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CMS RVU26D · Effective 2026-10-01

41005 in Chicago

Office / nonfacility

$239.27

Base rate per service

Facility setting

$119.43

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Oral surgery

About 41005: Intraoral vestibular abscess drainage

Reports intraoral incision and drainage of a collection in the mouth vestibule, the space between the cheeks or lips and the gums.

This service opens and drains a localized collection in the oral vestibule through an incision made inside the mouth. The vestibule is the space between the inner cheek or lip and the gum. A typical situation is an infection that has spread into this soft-tissue space; the target is the vestibular collection, rather than drainage confined to the tooth-bearing alveolar structures. Oral and maxillofacial surgeons, dentists, and other physicians who treat oral infections may perform it in an office, clinic, or facility setting.

Select the code based on the collection’s documented location and the intraoral approach. The record should identify the vestibular site, the incision and drainage performed, and relevant findings such as the collection’s contents. Related postoperative visits are included in the 10-day global period. 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 not appropriate for this descriptor and anatomy. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 41005

Global period
Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.28 · 18%
  • Practice expense (office) RVU5.48 · 79%
  • Malpractice RVU0.16 · 2%

145

Medicare services in 2024 · #4586 by national volume

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.

41005 compared with similar codes

Office rates for Chicago, from the same CMS release.

41000

Oral abscess drainage

Floor of mouth

$167.96

Use 41005 for an intraoral vestibular collection. Use 41000 when the drainage site is the dentoalveolar structures.

41006

Mouth lesion drainage

Floor of mouth, extraoral

$367.38

Use 41006 for a collection in the floor of the mouth or the specified associated spaces; 41005 is for the mouth vestibule.

41015

Mouth lesion drainage

Extraoral floor-of-mouth approach

$432.20

41015 describes drainage of specified sublingual, submental, or submandibular spaces by an extraoral approach, not intraoral vestibular drainage.

The same code, a different location

How does Chicago compare?

In East St. Louis, the office rate for 41005 is $221.91—$17.36 lower than the $239.27 rate in Chicago. Both use the same code, release and participation basis.

41005 across payment areas

Same release and payment basis · bars start at $0

  1. Chicago · This locality

    $239.27

  2. East St. Louis

    $221.91

    $17.36 lower than Chicago

  3. Rest Of Illinois

    $218.22

    $21.05 lower than Chicago

  4. Suburban Chicago

    $240.50

    $1.23 higher than Chicago

  5. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $264.59

    $25.32 higher than Chicago

  6. Dc + Md/Va Suburbs

    $266.63

    $27.36 higher than Chicago

  7. Miami

    $246.81

    $7.54 higher than Chicago

Other payment areas listed in Illinois appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 41005 ranges from $202.73 in Arkansas to $314.26 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Manhattan

    New York · 41005

    Office

    $266.65

    Facility

    $128.10

    $27.38 higher than Chicago for the office setting.

  • Alaska*

    Alaska · 41005

    Office

    $262.01

    Facility

    $135.02

    $22.74 higher than Chicago for the office setting.

  • Alabama

    Alabama · 41005

    Office

    $205.94

    Facility

    $101.60

    $33.33 lower than Chicago for the office setting.

  • Arkansas

    Arkansas · 41005

    Office

    $202.73

    Facility

    $100.31

    $36.54 lower than Chicago for the office setting.

  • Arizona

    Arizona · 41005

    Office

    $224.69

    Facility

    $109.15

    $14.58 lower than Chicago for the office setting.

  • Bakersfield

    California · 41005

    Office

    $247.43

    Facility

    $116.74

    $8.16 higher than Chicago for the office setting.

  • Chico

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • El Centro

    California · 41005

    Office

    $246.98

    Facility

    $116.29

    $7.71 higher than Chicago for the office setting.

  • Fresno

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Hanford-Corcoran

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Madera

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Merced

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Modesto

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Napa

    California · 41005

    Office

    $289.40

    Facility

    $132.24

    $50.13 higher than Chicago for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 41005

    Office

    $263.63

    Facility

    $122.69

    $24.36 higher than Chicago for the office setting.

