CPT code 41105: Tongue biopsy, posterior one-third2026 Medicare rate & RVUs in Illinois
Reports tissue sampling from the posterior one-third of the tongue to evaluate a suspicious lesion or other abnormal tissue.
Medicare pays $181.40–$199.04 for 41105 in the office in Illinois, from Rest of Illinois to Chicago, IL. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 41105 covers
This service is a tissue sample taken from the posterior one-third of the tongue for diagnostic evaluation, such as investigation of a suspicious ulcer, mass, or mucosal change. An otolaryngologist, head-and-neck surgeon, or oral and maxillofacial surgeon may perform it in an office, procedure room, or operating room, depending on access and the patient’s needs. The sample is submitted for pathologic examination; this code describes the biopsy procedure, not the pathology interpretation.
Choose this code for a biopsy from the posterior tongue, rather than the anterior two-thirds or the floor of the mouth. The note should identify the sampled site and the lesion or abnormal tissue prompting the biopsy. It has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures subject to the standard reduction are performed in the same session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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.
Where 41105 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$181.40 to $199.04
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $199.04 | $109.75 |
| East St. Louis, IL | $185.36 | $103.62 |
| Rest of Illinois | $181.40 | $100.29 |
| Suburban Chicago, IL | $198.52 | $107.27 |
How the 41105 rate is calculated
Each of 41105’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 · 41105
RVUs × geographic indexes × conversion factor
Work1.43
1.43 RVUs× 1.000 GPCI
Practice expense4.04
4.04 RVUs× 1.000 GPCI
Malpractice0.20
0.20 RVUs× 1.000 GPCI
Adjusted RVUs
5.6700
Conversion factor
$33.4009
Medicare rate
$189.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 41105
41105 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41105
Tongue biopsy, posterior one-third
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 1 | Not paid (statutory restriction). |
| 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 41105
Tongue biopsy, posterior one-third
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.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
41105 without 51 · national office
$189.38
Tongue biopsy, posterior one-third
41105-51 · Second procedure: 50%
$94.69
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%).
41105 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 41100Tongue biopsyAnterior two-thirds
- 41100 describes biopsy of the anterior two-thirds of the tongue. Use 41105 when the sampled tissue is from the posterior one-third.
- 41108Oral biopsyFloor of mouth
- 41108 is for tissue sampled from the floor of the mouth, not the tongue. Select by the documented specimen site.
- 41110Tongue lesion excisionWithout closure
- 41105 represents diagnostic sampling of posterior tongue tissue. 41110 is an excision code for removing a tongue lesion without closure.
41105 billing questions
How is 41105 distinguished from 41100?
41105 is for a biopsy of the posterior one-third of the tongue; 41100 is for the anterior two-thirds. The documentation should identify which part of the tongue was sampled.
Can 41105 be used for a floor-of-mouth biopsy?
No. A biopsy of the floor of the mouth is reported with 41108; 41105 is for the posterior tongue.
When would a tongue lesion excision code be more appropriate?
Use a biopsy code when tissue is sampled for diagnosis. When the lesion is removed rather than sampled, consider the applicable tongue lesion excision code, such as 41110.
Is modifier 50 appropriate for a biopsy of both sides of the tongue?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not append modifier 50.
Are related postoperative visits included?
Yes. Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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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