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CPT code 41016: Abscess drainage, intraoral deep-space approach2026 Medicare rate & RVUs in Puerto Rico

Reports operative intraoral drainage of an abscess involving the sublingual, submandibular, or submental space.

CMS RVU26DEffective Oct 1, 2026One payment locality157 Medicare services in 2024

In Puerto Rico, Medicare pays $486.98 for 41016 in the office and $326.91 when it’s performed in a hospital or facility.

$486.98Office (non-facility)
$326.91Hospital or facility
+0.7%vs the national office rate ($483.65)

Check a contract rate as a % of Medicare · 41016 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 41016 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 41016 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 41016 covers

Code 41016 describes surgical drainage reached through the mouth for an infection in the sublingual, submandibular, or submental space. Oral and maxillofacial surgeons and otolaryngologists commonly perform it in an operating room when a deep infection requires operative access, rather than drainage of a superficial oral lesion. The documented approach must be intraoral and the involved space must support selection of this code.

Record the affected space, incision route, findings, and drainage performed. The 90-day global period includes the preoperative visit on the day before surgery and related postoperative care for 90 days. 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 50% reduction. Modifier 50 is not appropriate for this anatomy. An assistant is paid only when medical necessity is documented; 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 Puerto Rico compares for 41016

Across 109 of 109 payment localities, the office rate for 41016 runs from $428.28 in Arkansas to $635.12 in San Benito County, CA. Puerto Rico pays $486.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

41016 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$486.98
  2. Los Angeles, CA · California$543.05+$56.07
  3. Washington, DC area · District of Columbia$551.58+$64.60
  4. Miami, FL · Florida$525.71+$38.73
  5. Chicago, IL · Illinois$510.47+$23.49
  6. Manhattan, NY · New York$556.54+$69.56
  7. Alaska · Alaska$564.89+$77.91

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

Every other payment area

41016 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$434.49$295.96
ArkansasArkansas$428.28$292.28
ArizonaArizona$470.77$317.36
Bakersfield, CACalifornia$510.45$336.93
Chico, CACalifornia$508.81$335.29
El Centro, CACalifornia$508.90$335.38
Fresno, CACalifornia$508.81$335.29
Hanford, CACalifornia$508.81$335.29

41016 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.

$428.28

$571.97

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

View every state and territory as a table
41016 office rate range by state
State / territoryOffice rate rangeLocalities
AK$564.891
AL$434.491
AR$428.281
AZ$470.771
CA$508.81–$635.1229
CO$502.201
CT$515.591
DC$551.581
DE$478.501
FL$478.61–$525.713
GA$451.78–$493.072
GU$520.751
HI$520.751
IA$444.461
ID$447.521
IL$465.61–$510.474
IN$450.061
KS$442.851
KY$445.611
LA$445.10–$466.822
MA$499.44–$550.882
MD$487.42–$551.583
ME$450.31–$473.792
MI$457.49–$484.982
MN$480.001
MO$437.85–$467.923
MS$433.131
MT$483.611
NC$454.891
ND$472.531
NE$446.731
NH$494.771
NJ$521.13–$546.062
NM$460.151
NV$480.851
NY$461.67–$570.475
OH$455.231
OK$444.341
OR$476.78–$517.492
PA$455.69–$503.182
PR$486.981
RI$495.061
SC$455.891
SD$471.231
TN$445.111
TX$452.77–$500.838
UT$462.041
VA$472.56–$551.582
VI$486.981
VT$471.121
WA$498.35–$561.582
WI$456.911
WV$448.701
WY$478.781

See 41016 in every payment locality

How the 41016 rate is calculated

Each of 41016’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 · 41016

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.09

4.09 RVUs× 1.000 GPCI

Practice expense9.83

9.83 RVUs× 1.000 GPCI

Malpractice0.56

0.56 RVUs× 1.000 GPCI

Adjusted RVUs

14.4800

Conversion factor

$33.4009

Medicare rate

$483.65

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,891

Code
41016
Physician work
4.09
Practice expense
9.83
Malpractice
0.56

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 41016 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.09× 1.0004.0900
Practice expense9.83× 1.0119.9381
Malpractice0.56× 0.9850.5516
Total RVUs14.5797
Conversion factor× 33.4009

Office rate, Puerto Rico$486.98

Office: (4.09 × 1 + 9.83 × 1.011 + 0.56 × 0.985) × $33.4009 = $486.98

Facility: (4.09 × 1 + 5.09 × 1.011 + 0.56 × 0.985) × $33.4009 = $326.91

Open 41016 in the RVU calculator

Payment rules and modifiers for 41016

41016 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41016

Abscess drainage, intraoral deep-space 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 · 41016

Abscess drainage, intraoral deep-space 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

41016 without 51 · national office

$483.65

Abscess drainage, intraoral deep-space approach

41016-51 · Second procedure: 50%

$241.83

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 41016

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

Codes related to 41016
CodeHow it relatesOffice range, Puerto Rico
Same family
41017Lesion drainage, floor of mouth, intraoralDrainage of the same deep spaces using an external approach.$482.26
41015Mouth lesion drainage, extraoral floor-of-mouth approachExternal drainage for an abscess in the masticator space.$413.16
41005Oral drainage, mouth vestibuleIntraoral drainage involving the tongue or floor of the mouth.$233.07
41006Mouth lesion drainage, floor of mouth, extraoralExternal drainage involving the tongue or floor of the mouth.$351.35

How 41016 has changed in Puerto Rico

41016 · Office / nonfacility

$486.98

Effective 2026-10-01

The base rate is $32.96 higher than on 2025-10-01, moving from $454.02 to $486.98 (7.3%).