  • Redding

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Rest Of California

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 41005

    Office

    $248.69

    Facility

    $118.00

    $9.42 higher than Chicago for the office setting.

  • Sacramento-Roseville-Folsom

    California · 41005

    Office

    $260.03

    Facility

    $121.35

    $20.76 higher than Chicago for the office setting.

  • Salinas

    California · 41005

    Office

    $259.08

    Facility

    $120.88

    $19.81 higher than Chicago for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 41005

    Office

    $265.84

    Facility

    $123.23

    $26.57 higher than Chicago for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 41005

    Office

    $307.35

    Facility

    $139.22

    $68.08 higher than Chicago for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 41005

    Office

    $307.17

    Facility

    $139.04

    $67.90 higher than Chicago for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 41005

    Office

    $314.26

    Facility

    $142.31

    $74.99 higher than Chicago for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 41005

    Office

    $313.52

    Facility

    $141.57

    $74.25 higher than Chicago for the office setting.

  • San Luis Obispo-Paso Robles

    California · 41005

    Office

    $254.82

    Facility

    $119.01

    $15.55 higher than Chicago for the office setting.

  • Santa Cruz-Watsonville

    California · 41005

    Office

    $268.91

    Facility

    $124.03

    $29.64 higher than Chicago for the office setting.

  • Santa Maria-Santa Barbara

    California · 41005

    Office

    $260.24

    Facility

    $121.20

    $20.97 higher than Chicago for the office setting.

  • Santa Rosa-Petaluma

    California · 41005

    Office

    $271.67

    Facility

    $125.24

    $32.40 higher than Chicago for the office setting.

  • Stockton

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Vallejo

    California · 41005

    Office

    $289.14

    Facility

    $131.98

    $49.87 higher than Chicago for the office setting.

  • Visalia

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Yuba City

    California · 41005

    Office

    $246.95

    Facility

    $116.26

    $7.68 higher than Chicago for the office setting.

  • Colorado

    Colorado · 41005

    Office

    $242.19

    Facility

    $115.32

    $2.92 higher than Chicago for the office setting.

  • Connecticut

    Connecticut · 41005

    Office

    $247.21

    Facility

    $118.78

    $7.94 higher than Chicago for the office setting.

  • Delaware

    Delaware · 41005

    Office

    $228.61

    Facility

    $110.80

    $10.66 lower than Chicago for the office setting.

  • Fort Lauderdale

    Florida · 41005

    Office

    $237.83

    Facility

    $117.04

    $1.44 lower than Chicago for the office setting.

  • Rest Of Florida

    Florida · 41005

    Office

    $225.77

    Facility

    $111.77

    $13.50 lower than Chicago for the office setting.

  • Atlanta

    Georgia · 41005

    Office

    $235.27

    Facility

    $114.12

    $4.00 lower than Chicago for the office setting.

  • Rest Of Georgia

    Georgia · 41005

    Office

    $212.39

    Facility

    $106.03

    $26.88 lower than Chicago for the office setting.

  • Hawaii, Guam

    Hawaii · 41005

    Office

    $253.96

    Facility

    $118.38

    $14.69 higher than Chicago for the office setting.

  • Iowa

    Iowa · 41005

    Office

    $212.35

    Facility

    $103.25

    $26.92 lower than Chicago for the office setting.

  • Idaho

    Idaho · 41005

    Office

    $213.67

    Facility

    $103.97

    $25.60 lower than Chicago for the office setting.

  • Indiana

    Indiana · 41005

    Office

    $215.03

    Facility

    $104.49

    $24.24 lower than Chicago for the office setting.

  • Kansas

    Kansas · 41005

    Office

    $210.91

    Facility

    $103.12

    $28.36 lower than Chicago for the office setting.

  • Kentucky

    Kentucky · 41005

    Office

    $210.36

    Facility

    $104.36

    $28.91 lower than Chicago for the office setting.

  • New Orleans

    Louisiana · 41005

    Office

    $221.06

    Facility

    $108.86

    $18.21 lower than Chicago for the office setting.

  • Rest Of Louisiana

    Louisiana · 41005

    Office

    $209.86

    Facility

    $104.33

    $29.41 lower than Chicago for the office setting.

