CPT code 41015: Mouth lesion drainage, extraoral floor-of-mouth approach2026 Medicare rate & RVUs in Oklahoma
Reports surgical drainage of an abscess, cyst, or hematoma in the floor of the mouth when the surgeon reaches the collection through an external incision.
In Oklahoma, Medicare pays $379.05 for 41015 in the office and $262.43 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 41015 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 41015 covers
This service drains a collection in the floor of the mouth through an incision made outside the mouth. Oral and maxillofacial surgeons and other surgeons treating deep oral infections may perform it, commonly in a facility when the collection requires external access. The operative report should identify the floor-of-mouth site and document the external approach and drainage performed; the code is distinguished from procedures that reach a collection through the oral cavity or target another space.
Report the service for the documented site and approach, not simply because a patient has an oral abscess. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment requires documentation of 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 Oklahoma compares for 41015
Across 109 of 109 payment localities, the office rate for 41015 runs from $366.19 in Arkansas to $534.18 in San Benito County, CA. Oklahoma pays $379.05. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Oklahoma · this page$379.05
- Los Angeles, CA · California$458.94+$79.89
- Washington, DC area · District of Columbia$466.10+$87.05
- Miami, FL · Florida$444.24+$65.19
- Chicago, IL · Illinois$432.20+$53.15
- Manhattan, NY · New York$470.34+$91.29
- Alaska · Alaska$487.28+$108.23
Other areas in Oklahoma first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $371.16 | $256.88 |
| ArkansasArkansas | $366.19 | $254.01 |
| ArizonaArizona | $400.19 | $273.65 |
| Bakersfield, CACalifornia | $432.35 | $289.21 |
| Chico, CACalifornia | $430.99 | $287.85 |
| El Centro, CACalifornia | $431.06 | $287.93 |
| Fresno, CACalifornia | $430.99 | $287.85 |
| Hanford, CACalifornia | $430.99 | $287.85 |
| Madera, CACalifornia | $430.99 | $287.85 |
| Merced, CACalifornia | $430.99 | $287.85 |
| Modesto, CACalifornia | $430.99 | $287.85 |
| Napa, CACalifornia | $494.96 | $322.83 |
| Oxnard, CACalifornia | $456.33 | $301.97 |
| Redding, CACalifornia | $430.99 | $287.85 |
| Rest of CaliforniaCalifornia | $430.99 | $287.85 |
| Riverside, CACalifornia | $435.88 | $292.75 |
| Sacramento, CACalifornia | $451.10 | $299.22 |
| Salinas, CACalifornia | $449.39 | $298.02 |
| San Diego, CACalifornia | $459.06 | $302.86 |
| Marin County, CACalifornia | $522.63 | $338.49 |
| San Francisco, CACalifornia | $522.12 | $337.98 |
| San Benito County, CACalifornia | $534.18 | $345.86 |
| Santa Clara County, CACalifornia | $532.10 | $343.77 |
| San Luis Obispo, CACalifornia | $442.27 | $293.52 |
| Santa Cruz, CACalifornia | $462.76 | $304.08 |
| Santa Maria, CACalifornia | $450.83 | $298.55 |
| Santa Rosa, CACalifornia | $467.37 | $306.99 |
| Stockton, CACalifornia | $430.99 | $287.85 |
| Vallejo, CACalifornia | $494.23 | $322.10 |
| Visalia, CACalifornia | $430.99 | $287.85 |
| Yuba City, CACalifornia | $430.99 | $287.85 |
| ColoradoColorado | $425.60 | $286.65 |
| ConnecticutConnecticut | $436.53 | $295.87 |
