CPT code 41145: Total glossectomy, bilateral radical neck dissection2026 Medicare rate & RVUs in Michigan
Reports complete tongue removal with bilateral radical neck dissection, with or without tracheostomy, typically for advanced oral cavity cancer.
CMS doesn’t publish an office rate for 41145 in Michigan.
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 41145 covers
This code describes removal of the entire tongue together with radical neck dissections on both sides of the neck; a tracheostomy may or may not be performed. Head and neck surgeons typically perform this extensive operation in a hospital setting for advanced cancers involving the tongue. The defining distinction is the combination of total tongue removal and bilateral radical neck dissection, rather than tongue removal alone or a partial glossectomy.
Select the code when the operative report supports total glossectomy and bilateral radical neck dissection. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate because bilateral neck surgery is built into this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 41145 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | $2,504.93 |
| Rest of Michigan | Unavailable | $2,352.43 |
How the 41145 rate is calculated
Each of 41145’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 · 41145
RVUs × geographic indexes × conversion factor
Work36.98
36.98 RVUs× 1.000 GPCI
Practice expense29.96
29.96 RVUs× 1.000 GPCI
Malpractice5.40
5.40 RVUs× 1.000 GPCI
Adjusted RVUs
72.3400
Conversion factor
$33.4009
Medicare rate
$2,416.22
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 41145
41145 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41145
Total glossectomy, bilateral radical neck dissection
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 41145
Total glossectomy, bilateral radical neck dissection
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
41145 without 51 · national facility
$2,416.22
Total glossectomy, bilateral radical neck dissection
41145-51 · Second procedure: 50%
$1,208.11
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%).
41145 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 41135Tongue and neck surgeryPartial glossectomy, unilateral dissection
- Use 41135 for total glossectomy without radical neck dissection. This code includes bilateral radical neck dissection.
- 41140Total glossectomyUnilateral radical neck dissection
- Both codes describe total glossectomy with radical neck dissection; 41140 is unilateral, while this code is bilateral.
- 41130Tongue resectionHemiglossectomy
- 41130 represents hemiglossectomy, not removal of the entire tongue with bilateral radical neck dissection.
41145 billing questions
How does this differ from 41140?
41145 includes radical neck dissection on both sides of the neck. Use 41140 when the total glossectomy is accompanied by unilateral radical neck dissection.
When is 41135 a better choice?
41135 describes total glossectomy without radical neck dissection. Choose 41145 when the operative report documents bilateral radical neck dissection as part of the operation.
Should modifier 50 be appended for the bilateral neck work?
No. Bilateral radical neck dissection is part of 41145, so modifier 50 is inappropriate.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be allowed for this operation. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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