  • Metropolitan Boston

    Massachusetts · 41005

    Office

    $267.81

    Facility

    $125.43

    $28.54 higher than Chicago for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 41005

    Office

    $240.43

    Facility

    $114.87

    $1.16 higher than Chicago for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 41005

    Office

    $246.45

    Facility

    $118.50

    $7.18 higher than Chicago for the office setting.

  • Rest Of Maryland

    Maryland · 41005

    Office

    $233.32

    Facility

    $112.65

    $5.95 lower than Chicago for the office setting.

  • Rest Of Maine

    Maine · 41005

    Office

    $214.47

    Facility

    $104.77

    $24.80 lower than Chicago for the office setting.

  • Southern Maine

    Maine · 41005

    Office

    $227.51

    Facility

    $109.35

    $11.76 lower than Chicago for the office setting.

  • Detroit

    Michigan · 41005

    Office

    $228.39

    Facility

    $113.33

    $10.88 lower than Chicago for the office setting.

  • Rest Of Michigan

    Michigan · 41005

    Office

    $215.90

    Facility

    $107.03

    $23.37 lower than Chicago for the office setting.

  • Minnesota

    Minnesota · 41005

    Office

    $232.68

    Facility

    $109.98

    $6.59 lower than Chicago for the office setting.

  • Metropolitan Kansas City

    Missouri · 41005

    Office

    $219.85

    Facility

    $107.88

    $19.42 lower than Chicago for the office setting.

  • Metropolitan St. Louis

    Missouri · 41005

    Office

    $222.36

    Facility

    $108.84

    $16.91 lower than Chicago for the office setting.

  • Rest Of Missouri

    Missouri · 41005

    Office

    $205.74

    Facility

    $102.95

    $33.53 lower than Chicago for the office setting.

  • Mississippi

    Mississippi · 41005

    Office

    $204.30

    Facility

    $101.63

    $34.97 lower than Chicago for the office setting.

  • Montana**

    Montana · 41005

    Office

    $231.12

    Facility

    $111.88

    $8.15 lower than Chicago for the office setting.

  • North Carolina

    North Carolina · 41005

    Office

    $216.94

    Facility

    $105.69

    $22.33 lower than Chicago for the office setting.

  • North Dakota**

    North Dakota · 41005

    Office

    $227.96

    Facility

    $108.72

    $11.31 lower than Chicago for the office setting.

  • Nebraska

    Nebraska · 41005

    Office

    $213.72

    Facility

    $103.66

    $25.55 lower than Chicago for the office setting.

  • New Hampshire

    New Hampshire · 41005

    Office

    $237.97

    Facility

    $113.84

    $1.30 lower than Chicago for the office setting.

  • Northern Nj

    New Jersey · 41005

    Office

    $263.48

    Facility

    $125.16

    $24.21 higher than Chicago for the office setting.

  • Rest Of New Jersey

    New Jersey · 41005

    Office

    $250.20

    Facility

    $119.99

    $10.93 higher than Chicago for the office setting.

  • New Mexico

    New Mexico · 41005

    Office

    $217.02

    Facility

    $107.67

    $22.25 lower than Chicago for the office setting.

  • Nevada**

    Nevada · 41005

    Office

    $230.42

    Facility

    $111.06

    $8.85 lower than Chicago for the office setting.

  • Nyc Suburbs/Long Island

    New York · 41005

    Office

    $273.04

    Facility

    $131.27

    $33.77 higher than Chicago for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 41005

    Office

    $251.57

    Facility

    $121.00

    $12.30 higher than Chicago for the office setting.

  • Queens

    New York · 41005

    Office

    $269.55

    Facility

    $128.60

    $30.28 higher than Chicago for the office setting.

  • Rest Of New York

    New York · 41005

    Office

    $220.40

    Facility

    $107.12

    $18.87 lower than Chicago for the office setting.

  • Ohio

    Ohio · 41005

    Office

    $215.25

    Facility

    $106.39

    $24.02 lower than Chicago for the office setting.

  • Oklahoma

    Oklahoma · 41005

    Office

    $210.36

    Facility

    $103.88

    $28.91 lower than Chicago for the office setting.