| DelawareDelaware | $406.49 | $277.46 |
| Fort Lauderdale, FLFlorida | $426.05 | $293.76 |
| Rest of FloridaFlorida | $406.51 | $281.65 |
| Atlanta, GAGeorgia | $418.12 | $285.43 |
| Rest of GeorgiaGeorgia | $385.03 | $268.54 |
| Hawaii, Guam, HIHawaii | $440.14 | $291.65 |
| IowaIowa | $379.12 | $259.62 |
| IdahoIdaho | $381.57 | $261.42 |
| East St. Louis, ILIllinois | $404.74 | $284.59 |
| Rest of IllinoisIllinois | $396.12 | $276.88 |
| Suburban Chicago, ILIllinois | $430.12 | $296.00 |
| IndianaIndiana | $383.61 | $262.54 |
| KansasKansas | $377.84 | $259.78 |
| KentuckyKentucky | $380.08 | $263.98 |
| New Orleans, LALouisiana | $397.05 | $274.16 |
| Rest of LouisianaLouisiana | $379.67 | $264.10 |
| Metropolitan Boston, MAMassachusetts | $465.23 | $309.29 |
| Rest of MassachusettsMassachusetts | $423.49 | $285.97 |
| Baltimore area, MDMaryland | $435.35 | $295.22 |
| Rest of MarylandMaryland | $413.74 | $281.58 |
| Rest of MaineMaine | $383.81 | $263.66 |
| Southern Maine, MEMaine | $402.59 | $273.17 |
| Detroit, MIMichigan | $411.62 | $285.59 |
| Rest of MichiganMichigan | $389.60 | $270.36 |
| MinnesotaMinnesota | $407.53 | $273.14 |
| Metropolitan Kansas City, MOMissouri | $394.14 | $271.51 |
| Metropolitan St. Louis, MOMissouri | $397.93 | $273.60 |
| Rest of MissouriMissouri | $373.88 | $261.30 |
| MississippiMississippi | $370.08 | $257.64 |
| MontanaMontana | $410.47 | $279.87 |
| North CarolinaNorth Carolina | $387.48 | $265.63 |
| North DakotaNorth Dakota | $401.57 | $270.97 |
| NebraskaNebraska | $380.93 | $260.39 |
| New HampshireNew Hampshire | $419.38 | $283.43 |
| Northern New JerseyNew Jersey | $461.90 | $310.41 |
| Rest of New JerseyNew Jersey | $441.43 | $298.81 |
| New MexicoNew Mexico | $391.73 | $271.97 |
| NevadaNevada | $408.25 | $277.52 |
| NYC suburbs and Long Island, NYNew York | $481.50 | $326.22 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $444.58 | $301.57 |
| Queens, NYNew York | $473.43 | $319.06 |
| Rest of New YorkNew York | $392.91 | $268.84 |
| OhioOhio | $387.78 | $268.54 |
| Portland, OROregon | $437.92 | $292.82 |
| Rest of OregonOregon | $404.98 | $274.91 |
| Metropolitan Philadelphia, PAPennsylvania | $426.55 | $290.60 |
| Rest of PennsylvaniaPennsylvania | $388.14 | $268.25 |
| Puerto RicoPuerto Rico | $413.16 | $281.13 |
| Rhode IslandRhode Island | $420.06 | $285.16 |
| South CarolinaSouth Carolina | $388.29 | $267.62 |
| South DakotaSouth Dakota | $400.52 | $269.92 |
| TennesseeTennessee | $379.65 | $260.93 |
| Austin, TXTexas | $424.28 | $286.10 |
| Beaumont, TXTexas | $385.80 | $266.96 |
| Brazoria, TXTexas | $405.89 | $276.47 |
| Dallas, TXTexas | $408.51 | $278.43 |
| Fort Worth, TXTexas | $406.08 | $277.31 |
| Galveston, TXTexas | $407.14 | $277.45 |
| Houston, TXTexas | $415.37 | $285.69 |
| Rest of TexasTexas | $395.65 | $271.71 |
| UtahUtah | $393.21 | $270.45 |
| VirginiaVirginia | $401.62 | $273.24 |
| Virgin Islands, VIUnited States Virgin Islands | $413.16 | $281.13 |
| VermontVermont | $400.45 | $271.16 |
| Rest of WashingtonWashington | $422.55 | $285.03 |
| King County, WAWashington | $473.99 | $313.74 |
| WisconsinWisconsin | $389.07 | $263.96 |
| West VirginiaWest Virginia | $382.58 | $269.09 |
| WyomingWyoming | $406.59 | $275.99 |
41015 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.
$366.19
$487.28
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $487.28 | 1 |
| AL | $371.16 | 1 |
| AR | $366.19 | 1 |
| AZ | $400.19 | 1 |
| CA | $430.99–$534.18 | 29 |
| CO | $425.60 | 1 |
| CT | $436.53 | 1 |
| DC | $466.10 | 1 |
| DE | $406.49 | 1 |
| FL | $406.51–$444.24 | 3 |
| GA | $385.03–$418.12 | 2 |
| GU | $440.14 | 1 |
| HI | $440.14 | 1 |
| IA | $379.12 | 1 |
| ID | $381.57 | 1 |
| IL | $396.12–$432.20 | 4 |
| IN | $383.61 | 1 |
| KS | $377.84 | 1 |
| KY | $380.08 | 1 |
| LA | $379.67–$397.05 | 2 |
| MA | $423.49–$465.23 | 2 |
| MD | $413.74–$466.10 | 3 |
| ME | $383.81–$402.59 | 2 |
| MI | $389.60–$411.62 | 2 |
| MN | $407.53 | 1 |
| MO | $373.88–$397.93 | 3 |
| MS | $370.08 | 1 |
| MT | $410.47 | 1 |
| NC | $387.48 | 1 |
| ND | $401.57 | 1 |
| NE | $380.93 | 1 |
| NH | $419.38 | 1 |
| NJ | $441.43–$461.90 | 2 |
| NM | $391.73 | 1 |
| NV | $408.25 | 1 |
| NY | $392.91–$481.50 | 5 |
| OH | $387.78 | 1 |
| OK | $379.05 | 1 |
| OR | $404.98–$437.92 | 2 |
| PA | $388.14–$426.55 | 2 |
| PR | $413.16 | 1 |
| RI | $420.06 | 1 |
| SC | $388.29 | 1 |
| SD | $400.52 | 1 |
| TN | $379.65 | 1 |
| TX | $385.80–$424.28 | 8 |
| UT | $393.21 | 1 |
| VA | $401.62–$466.10 | 2 |
| VI | $413.16 | 1 |
| VT | $400.45 | 1 |
| WA | $422.55–$473.99 | 2 |
| WI | $389.07 | 1 |
| WV | $382.58 | 1 |
| WY | $406.59 | 1 |
How the 41015 rate is calculated
Each of 41015’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 · 41015
RVUs × geographic indexes × conversion factor
Work3.98
3.98 RVUs× 1.000 GPCI
Practice expense7.86
7.86 RVUs× 1.000 GPCI
Malpractice0.45
0.45 RVUs× 1.000 GPCI
Adjusted RVUs
12.2900
Conversion factor
$33.4009
Medicare rate
$410.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Oklahoma inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,890
- Code
- 41015
- Physician work
- 3.98
- Practice expense
- 7.86
- Malpractice
- 0.45
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.98 | × 1.000 | 3.9800 |
| Practice expense | 7.86 | × 0.893 | 7.0190 |
| Malpractice | 0.45 | × 0.777 | 0.3497 |
| Total RVUs | 11.3486 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Oklahoma$379.05
Office: (3.98 × 1 + 7.86 × 0.893 + 0.45 × 0.777) × $33.4009 = $379.05
Facility: (3.98 × 1 + 3.95 × 0.893 + 0.45 × 0.777) × $33.4009 = $262.43
Payment rules and modifiers for 41015
41015 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41015
Mouth lesion drainage, extraoral floor-of-mouth approach
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 41015
Mouth lesion drainage, extraoral floor-of-mouth 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
41015 without 51 · national office
$410.50
Mouth lesion drainage, extraoral floor-of-mouth approach
41015-51 · Second procedure: 50%
$205.25
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%).
