate

$432.88

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

The exact Nebraska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,887

Code
41009
Physician work
3.62
Practice expense
8.86
Malpractice
0.48

GPCI2026.csv

72

Locality
Nebraska
Physician work
1.000
Practice expense
0.923
Malpractice
0.378
Office calculation for 41009 in Nebraska
ComponentRVULocality factorAdjusted
Physician work3.62× 1.0003.6200
Practice expense8.86× 0.9238.1778
Malpractice0.48× 0.3780.1814
Total RVUs11.9792
Conversion factor× 33.4009

Office rate, Nebraska$400.12

Office: (3.62 × 1 + 8.86 × 0.923 + 0.48 × 0.378) × $33.4009 = $400.12

Facility: (3.62 × 1 + 3.81 × 0.923 + 0.48 × 0.378) × $33.4009 = $244.43

Open 41009 in the RVU calculator

Payment rules and modifiers for 41009

41009 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41009

Abscess drainage, intraoral pharyngeal space

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 · 41009

Abscess drainage, intraoral pharyngeal space

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

41009 without 51 · national office

$432.88

Abscess drainage, intraoral pharyngeal space

41009-51 · Second procedure: 50%

$216.44

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 41009 has changed in Nebraska

41009 · Office / nonfacility

$400.12

Effective 2026-10-01

The base rate is $20.10 higher than on 2025-10-01, moving from $380.02 to $400.12 (5.3%).

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

    $380.02changed to$400.12

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.71 changed to 3.62
    • Practice expense RVU 8.62 changed to 8.86
    • Malpractice RVU 0.44 changed to 0.48
    • Practice expense GPCI 0.917 changed to 0.923
    • Malpractice GPCI 0.304 changed to 0.378

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $390.46changed to$380.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.60 changed to 8.62

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $384.09changed to$390.46

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $395.53changed to$384.09

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.41 changed to 0.44
    • Practice expense GPCI 0.913 changed to 0.917
    • Malpractice GPCI 0.269 changed to 0.304
  5. January 1, 2023

    RVU23A

    $398.02changed to$395.53

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.48 changed to 8.60
    • Malpractice RVU 0.39 changed to 0.41
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.235 changed to 0.269

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $399.26changed to$398.02

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.42 changed to 8.48
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $390.95changed to$399.26

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.72 changed to 8.42
    • Malpractice RVU 0.38 changed to 0.37
    • Practice expense GPCI 0.909 changed to 0.908
    • Malpractice GPCI 0.277 changed to 0.235

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $387.97changed to$390.95

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.54 changed to 7.72
    • Malpractice RVU 0.61 changed to 0.38
    • Practice expense GPCI 0.910 changed to 0.909
    • Malpractice GPCI 0.318 changed to 0.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $381.65changed to$387.97

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.36 changed to 7.54

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $382.33changed to$381.65

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.41 changed to 7.36
    • Practice expense GPCI 0.909 changed to 0.910
    • Malpractice GPCI 0.340 changed to 0.318

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $382.62changed to$382.33

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.44 changed to 7.41
    • Practice expense GPCI 0.908 changed to 0.909
    • Malpractice GPCI 0.362 changed to 0.340

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $383.67changed to$382.62

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.43 changed to 7.44

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $381.76changed to$383.67

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $379.68changed to$381.76

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.46 changed to 0.61
    • Practice expense GPCI 0.906 changed to 0.908
    • Malpractice GPCI 0.342 changed to 0.362

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $380.00changed to$379.68

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.08 changed to 7.43
    • Malpractice RVU 0.48 changed to 0.46
    • Practice expense GPCI 0.904 changed to 0.906
    • Malpractice GPCI 0.322 changed to 0.342