  • Portland

    Oregon · 41005

    Office

    $250.77

    Facility

    $118.29

    $11.50 higher than Chicago for the office setting.

  • Rest Of Oregon

    Oregon · 41005

    Office

    $228.81

    Facility

    $110.05

    $10.46 lower than Chicago for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 41005

    Office

    $240.44

    Facility

    $116.31

    $1.17 higher than Chicago for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 41005

    Office

    $215.83

    Facility

    $106.37

    $23.44 lower than Chicago for the office setting.

  • Puerto Rico

    Puerto Rico · 41005

    Office

    $233.07

    Facility

    $112.51

    $6.20 lower than Chicago for the office setting.

  • Rhode Island

    Rhode Island · 41005

    Office

    $237.41

    Facility

    $114.23

    $1.86 lower than Chicago for the office setting.

  • South Carolina

    South Carolina · 41005

    Office

    $216.42

    Facility

    $106.24

    $22.85 lower than Chicago for the office setting.

  • South Dakota**

    South Dakota · 41005

    Office

    $227.59

    Facility

    $108.34

    $11.68 lower than Chicago for the office setting.

  • Tennessee

    Tennessee · 41005

    Office

    $212.00

    Facility

    $103.61

    $27.27 lower than Chicago for the office setting.

  • Austin

    Texas · 41005

    Office

    $241.23

    Facility

    $115.07

    $1.96 higher than Chicago for the office setting.

  • Beaumont

    Texas · 41005

    Office

    $214.28

    Facility

    $105.77

    $24.99 lower than Chicago for the office setting.

  • Brazoria

    Texas · 41005

    Office

    $228.65

    Facility

    $110.49

    $10.62 lower than Chicago for the office setting.

  • Dallas

    Texas · 41005

    Office

    $230.03

    Facility

    $111.26

    $9.24 lower than Chicago for the office setting.

  • Fort Worth

    Texas · 41005

    Office

    $228.27

    Facility

    $110.70

    $11.00 lower than Chicago for the office setting.

  • Galveston

    Texas · 41005

    Office

    $229.28

    Facility

    $110.87

    $9.99 lower than Chicago for the office setting.

  • Houston

    Texas · 41005

    Office

    $232.20

    Facility

    $113.80

    $7.07 lower than Chicago for the office setting.

  • Rest Of Texas

    Texas · 41005

    Office

    $221.28

    Facility

    $108.12

    $17.99 lower than Chicago for the office setting.

  • Utah

    Utah · 41005

    Office

    $219.61

    Facility

    $107.52

    $19.66 lower than Chicago for the office setting.

  • Virginia

    Virginia · 41005

    Office

    $226.45

    Facility

    $109.24

    $12.82 lower than Chicago for the office setting.

  • Virgin Islands

    United States Virgin Islands · 41005

    Office

    $233.07

    Facility

    $112.51

    $6.20 lower than Chicago for the office setting.

  • Vermont

    Vermont · 41005

    Office

    $226.66

    Facility

    $108.62

    $12.61 lower than Chicago for the office setting.

  • Rest Of Washington

    Washington · 41005

    Office

    $240.11

    Facility

    $114.55

    $0.84 higher than Chicago for the office setting.

  • Seattle (King Cnty)

    Washington · 41005

    Office

    $273.84

    Facility

    $127.53

    $34.57 higher than Chicago for the office setting.

  • Wisconsin

    Wisconsin · 41005

    Office

    $219.75

    Facility

    $105.52

    $19.52 lower than Chicago for the office setting.

  • West Virginia

    West Virginia · 41005

    Office

    $209.46

    Facility

    $105.84

    $29.81 lower than Chicago for the office setting.

  • Wyoming**

    Wyoming · 41005

    Office

    $229.74

    Facility

    $110.50

    $9.53 lower than Chicago for the office setting.