How 41015 has changed in Oklahoma
41015 · Office / nonfacility
$379.05
Effective 2026-10-01
The base rate is $16.63 higher than on 2025-10-01, moving from $362.42 to $379.05 (4.6%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$362.42changed to$379.05
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.08 changed to 3.98
- Practice expense RVU 7.64 changed to 7.86
- Malpractice RVU 0.39 changed to 0.45
- Practice expense GPCI 0.891 changed to 0.893
- Malpractice GPCI 0.813 changed to 0.777
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$369.38changed to$362.42
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 7.51 changed to 7.64
- Malpractice RVU 0.40 changed to 0.39
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$363.35changed to$369.38
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$373.15changed to$363.35
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 7.49 changed to 7.51
- Malpractice RVU 0.37 changed to 0.40
- Practice expense GPCI 0.886 changed to 0.891
- Malpractice GPCI 0.798 changed to 0.813
January 1, 2023
RVU23A
$377.80changed to$373.15
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 7.45 changed to 7.49
- Malpractice RVU 0.35 changed to 0.37
- Practice expense GPCI 0.881 changed to 0.886
- Malpractice GPCI 0.782 changed to 0.798
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$381.89changed to$377.80
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 7.49 changed to 7.45
- Malpractice RVU 0.34 changed to 0.35
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$387.47changed to$381.89
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 7.17 changed to 7.49
- Malpractice RVU 0.35 changed to 0.34
- Practice expense GPCI 0.886 changed to 0.881
- Malpractice GPCI 0.868 changed to 0.782
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$404.85changed to$387.47
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 7.29 changed to 7.17
- Malpractice RVU 0.69 changed to 0.35
- Practice expense GPCI 0.891 changed to 0.886
- Malpractice GPCI 0.954 changed to 0.868
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$412.43changed to$404.85
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 7.54 changed to 7.29
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$435.86changed to$412.43
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.45 changed to 7.54
- Malpractice RVU 0.68 changed to 0.69
- Practice expense GPCI 0.882 changed to 0.891
- Malpractice GPCI 0.900 changed to 0.954
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$430.78changed to$435.86
- Conversion factor 35.8043 changed to 35.8887
- Malpractice RVU 0.69 changed to 0.68
- Practice expense GPCI 0.872 changed to 0.882
- Malpractice GPCI 0.845 changed to 0.900
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$432.65changed to$430.78
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.46 changed to 8.45
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$430.49changed to$432.65
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$419.37changed to$430.49
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 8.37 changed to 8.46
- Malpractice RVU 0.50 changed to 0.69
- Practice expense GPCI 0.864 changed to 0.872
- Malpractice GPCI 0.790 changed to 0.845
Held through RVU15B.
January 1, 2014
RVU14A
$417.12changed to$419.37
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 9.11 changed to 8.37
- Malpractice RVU 0.52 changed to 0.50
- Practice expense GPCI 0.856 changed to 0.864
- Malpractice GPCI 0.734 changed to 0.790
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $417.12
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $379.05 | $262.43 | RVU26D |
| 2026-07-01 | $379.05 | $262.43 | RVU26C |
| 2026-04-01 | $379.05 | $262.43 | RVU26B |
| 2026-01-01 | $379.05 | $262.43 | RVU26A |
