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CPT code 41018: Abscess drainage, parapharyngeal space, external approach2026 Medicare rate & RVUs in Iowa

Reports surgical drainage of an abscess in the parapharyngeal space through an external approach, typically for a deep neck infection requiring operative access.

CMS RVU26DEffective Oct 1, 2026One payment locality165 Medicare services in 2024

In Iowa, Medicare pays $503.99 for 41018 in the office and $345.07 when it’s performed in a hospital or facility.

$503.99Office (non-facility)
$345.07Hospital or facility
−8.1%vs the national office rate ($548.44)

Check a contract rate as a % of Medicare · 41018 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 41018 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 41018 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 41018 covers

This service involves surgically opening and draining an infected collection in the parapharyngeal space through an external, typically transcervical, approach. It is generally performed by an otolaryngologist or oral and maxillofacial surgeon in an operating room when the infection’s location or extent calls for operative access to this deep space. The operative work addresses the parapharyngeal collection, rather than a more superficial mouth or neck abscess.

Report the code when the documented site is the parapharyngeal space and the surgeon performs external drainage. The operative note should identify the involved space, approach, and drainage performed; a general diagnosis of a neck abscess alone does not establish the specific service. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other 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 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 Iowa compares for 41018

Across 109 of 109 payment localities, the office rate for 41018 runs from $486.93 in Arkansas to $712.93 in San Benito County, CA. Iowa pays $503.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

41018 in Iowa vs other payment areas
  1. Iowa · this page$503.99
  2. Los Angeles, CA · California$612.36+$108.37
  3. Washington, DC area · District of Columbia$623.44+$119.45
  4. Miami, FL · Florida$599.25+$95.26
  5. Chicago, IL · Illinois$582.12+$78.13
  6. Manhattan, NY · New York$630.68+$126.69
  7. Alaska · Alaska$645.86+$141.87

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

Every other payment area

41018 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$493.81$341.84
ArkansasArkansas$486.93$337.73
ArizonaArizona$534.03$365.73
Bakersfield, CACalifornia$576.45$386.10
Chico, CACalifornia$574.38$384.02
El Centro, CACalifornia$574.50$384.14
Fresno, CACalifornia$574.38$384.02
Hanford, CACalifornia$574.38$384.02

41018 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.

$486.93

$645.86

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

View every state and territory as a table
41018 office rate range by state
State / territoryOffice rate rangeLocalities
AK$645.861
AL$493.811
AR$486.931
AZ$534.031
CA$574.38–$712.9329
CO$567.991
CT$584.141
DC$623.441
DE$542.641
FL$544.76–$599.253
GA$514.69–$559.392
GU$587.061
HI$587.061
IA$503.991
ID$507.571
IL$530.93–$582.124
IN$510.361
KS$502.631
KY$507.051
LA$506.65–$530.742
MA$565.15–$621.622
MD$552.45–$623.443
ME$511.10–$536.502
MI$520.64–$552.302
MN$542.031
MO$498.88–$531.463
MS$492.951
MT$548.401
NC$516.121
ND$534.361
NE$506.381
NH$560.021
NJ$590.18–$617.522
NM$523.771
NV$544.841
NY$523.66–$646.695
OH$517.771
OK$505.201
OR$539.98–$584.472
PA$518.05–$570.622
PR$551.991
RI$560.821
SC$517.931
SD$532.701
TN$505.181
TX$514.83–$566.658
UT$524.741
VA$535.44–$623.442
VI$551.991
VT$533.181
WA$563.79–$633.122
WI$517.131
WV$512.201
WY$542.281

See 41018 in every payment locality

How the 41018 rate is calculated

Each of 41018’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 · 41018

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.09

5.09 RVUs× 1.000 GPCI

Practice expense10.62

10.62 RVUs× 1.000 GPCI

Malpractice0.71

0.71 RVUs× 1.000 GPCI

Adjusted RVUs

16.4200

Conversion factor

$33.4009

Medicare rate

$548.44

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

4,893

Code
41018
Physician work
5.09
Practice expense
10.62
Malpractice
0.71

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 41018 in Iowa
ComponentRVULocality factorAdjusted
Physician work5.09× 1.0005.0900
Practice expense10.62× 0.9159.7173
Malpractice0.71× 0.3970.2819
Total RVUs15.0892
Conversion factor× 33.4009

Office rate, Iowa$503.99

Office: (5.09 × 1 + 10.62 × 0.915 + 0.71 × 0.397) × $33.4009 = $503.99

Facility: (5.09 × 1 + 5.42 × 0.915 + 0.71 × 0.397) × $33.4009 = $345.07

Open 41018 in the RVU calculator

Payment rules and modifiers for 41018

41018 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41018

Abscess drainage, parapharyngeal space, external 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 · 41018

Abscess drainage, parapharyngeal space, external 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

41018 without 51 · national office

$548.44

Abscess drainage, parapharyngeal space, external approach

41018-51 · Second procedure: 50%

$274.22

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 41018

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

Codes related to 41018
CodeHow it relatesOffice range, Iowa
Same family
41015Mouth lesion drainage, extraoral floor-of-mouth approachDrainage of a floor-of-mouth abscess through a submental approach.$379.12
41016Abscess drainage, intraoral deep-space approachDrainage of a floor-of-mouth abscess through a submandibular approach.$444.46
41017Lesion drainage, floor of mouth, intraoralDrainage of an abscess in the masticator space.$440.35

How 41018 has changed in Iowa

41018 · Office / nonfacility

$503.99

Effective 2026-10-01

The base rate is $30.65 higher than on 2025-10-01, moving from $473.34 to $503.99 (6.5%).

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

    $473.34changed to$503.99

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.22 changed to 5.09
    • Practice expense RVU 10.01 changed to 10.62
    • Malpractice RVU 0.60 changed to 0.71
    • 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

    $484.83changed to$473.34

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.94 changed to 10.01
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $476.91changed to$484.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $493.94changed to$476.91

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.01 changed to 9.94
    • Malpractice RVU 0.56 changed to 0.59
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $496.17changed to$493.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.79 changed to 10.01
    • 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

    $497.47changed to$496.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.72 changed to 9.79
    • Malpractice RVU 0.52 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $485.71changed to$497.47

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.84 changed to 9.72
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $484.16changed to$485.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.66 changed to 8.84
    • Malpractice RVU 0.85 changed to 0.52
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $481.16changed to$484.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.58 changed to 8.66
    • Malpractice RVU 0.86 changed to 0.85

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $481.32changed to$481.16

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.65 changed to 8.58
    • Malpractice RVU 0.85 changed to 0.86
    • 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

    $482.00changed to$481.32

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.72 changed to 8.65
    • Malpractice RVU 0.87 changed to 0.85
    • 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

    $482.10changed to$482.00

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.68 changed to 8.72
    • Malpractice RVU 0.85 changed to 0.87

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $479.70changed to$482.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $474.61changed to$479.70

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.66 changed to 8.68
    • Malpractice RVU 0.64 changed to 0.85
    • 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

    $482.84changed to$474.61

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.77 changed to 8.66
    • Malpractice RVU 0.67 changed to 0.64
    • 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: $482.84

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$503.99$345.07RVU26D
2026-07-01$503.99$345.07RVU26C
2026-04-01$503.99$345.07RVU26B
2026-01-01$503.99$345.07RVU26A
2025-10-01$473.34$364.95RVU25D
2025-07-01$473.34$364.95RVU25C
2025-04-01$473.34$364.95RVU25B
2025-01-01$473.34$364.95RVU25A
2024-10-01$484.83$371.16RVU24D
2024-07-01$484.83$371.16RVU24C
2024-04-01$484.83$371.16RVU24B
2024-03-09$484.83$371.16RVU24AR
2024-01-01$476.91$365.11RVU24A
2023-10-01$493.94$375.83RVU23D
2023-07-01$493.94$375.83RVU23C
2023-04-01$493.94$375.83RVU23B
2023-01-01$493.94$375.83RVU23A
2022-10-01$496.17$376.27RVU22D
2022-07-01$496.17$376.27RVU22C
2022-04-01$496.17$376.27RVU22B
2022-01-01$496.17$376.27RVU22A
2021-10-01$497.47$379.11RVU21D
2021-07-01$497.47$379.11RVU21C
2021-04-01$497.47$379.11RVU21B
2021-01-01$497.47$379.11RVU21A
2020-10-01$485.71$383.58RVU20D
2020-07-01$485.71$383.58RVU20C
2020-04-01$485.71$383.58RVU20B
2020-01-01$485.71$383.58RVU20A
2019-10-01$484.16$390.67RVU19D
2019-07-01$484.16$390.67RVU19C
2019-04-01$484.16$390.67RVU19B
2019-01-01$484.16$390.67RVU19A
2018-10-01$481.16$394.64RVU18D
2018-07-01$481.16$394.64RVU18C
2018-04-01$481.16$394.64RVU18B
2018-01-01$481.16$394.64RVU18AR1
2017-10-01$481.32$396.19RVU17D
2017-07-01$481.32$396.19RVU17C
2017-04-01$481.32$396.19RVU17B
2017-01-01$481.32$396.19RVU17A
2016-10-01$482.00$397.31RVU16D
2016-07-01$482.00$397.31RVU16C
2016-04-01$482.00$397.31RVU16B
2016-01-01$482.00$397.31RVU16A
2015-10-01$482.10$396.45RVU15D
2015-07-01$482.10$396.45RVU15C
2015-04-01$479.70$394.48RVU15B
2015-01-01$479.70$394.48RVU15A
2014-10-01$474.61$391.21RVU14D
2014-07-01$474.61$391.21RVU14C
2014-04-01$474.61$391.21RVU14B
2014-01-01$474.61$391.21RVU14A
2013-10-01$482.84$388.98RVU13D
2013-07-01$482.84$388.98RVU13C
2013-04-01$482.84$388.98RVU13B
2013-01-01$482.84$388.98RVU13AR

Price 41018 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.

Browse all communities in Iowa

41018 billing questions

How is this distinguished from drainage of a masticator-space abscess?

Use this code for drainage of a parapharyngeal-space collection by an external approach. A collection in the masticator space belongs to the code for that space, even when the infection is also described as a deep neck infection.

Does an intraoral drainage approach qualify?

This code describes external drainage. Confirm the documented operative approach and the infected space rather than selecting the code from the diagnosis alone.

What documentation supports reporting this code?

The operative report should identify the parapharyngeal space, describe the external approach, and document that the collection was surgically drained.

Is the related postoperative care separately reported during the global period?

The 90-day global period includes the day-before preoperative visit and related postoperative care. The code’s global period does not make unrelated services part of that package.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

How is payment adjusted when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and the other procedure or procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code.

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 41018PPRRVU2026_Oct_nonQPP.csv, line 4,893 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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