See how rates vary across the country

41005 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$202.73

$280.61

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$262.011
AL$205.941
AR$202.731
AZ$224.691
CA$246.95–$314.2629
CO$242.191
CT$247.211
DC$266.631
DE$228.611
FL$225.77–$246.813
GA$212.39–$235.272
GU$253.961
HI$253.961
IA$212.351
ID$213.671
IL$218.22–$240.504
IN$215.031
KS$210.911
KY$210.361
LA$209.86–$221.062
MA$240.43–$267.812
MD$233.32–$266.633
ME$214.47–$227.512
MI$215.90–$228.392
MN$232.681
MO$205.74–$222.363
MS$204.301
MT$231.121
NC$216.941
ND$227.961
NE$213.721
NH$237.971
NJ$250.20–$263.482
NM$217.021
NV$230.421
NY$220.40–$273.045
OH$215.251
OK$210.361
OR$228.81–$250.772
PA$215.83–$240.442
PR$233.071
RI$237.411
SC$216.421
SD$227.591
TN$212.001
TX$214.28–$241.238
UT$219.611
VA$226.45–$266.632
VI$233.071
VT$226.661
WA$240.11–$273.842
WI$219.751
WV$209.461
WY$229.741

Explore 41005 on the national rate map →

Where does this rate apply?

Chicago is a Medicare payment area. Our Census mapping connects it to 137 cities and communities in Illinois, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Illinois →

Why are the office and facility amounts different?

For 41005 in Chicago, the physician’s office rate is $239.27 and the facility-setting rate is $119.43: a difference of $119.84.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 41005 in Chicago. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$263.20

$239.27 × 110% = $263.20

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 41005 in Chicago.

PPRRVU2026_Oct_nonQPP.csv

4,883

Code
41005
Physician work
1.28
Practice expense
5.48
Malpractice
0.16

GPCI2026.csv

48

Locality
Chicago
Physician work
1.007
Practice expense
1.005
Malpractice
2.295
Office / nonfacility calculation for 41005 in Chicago
ComponentRVULocality factorAdjusted
Physician work1.28× 1.0071.2890
Practice expense5.48× 1.0055.5074
Malpractice0.16× 2.2950.3672
Total RVUs7.1636
Conversion factor× 33.4009

Office / nonfacility rate, Chicago$239.27

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 41005 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.281.007
Practice expense5.481.005
Malpractice0.162.295

(1.28 × 1.007 + 5.48 × 1.005 + 0.16 × 2.295) × $33.4009 = $239.27

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.281.007
Practice expense1.911.005
Malpractice0.162.295

(1.28 × 1.007 + 1.91 × 1.005 + 0.16 × 2.295) × $33.4009 = $119.43

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

41005 · Office / nonfacility

$239.27

Effective 2026-10-01

The base rate is $9.44 higher than on 2025-10-01, moving from $229.83 to $239.27 (4.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $229.83changed to$239.27

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.31 changed to 1.28
    • Practice expense RVU 5.36 changed to 5.48
    • Malpractice RVU 0.15 changed to 0.16
    • Practice expense GPCI 1.023 changed to 1.005
    • Malpractice GPCI 2.018 changed to 2.295

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $229.83

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$239.27$119.43RVU26D
2026-07-01$239.27$119.43RVU26C
2026-04-01$239.27$119.43RVU26B
2026-01-01$239.27$119.43RVU26A
2025-10-01$229.83$122.61RVU25D
2025-07-01$229.83$122.61RVU25C
2025-04-01$229.83$122.61RVU25B
2025-01-01$229.83$122.61RVU25A

41005 billing questions

How is this different from 41000?

41005 is for a collection in the mouth vestibule, between the cheek or lip and the gum. 41000 is used for drainage involving dentoalveolar structures.

Does the incision have to be made inside the mouth?

Yes. This code describes drainage of a vestibular collection by an intraoral approach.

Are related postoperative visits separately reported?

Related postoperative visits during the 10-day global period are included in the procedure.

Can modifier 50 be used for drainage on both sides?

No. The descriptor and anatomy make modifier 50 inappropriate for this code.

When can an assistant-at-surgery be paid?

Assistant-at-surgery payment is allowed only when the documentation supports medical necessity. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 41005PPRRVU2026_Oct_nonQPP.csv, line 4,883 (RVU26D)
Geographic factors for ChicagoGPCI2026.csv, line 48 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet