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CPT code 41100: Tongue biopsy, anterior two-thirds2026 Medicare rate & RVUs in Puerto Rico

Reports tissue sampling from a lesion in the anterior two-thirds of the tongue for microscopic diagnosis, rather than complete lesion removal.

CMS RVU26DEffective Oct 1, 2026One payment locality6.6K Medicare services in 2024

In Puerto Rico, Medicare pays $189.44 for 41100 in the office and $97.93 when it’s performed in a hospital or facility.

$189.44Office (non-facility)
$97.93Hospital or facility
+0.7%vs the national office rate ($188.05)

Check a contract rate as a % of Medicare · 41100 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 41100 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 41100 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 41100 covers

This service samples tissue from the front two-thirds of the tongue, from the tip through the body, for pathologic examination. An otolaryngologist, oral and maxillofacial surgeon, or other qualified clinician may perform it in an office or facility. Common reasons include evaluating a persistent tongue ulcer or a suspicious white or red mucosal patch. The biopsy obtains diagnostic tissue; it is not reported in place of an excision that removes the lesion.

Document the exact tongue site, the clinical concern, and the tissue obtained for examination. Choose the posterior-tongue biopsy code when the sampled site is in the back third, and use a floor-of-mouth code for tissue from that separate site. Medicare assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 41100

Across 109 of 109 payment localities, the office rate for 41100 runs from $165.85 in Arkansas to $250.11 in San Benito County, CA. Puerto Rico pays $189.44. The RVUs are the same everywhere; the geographic indexes change the dollars.

41100 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$189.44
  2. Los Angeles, CA · California$212.62+$23.18
  3. Washington, DC area · District of Columbia$215.39+$25.95
  4. Miami, FL · Florida$203.31+$13.87
  5. Chicago, IL · Illinois$197.27+$7.83
  6. Manhattan, NY · New York$216.68+$27.24
  7. Alaska · Alaska$217.06+$27.62

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

Every other payment area

41100 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$168.34$89.14
ArkansasArkansas$165.85$88.09
ArizonaArizona$182.93$95.22
Bakersfield, CACalifornia$199.46$100.25
Chico, CACalifornia$198.90$99.70
El Centro, CACalifornia$198.94$99.73
Fresno, CACalifornia$198.90$99.70
Hanford, CACalifornia$198.90$99.70

41100 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.

$165.85

$224.51

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

View every state and territory as a table
41100 office rate range by state
State / territoryOffice rate rangeLocalities
AK$217.061
AL$168.341
AR$165.851
AZ$182.931
CA$198.90–$250.1129
CO$195.891
CT$200.741
DC$215.391
DE$186.011
FL$185.27–$203.313
GA$174.62–$191.632
GU$203.951
HI$203.951
IA$172.691
ID$173.851
IL$179.82–$197.274
IN$174.891
KS$171.881
KY$172.461
LA$172.19–$180.912
MA$194.68–$215.552
MD$189.61–$215.393
ME$174.80–$184.482
MI$177.07–$187.652
MN$187.511
MO$169.17–$181.553
MS$167.541
MT$188.031
NC$176.671
ND$184.281
NE$173.661
NH$192.811
NJ$202.98–$213.082
NM$178.071
NV$187.121
NY$179.38–$222.075
OH$176.301
OK$172.121
OR$185.62–$202.212
PA$176.58–$195.662
PR$189.441
RI$192.711
SC$176.791
SD$183.831
TN$172.771
TX$175.39–$195.288
UT$179.261
VA$183.88–$215.392
VI$189.441
VT$183.561
WA$194.32–$219.972
WI$177.961
WV$173.021
WY$186.401

See 41100 in every payment locality

How the 41100 rate is calculated

Each of 41100’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 · 41100

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.38

1.38 RVUs× 1.000 GPCI

Practice expense4.06

4.06 RVUs× 1.000 GPCI

Malpractice0.19

0.19 RVUs× 1.000 GPCI

Adjusted RVUs

5.6300

Conversion factor

$33.4009

Medicare rate

$188.05

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

4,895

Code
41100
Physician work
1.38
Practice expense
4.06
Malpractice
0.19

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 41100 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.38× 1.0001.3800
Practice expense4.06× 1.0114.1047
Malpractice0.19× 0.9850.1872
Total RVUs5.6718
Conversion factor× 33.4009

Office rate, Puerto Rico$189.44

Office: (1.38 × 1 + 4.06 × 1.011 + 0.19 × 0.985) × $33.4009 = $189.44

Facility: (1.38 × 1 + 1.35 × 1.011 + 0.19 × 0.985) × $33.4009 = $97.93

Open 41100 in the RVU calculator

Payment rules and modifiers for 41100

41100 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41100

Tongue biopsy, anterior two-thirds

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 41100

Tongue biopsy, anterior two-thirds

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

41100 without 51 · national office

$188.05

Tongue biopsy, anterior two-thirds

41100-51 · Second procedure: 50%

$94.03

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 41100

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

Codes related to 41100
CodeHow it relatesOffice range, Puerto Rico
Same family
41105Tongue biopsy, posterior one-thirdBiopsy code for a site in the posterior third of the tongue.$190.77
Used instead
41108Oral biopsy, floor of mouthApplies when the sampled tissue is from the floor of the mouth, not the tongue.$171.36
41110Tongue lesion excision, without closureTongue-lesion excision code when tissue is removed rather than sampled for diagnosis.$228.55
41112Tongue excision, anterior two-thirds, with closureTongue-lesion excision option; distinguish lesion removal from diagnostic biopsy.$344.78
Often billed with
88305Tissue pathology exam, level IV specimenMay be reported for the laboratory's histopathologic examination of the biopsy specimen.$70.63

How 41100 has changed in Puerto Rico

41100 · Office / nonfacility

$189.44

Effective 2026-10-01

The base rate is $7.82 higher than on 2025-10-01, moving from $181.62 to $189.44 (4.3%).

