Billing code 41826: Gum lesion excisionMedicare rate & RVUs

Medicare pays $300.27 for 41826 nationally in the office and $179.03 in a hospital or facility. Local office rates run $265.67–$398.16.

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

What 41826 covers

A dentist, oral surgeon, or other qualified clinician uses this service to surgically remove a lesion arising in gingival tissue. It may be performed in an office or facility when a localized gum growth or abnormal area is excised. The operative record should identify the gum site, describe the lesion and the tissue removal, and note specimen handling when tissue is submitted for examination.

Select 41826 for the documented gum-lesion excision, not for draining a gum lesion or removing a foreign body. Record the operative details that establish the service performed; do not rely on the diagnosis alone to distinguish excision from another procedure. 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and 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 41826 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

41826 rates by state

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

How the 41826 rate is calculated

Each of 41826’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 41826

41826 has a 10-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

41826 compared with similar codes

How to choose

41800Gum drainage

Use 41800 when the service is drainage of a gum lesion. Use 41826 when the clinician surgically excises the lesion.

41805Foreign body removal

Use 41805 for removal of a foreign body from gingiva; 41826 describes excision of a gum lesion.

41820Excision gum each quadrant

41820 describes gum excision by quadrant. 41826 is reported for the documented gum-lesion excision, not simply because tissue removal occurred.

Codes related to 41826

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