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

    $454.02changed to$486.98

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.19 changed to 4.09
    • Practice expense RVU 9.30 changed to 9.83
    • Malpractice RVU 0.49 changed to 0.56
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $467.25changed to$454.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.32 changed to 9.30
    • Malpractice RVU 0.47 changed to 0.49

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $459.62changed to$467.25

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $478.09changed to$459.62

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.41 changed to 9.32
    • Malpractice RVU 0.44 changed to 0.47
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $475.78changed to$478.09

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $490.36changed to$475.78

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.48 changed to 9.41
    • Malpractice RVU 0.43 changed to 0.44
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $490.19changed to$490.36

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.34 changed to 9.48
    • Malpractice RVU 0.45 changed to 0.43

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $471.74changed to$490.19

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.36 changed to 9.34
    • Malpractice RVU 0.46 changed to 0.45
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $463.42changed to$471.74

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.94 changed to 8.36
    • Malpractice RVU 0.68 changed to 0.46
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $460.00changed to$463.42

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.85 changed to 7.94
    • Malpractice RVU 0.69 changed to 0.68

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $410.27changed to$460.00

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.95 changed to 7.85
    • Malpractice RVU 0.68 changed to 0.69
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $359.95changed to$410.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.03 changed to 7.95
    • Malpractice RVU 0.69 changed to 0.68
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $360.13changed to$359.95

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.99 changed to 8.03
    • Malpractice RVU 0.68 changed to 0.69

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $358.34changed to$360.13

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $353.36changed to$358.34

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.00 changed to 7.99
    • Malpractice RVU 0.51 changed to 0.68
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $343.81changed to$353.36

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.53 changed to 8.00
    • Malpractice RVU 0.53 changed to 0.51
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $343.81

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$486.98$326.91RVU26D
2026-07-01$486.98$326.91RVU26C
2026-04-01$486.98$326.91RVU26B
2026-01-01$486.98$326.91RVU26A
2025-10-01$454.02$339.69RVU25D
2025-07-01$454.02$339.69RVU25C
2025-04-01$454.02$339.69RVU25B
2025-01-01$454.02$339.69RVU25A
2024-10-01$467.25$345.91RVU24D
2024-07-01$467.25$345.91RVU24C
2024-04-01$467.25$345.91RVU24B
2024-03-09$467.25$345.91RVU24AR
2024-01-01$459.62$340.26RVU24A
2023-10-01$478.09$351.02RVU23D
2023-07-01$475.78$349.72RVU23C
2023-04-01$475.78$349.72RVU23B
2023-01-01$475.78$349.72RVU23A
2022-10-01$490.36$356.41RVU22D
2022-07-01$490.36$356.41RVU22C
2022-04-01$490.36$356.41RVU22B
2022-01-01$490.36$356.41RVU22A
2021-10-01$490.19$359.00RVU21D
2021-07-01$490.19$359.00RVU21C
2021-04-01$490.19$359.00RVU21B
2021-01-01$490.19$359.00RVU21A
2020-10-01$471.74$359.33RVU20D
2020-07-01$471.74$359.33RVU20C
2020-04-01$471.74$359.33RVU20B
2020-01-01$471.74$359.33RVU20A
2019-10-01$463.42$363.62RVU19D
2019-07-01$463.42$363.62RVU19C
2019-04-01$463.42$363.62RVU19B
2019-01-01$463.42$363.62RVU19A
2018-10-01$460.00$368.65RVU18D
2018-07-01$460.00$368.65RVU18C
2018-04-01$460.00$368.65RVU18B
2018-01-01$460.00$368.65RVU18AR1
2017-10-01$410.27$332.85RVU17D
2017-07-01$410.27$332.85RVU17C
2017-04-01$410.27$332.85RVU17B
2017-01-01$410.27$332.85RVU17A
2016-10-01$359.95$295.58RVU16D
2016-07-01$359.95$295.58RVU16C
2016-04-01$359.95$295.58RVU16B
2016-01-01$359.95$295.58RVU16A
2015-10-01$360.13$295.79RVU15D
2015-07-01$360.13$295.79RVU15C
2015-04-01$358.34$294.31RVU15B
2015-01-01$358.34$294.31RVU15A
2014-10-01$353.36$290.89RVU14D
2014-07-01$353.36$290.89RVU14C
2014-04-01$353.36$290.89RVU14B
2014-01-01$353.36$290.89RVU14A
2013-10-01$343.81$284.99RVU13D
2013-07-01$343.81$284.99RVU13C
2013-04-01$343.81$284.99RVU13B
2013-01-01$343.81$284.99RVU13AR

Price 41016 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

41016 billing questions

How is 41016 distinguished from 41017?

41016 is for drainage through an intraoral approach. Use 41017 when the surgeon reaches the sublingual, submandibular, or submental space externally.

Does the note need to identify the space and approach?

Yes. Document the involved anatomic space and that drainage was performed through an intraoral incision.

Can modifier 50 be reported?

No. The anatomy is represented by a single procedure code, not a bilateral modifier 50 claim.

How does the 90-day global period affect follow-up billing?

The day-before preoperative visit and related postoperative care for 90 days are included in the global period.

Can an assistant surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures 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 41016PPRRVU2026_Oct_nonQPP.csv, line 4,891 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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