Billing code 41116: Oral lesion excisionMedicare rate & RVUs
Reports surgical removal of a lesion from the floor of the mouth, rather than diagnostic sampling or excision of a tongue lesion.
Medicare pays $335.35 for 41116 nationally in the office and $201.41 in a hospital or facility. Local office rates run $295.51–$445.39.
Medicare rate · 41116
Oral lesion excision
Swap in your local Medicare rate.
- Work RVUs
- 2.46
- Total RVUs
- 10.04
- Global days
- 090
National rate · 2026
$335.35
Office setting, before claim adjustments.
See every locality for 41116 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 41116 covers
This service removes a lesion arising in the soft tissue beneath the tongue, such as a localized mucosal growth or abnormal area on the floor of the mouth. Oral and maxillofacial surgeons, otolaryngologists, and other clinicians who perform oral surgery may provide it in an office or operating-room setting. The procedure is distinct from sampling a lesion for diagnosis and from removing a lesion whose site is the tongue.
Report the code when the operative documentation identifies the floor of the mouth as the lesion site and supports excision rather than biopsy alone. The service has a 90-day global period, which includes the day-before preoperative visit and related postoperative care for 90 days. When multiple 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 for this code. 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.
Where 41116 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$295.51 to $445.39
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $299.98 | $182.79 |
| Alaska* | $386.70 | $244.06 |
| Arizona | $326.14 | $196.35 |
| Arkansas | $295.51 | $180.46 |
| Atlanta | $341.87 | $205.79 |
| Austin | $348.13 | $206.42 |
| Bakersfield | $355.36 | $208.56 |
| Baltimore/Surr. Cntys | $357.11 | $213.40 |
| Beaumont | $312.79 | $190.90 |
| Brazoria | $331.19 | $198.45 |
| Chicago | $352.70 | $218.09 |
| Chico | $354.31 | $207.52 |
| Colorado | $349.13 | $206.62 |
| Connecticut | $358.08 | $213.83 |
| Dallas | $333.41 | $200.01 |
| Dc + Md/Va Suburbs | $384.07 | $226.29 |
| Delaware | $331.65 | $199.32 |
| Detroit | $335.15 | $205.90 |
| East St. Louis | $328.25 | $205.02 |
| El Centro | $354.37 | $207.58 |
| Fort Lauderdale | $348.20 | $212.52 |
| Fort Worth | $331.16 | $199.09 |
| Fresno | $354.31 | $207.52 |
| Galveston | $332.25 | $199.25 |
| Hanford-Corcoran | $354.31 | $207.52 |
| Hawaii, Guam | $363.32 | $211.03 |
| Houston | $338.84 | $205.84 |
| Idaho | $309.72 | $186.49 |
| Indiana | $311.56 | $187.40 |
| Iowa | $307.60 | $185.04 |
| Kansas | $306.23 | $185.15 |
| Kentucky | $307.55 | $188.48 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $378.80 | $220.36 |
| Madera | $354.31 | $207.52 |
| Manhattan | $386.72 | $231.08 |
| Merced | $354.31 | $207.52 |
| Metropolitan Boston | $384.18 | $224.25 |
| Metropolitan Kansas City | $320.36 | $194.59 |
| Metropolitan Philadelphia | $349.03 | $209.60 |
| Metropolitan St. Louis | $323.79 | $196.29 |
| Miami | $363.62 | $224.19 |
| Minnesota | $333.87 | $196.05 |
| Mississippi | $298.69 | $183.37 |
| Modesto | $354.31 | $207.52 |
| Montana** | $335.32 | $201.38 |
| Napa | $411.29 | $234.76 |
| Nebraska | $309.30 | $185.67 |
| Nevada** | $333.58 | $199.51 |
| New Hampshire | $343.73 | $204.30 |
| New Mexico | $317.75 | $194.93 |
| New Orleans | $322.75 | $196.72 |
| North Carolina | $314.85 | $189.88 |
| North Dakota** | $328.20 | $194.26 |
| Northern Nj | $379.92 | $224.56 |
| Nyc Suburbs/Long Island | $396.49 | $237.23 |
| Ohio | $314.46 | $192.18 |
| Oklahoma | $306.86 | $187.25 |
| Oxnard-Thousand Oaks-Ventura | $377.00 | $218.69 |
| Portland | $360.35 | $211.54 |
| Poughkpsie/N Nyc Suburbs | $364.48 | $217.82 |
| Puerto Rico | $337.82 | $202.41 |
| Queens | $389.81 | $231.49 |
| Redding | $354.31 | $207.52 |
| Rest Of California | $354.31 | $207.52 |
| Rest Of Florida | $330.78 | $202.74 |
| Rest Of Georgia | $311.61 | $192.14 |
| Rest Of Illinois | $321.13 | $198.85 |
| Rest Of Louisiana | $307.11 | $188.57 |
| Rest Of Maine | $311.51 | $188.28 |
| Rest Of Maryland | $338.07 | $202.53 |
| Rest Of Massachusetts | $347.00 | $205.96 |
| Rest Of Michigan | $315.92 | $193.63 |
| Rest Of Missouri | $301.75 | $186.30 |
| Rest Of New Jersey | $361.98 | $215.72 |
| Rest Of New York | $319.72 | $192.48 |
| Rest Of Oregon | $330.81 | $197.41 |
| Rest Of Pennsylvania | $314.91 | $191.95 |
| Rest Of Texas | $321.88 | $194.77 |
| Rest Of Washington | $346.32 | $205.28 |
| Rhode Island | $343.57 | $205.21 |
| Riverside-San Bernardino-Ontario | $358.21 | $211.41 |