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $380.00

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$400.12$244.43RVU26D
2026-07-01$400.12$244.43RVU26C
2026-04-01$400.12$244.43RVU26B
2026-01-01$400.12$244.43RVU26A
2025-10-01$380.02$260.18RVU25D
2025-07-01$380.02$260.18RVU25C
2025-04-01$380.02$260.18RVU25B
2025-01-01$380.02$260.18RVU25A
2024-10-01$390.46$263.78RVU24D
2024-07-01$390.46$263.78RVU24C
2024-04-01$390.46$263.78RVU24B
2024-03-09$390.46$263.78RVU24AR
2024-01-01$384.09$259.48RVU24A
2023-10-01$395.53$264.97RVU23D
2023-07-01$395.53$264.97RVU23C
2023-04-01$395.53$264.97RVU23B
2023-01-01$395.53$264.97RVU23A
2022-10-01$398.02$263.85RVU22D
2022-07-01$398.02$263.85RVU22C
2022-04-01$398.02$263.85RVU22B
2022-01-01$398.02$263.85RVU22A
2021-10-01$399.26$264.92RVU21D
2021-07-01$399.26$264.92RVU21C
2021-04-01$399.26$264.92RVU21B
2021-01-01$399.26$264.92RVU21A
2020-10-01$390.95$272.19RVU20D
2020-07-01$390.95$272.19RVU20C
2020-04-01$390.95$272.19RVU20B
2020-01-01$390.95$272.19RVU20A
2019-10-01$387.97$276.47RVU19D
2019-07-01$387.97$276.47RVU19C
2019-04-01$387.97$276.47RVU19B
2019-01-01$387.97$276.47RVU19A
2018-10-01$381.65$278.13RVU18D
2018-07-01$381.65$278.13RVU18C
2018-04-01$381.65$278.13RVU18B
2018-01-01$381.65$278.13RVU18AR1
2017-10-01$382.33$280.22RVU17D
2017-07-01$382.33$280.22RVU17C
2017-04-01$382.33$280.22RVU17B
2017-01-01$382.33$280.22RVU17A
2016-10-01$382.62$280.21RVU16D
2016-07-01$382.62$280.21RVU16C
2016-04-01$382.62$280.21RVU16B
2016-01-01$382.62$280.21RVU16A
2015-10-01$383.67$280.57RVU15D
2015-07-01$383.67$280.57RVU15C
2015-04-01$381.76$279.17RVU15B
2015-01-01$381.76$279.17RVU15A
2014-10-01$379.68$278.42RVU14D
2014-07-01$379.68$278.42RVU14C
2014-04-01$379.68$278.42RVU14B
2014-01-01$379.68$278.42RVU14A
2013-10-01$380.00$274.81RVU13D
2013-07-01$380.00$274.81RVU13C
2013-04-01$380.00$274.81RVU13B
2013-01-01$380.00$274.81RVU13AR

Price 41009 for an earlier date of service

Where the Nebraska rate applies

Nebraska is a Medicare payment area, not a city. Our Census mapping connects it to 593 cities and communities in Nebraska. Some span more than one payment area; confirm with the service ZIP.

  • Abie
  • Adams
  • Agnew
  • Ainsworth
  • Albion
  • Alda
  • Alexandria
  • Allen

Browse all communities in Nebraska

41009 billing questions

How does this differ from code 41018?

The key distinction is the surgical route: this code describes intraoral access to a retropharyngeal or parapharyngeal space. Code 41018 is for drainage of a deep pharyngeal space by an extraoral approach.

When would 41005 or 41006 be more appropriate?

Choose based on the collection's documented location. Those codes describe drainage in the oral vestibule or floor of the mouth, rather than a retropharyngeal or parapharyngeal space.

What documentation supports reporting this code?

The operative note should identify the retropharyngeal or parapharyngeal space involved and state that drainage was performed through an intraoral approach.

Does the 90-day global period include related postoperative care?

Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in this major-surgery global period.

Can modifier 50 be reported for bilateral drainage?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Assistant-at-surgery payment requires documented medical necessity.

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 41009PPRRVU2026_Oct_nonQPP.csv, line 4,887 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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