Billing code 41009: Abscess drainageMedicare rate & RVUs

Medicare pays $432.88 for 41009 nationally in the office and $264.20 in a hospital or facility. Local office rates run $383.37–$569.54.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 41009 covers

This service drains a deep collection in the retropharyngeal or parapharyngeal space through an intraoral approach. It is typically performed by an oral and maxillofacial surgeon or another surgeon treating a deep head-and-neck infection, often in an operating-room setting. A common clinical context is spread of an odontogenic infection into a deep pharyngeal space; the documented space and surgical route distinguish this service from drainage of an oral vestibule or floor-of-mouth collection.

Report the code when the operative record supports drainage of the specified deep space by the intraoral route. Document the involved anatomy, approach, and findings. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures receive 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.

Where 41009 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

41009 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 41009 rate is calculated

Each of 41009’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.

Payment rules and modifiers for 41009

41009 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

41009 compared with similar codes

How to choose

41005Oral drainage

Use 41005 for an intraoral vestibular collection. This code is for drainage of a retropharyngeal or parapharyngeal space.

41006Mouth lesion drainage

Use 41006 when the documented collection is in the floor of the mouth. This code identifies a deeper pharyngeal-space site.

41018Abscess drainage

Both concern deep pharyngeal-space drainage, but the approach differs: this code is intraoral, while 41018 is extraoral.

Codes related to 41009

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

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

Open CMS sourceHow we calculate rates