| 2025-10-01 | $362.42 | $277.11 | RVU25D |
| 2025-07-01 | $362.42 | $277.11 | RVU25C |
| 2025-04-01 | $362.42 | $277.11 | RVU25B |
| 2025-01-01 | $362.42 | $277.11 | RVU25A |
| 2024-10-01 | $369.38 | $280.10 | RVU24D |
| 2024-07-01 | $369.38 | $280.10 | RVU24C |
| 2024-04-01 | $369.38 | $280.10 | RVU24B |
| 2024-03-09 | $369.38 | $280.10 | RVU24AR |
| 2024-01-01 | $363.35 | $275.53 | RVU24A |
| 2023-10-01 | $373.15 | $281.87 | RVU23D |
| 2023-07-01 | $373.15 | $281.87 | RVU23C |
| 2023-04-01 | $373.15 | $281.87 | RVU23B |
| 2023-01-01 | $373.15 | $281.87 | RVU23A |
| 2022-10-01 | $377.80 | $283.29 | RVU22D |
| 2022-07-01 | $377.80 | $283.29 | RVU22C |
| 2022-04-01 | $377.80 | $283.29 | RVU22B |
| 2022-01-01 | $377.80 | $283.29 | RVU22A |
| 2021-10-01 | $381.89 | $288.13 | RVU21D |
| 2021-07-01 | $381.89 | $288.13 | RVU21C |
| 2021-04-01 | $381.89 | $288.13 | RVU21B |
| 2021-01-01 | $381.89 | $288.13 | RVU21A |
| 2020-10-01 | $387.47 | $301.78 | RVU20D |
| 2020-07-01 | $387.47 | $301.78 | RVU20C |
| 2020-04-01 | $387.47 | $301.78 | RVU20B |
| 2020-01-01 | $387.47 | $301.78 | RVU20A |
| 2019-10-01 | $404.85 | $323.61 | RVU19D |
| 2019-07-01 | $404.85 | $323.61 | RVU19C |
| 2019-04-01 | $404.85 | $323.61 | RVU19B |
| 2019-01-01 | $404.85 | $323.61 | RVU19A |
| 2018-10-01 | $412.43 | $334.48 | RVU18D |
| 2018-07-01 | $412.43 | $334.48 | RVU18C |
| 2018-04-01 | $412.43 | $334.48 | RVU18B |
| 2018-01-01 | $412.43 | $334.48 | RVU18AR1 |
| 2017-10-01 | $435.86 | $342.80 | RVU17D |
| 2017-07-01 | $435.86 | $342.80 | RVU17C |
| 2017-04-01 | $435.86 | $342.80 | RVU17B |
| 2017-01-01 | $435.86 | $342.80 | RVU17A |
| 2016-10-01 | $430.78 | $339.92 | RVU16D |
| 2016-07-01 | $430.78 | $339.92 | RVU16C |
| 2016-04-01 | $430.78 | $339.92 | RVU16B |
| 2016-01-01 | $430.78 | $339.92 | RVU16A |
| 2015-10-01 | $432.65 | $340.52 | RVU15D |
| 2015-07-01 | $432.65 | $340.52 | RVU15C |
| 2015-04-01 | $430.49 | $338.83 | RVU15B |
| 2015-01-01 | $430.49 | $338.83 | RVU15A |
| 2014-10-01 | $419.37 | $330.23 | RVU14D |
| 2014-07-01 | $419.37 | $330.23 | RVU14C |
| 2014-04-01 | $419.37 | $330.23 | RVU14B |
| 2014-01-01 | $419.37 | $330.23 | RVU14A |
| 2013-10-01 | $417.12 | $324.50 | RVU13D |
| 2013-07-01 | $417.12 | $324.50 | RVU13C |
| 2013-04-01 | $417.12 | $324.50 | RVU13B |
| 2013-01-01 | $417.12 | $324.50 | RVU13AR |
Where the Oklahoma rate applies
Oklahoma is a Medicare payment area, not a city. Our Census mapping connects it to 846 cities and communities in Oklahoma. Some span more than one payment area; confirm with the service ZIP.
- Lahoma
- Achille
- Ada
- Adair
- Adams
- Adamson
- Addington
- Afton
41015 billing questions
When is this code chosen over an intraoral drainage code?
Use it when the operative documentation identifies a floor-of-mouth collection and the surgeon drains it through an external incision. Drainage reached through the mouth is coded to the applicable intraoral service.
How is this distinguished from 41007?
The distinction is the documented target and approach: 41015 describes external access to a floor-of-mouth collection, while 41007 is for drainage of a submandibular-space collection.
What should the operative report document?
Document the collection's anatomic site, the external route of access, and the drainage performed. A general diagnosis of mouth abscess without the site and approach is not enough to establish this specific service.
Can modifier 50 be used for bilateral drainage?
No. CMS identifies bilateral adjustment as inappropriate for this code's descriptor and anatomy.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment requires medical-necessity documentation.
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
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