| Sacramento-Roseville-Folsom | $372.03 | $216.26 |
| Salinas | $370.66 | $215.42 |
| San Diego-Chula Vista-Carlsbad | $379.57 | $219.38 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $435.52 | $246.67 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $435.11 | $246.26 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $445.39 | $252.26 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $443.72 | $250.58 |
| San Luis Obispo-Paso Robles | $364.68 | $212.13 |
| Santa Cruz-Watsonville | $383.34 | $220.61 |
| Santa Maria-Santa Barbara | $372.10 | $215.93 |
| Santa Rosa-Petaluma | $387.21 | $222.74 |
| Seattle (King Cnty) | $391.99 | $227.65 |
| South Carolina | $315.21 | $191.46 |
| South Dakota** | $327.36 | $193.42 |
| Southern Maine | $328.74 | $196.01 |
| Stockton | $354.31 | $207.52 |
| Suburban Chicago | $351.71 | $214.16 |
| Tennessee | $307.83 | $186.08 |
| Utah | $319.65 | $193.75 |
| Vallejo | $410.70 | $234.17 |
| Vermont | $326.99 | $194.40 |
| Virgin Islands | $337.82 | $202.41 |
| Virginia | $327.71 | $196.05 |
| Visalia | $354.31 | $207.52 |
| West Virginia | $308.94 | $192.54 |
| Wisconsin | $316.90 | $188.58 |
| Wyoming** | $332.22 | $198.28 |
| Yuba City | $354.31 | $207.52 |
41116 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$295.51
$399.85
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $386.70 | 1 |
| AL | $299.98 | 1 |
| AR | $295.51 | 1 |
| AZ | $326.14 | 1 |
| CA | $354.31–$445.39 | 29 |
| CO | $349.13 | 1 |
| CT | $358.08 | 1 |
| DC | $384.07 | 1 |
| DE | $331.65 | 1 |
| FL | $330.78–$363.62 | 3 |
| GA | $311.61–$341.87 | 2 |
| GU | $363.32 | 1 |
| HI | $363.32 | 1 |
| IA | $307.60 | 1 |
| ID | $309.72 | 1 |
| IL | $321.13–$352.70 | 4 |
| IN | $311.56 | 1 |
| KS | $306.23 | 1 |
| KY | $307.55 | 1 |
| LA | $307.11–$322.75 | 2 |
| MA | $347.00–$384.18 | 2 |
| MD | $338.07–$384.07 | 3 |
| ME | $311.51–$328.74 | 2 |
| MI | $315.92–$335.15 | 2 |
| MN | $333.87 | 1 |
| MO | $301.75–$323.79 | 3 |
| MS | $298.69 | 1 |
| MT | $335.32 | 1 |
| NC | $314.85 | 1 |
| ND | $328.20 | 1 |
| NE | $309.30 | 1 |
| NH | $343.73 | 1 |
| NJ | $361.98–$379.92 | 2 |
| NM | $317.75 | 1 |
| NV | $333.58 | 1 |
| NY | $319.72–$396.49 | 5 |
| OH | $314.46 | 1 |
| OK | $306.86 | 1 |
| OR | $330.81–$360.35 | 2 |
| PA | $314.91–$349.03 | 2 |
| PR | $337.82 | 1 |
| RI | $343.57 | 1 |
| SC | $315.21 | 1 |
| SD | $327.36 | 1 |
| TN | $307.83 | 1 |
| TX | $312.79–$348.13 | 8 |
| UT | $319.65 | 1 |
| VA | $327.71–$384.07 | 2 |
| VI | $337.82 | 1 |
| VT | $326.99 | 1 |
| WA | $346.32–$391.99 | 2 |
| WI | $316.90 | 1 |
| WV | $308.94 | 1 |
| WY | $332.22 | 1 |
How the 41116 rate is calculated
Each of 41116’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 · 41116
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.46Practice expense 7.22Malpractice 0.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 41116
41116 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41116
Oral lesion excision
| 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) | 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) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 41116
Oral lesion excision
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
41116 without 51 · national office
$335.35
Oral lesion excision
41116-51 · Second procedure: 50%
$167.68
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%).
41116 compared with similar codes
Compare codes
41116 vs 41108 vs 41110 vs 41112: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 41108Oral biopsy
- 41108 describes biopsy of the floor of the mouth. Report 41116 when the service is excision of a lesion at that site.
- 41110Tongue lesion excision
- 41110 is for a lesion of the tongue. Use 41116 when the operative documentation locates the lesion in the floor of the mouth.
- 41112Tongue excision
- 41112 concerns excision of a tongue lesion, not a floor-of-mouth lesion. The documented anatomic site determines which code to consider.
41116 billing questions
When should this be reported instead of 41108?
Use 41116 for surgical excision of a floor-of-mouth lesion. Use 41108 when the service is a biopsy of that site rather than excision.
Does a lesion on the underside of the tongue qualify?
The operative note should establish that the lesion arises in the floor of the mouth, not the tongue. Tongue lesions are reported with the applicable tongue procedure code.
Is modifier 50 appropriate for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not append modifier 50.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
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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