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

    $181.62changed to$189.44

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.42 changed to 1.38
    • Practice expense RVU 3.99 changed to 4.06
    • Malpractice RVU 0.18 changed to 0.19
    • 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

    $188.90changed to$181.62

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.04 changed to 3.99
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $185.82changed to$188.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $192.80changed to$185.82

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.05 changed to 4.04
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $191.80changed to$192.80

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

  6. January 1, 2023

    RVU23A

    $195.85changed to$191.80

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.02 changed to 4.05
    • 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

    $193.62changed to$195.85

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.93 changed to 4.02
    • Malpractice RVU 0.17 changed to 0.19

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $181.35changed to$193.62

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.40 changed to 3.93
    • Malpractice RVU 0.18 changed to 0.17
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $178.79changed to$181.35

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.31 changed to 3.40
    • Malpractice RVU 0.21 changed to 0.18
    • 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

    $174.61changed to$178.79

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.20 changed to 3.31

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $154.72changed to$174.61

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.22 changed to 3.20
    • 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

    $135.44changed to$154.72

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.26 changed to 3.22
    • Malpractice RVU 0.22 changed to 0.21
    • 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

    $135.67changed to$135.44

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.25 changed to 3.26

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $135.00changed to$135.67

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $133.53changed to$135.00

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.26 changed to 3.25
    • Malpractice RVU 0.19 changed to 0.22
    • 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

    $133.05changed to$133.53

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.60 changed to 3.26
    • Malpractice RVU 0.20 changed to 0.19
    • 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: $133.05

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$189.44$97.93RVU26D
2026-07-01$189.44$97.93RVU26C
2026-04-01$189.44$97.93RVU26B
2026-01-01$189.44$97.93RVU26A
2025-10-01$181.62$105.72RVU25D
2025-07-01$181.62$105.72RVU25C
2025-04-01$181.62$105.72RVU25B
2025-01-01$181.62$105.72RVU25A
2024-10-01$188.90$108.12RVU24D
2024-07-01$188.90$108.12RVU24C
2024-04-01$188.90$108.12RVU24B
2024-03-09$188.90$108.12RVU24AR
2024-01-01$185.82$106.35RVU24A
2023-10-01$192.80$109.45RVU23D
2023-07-01$191.80$109.12RVU23C
2023-04-01$191.80$109.12RVU23B
2023-01-01$191.80$109.12RVU23A
2022-10-01$195.85$110.04RVU22D
2022-07-01$195.85$110.04RVU22C
2022-04-01$195.85$110.04RVU22B
2022-01-01$195.85$110.04RVU22A
2021-10-01$193.62$109.56RVU21D
2021-07-01$193.62$109.56RVU21C
2021-04-01$193.62$109.56RVU21B
2021-01-01$193.62$109.56RVU21A
2020-10-01$181.35$109.32RVU20D
2020-07-01$181.35$109.32RVU20C
2020-04-01$181.35$109.32RVU20B
2020-01-01$181.35$109.32RVU20A
2019-10-01$178.79$110.93RVU19D
2019-07-01$178.79$110.93RVU19C
2019-04-01$178.79$110.93RVU19B
2019-01-01$178.79$110.93RVU19A
2018-10-01$174.61$111.53RVU18D
2018-07-01$174.61$111.53RVU18C
2018-04-01$174.61$111.53RVU18B
2018-01-01$174.61$111.53RVU18AR1
2017-10-01$154.72$101.88RVU17D
2017-07-01$154.72$101.88RVU17C
2017-04-01$154.72$101.88RVU17B
2017-01-01$154.72$101.88RVU17A
2016-10-01$135.44$91.52RVU16D
2016-07-01$135.44$91.52RVU16C
2016-04-01$135.44$91.52RVU16B
2016-01-01$135.44$91.52RVU16A
2015-10-01$135.67$91.85RVU15D
2015-07-01$135.67$91.85RVU15C
2015-04-01$135.00$91.39RVU15B
2015-01-01$135.00$91.39RVU15A
2014-10-01$133.53$90.89RVU14D
2014-07-01$133.53$90.89RVU14C
2014-04-01$133.53$90.89RVU14B
2014-01-01$133.53$90.89RVU14A
2013-10-01$133.05$88.53RVU13D
2013-07-01$133.05$88.53RVU13C
2013-04-01$133.05$88.53RVU13B
2013-01-01$133.05$88.53RVU13AR

Price 41100 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

41100 billing questions

How does 41100 differ from 41105?

41100 is for sampling the anterior two-thirds of the tongue. Use 41105 when the biopsy site is in the posterior third.

Should 41100 be used when the entire lesion is removed?

No. This code describes diagnostic tissue sampling; select the applicable tongue-lesion excision code when the lesion is removed.

Can the pathology examination be billed separately?

The tissue examination is a separate laboratory service when performed and reported by the laboratory. The biopsy claim represents the clinician's sampling procedure.

Is modifier 50 appropriate for biopsies on both sides of the tongue?

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 the remaining procedures at 50%. Related postoperative visits are included for 10 days.

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 41100PPRRVU2026_Oct_nonQPP.csv, line 4,895 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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