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Billing code 41008: Tongue drainageMedicare rate & RVUs in Delaware

Reports incision and drainage of a collection involving the tongue when the surgeon reaches the site through the mouth.

CMS RVU26DEffective Oct 1, 2026One payment locality220 Medicare services in 2024

In Delaware, Medicare pays $409.99 for 41008 in the office and $242.35 when it’s performed in a hospital or facility.

$409.99Office (non-facility)
$242.35Hospital or facility
−1.1%vs the national office rate ($414.51)

Check a contract rate as a % of Medicare · 41008 nationwide

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

We’ll open 41008 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 41008 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 41008 covers

This procedure drains a localized collection, such as an abscess, cyst, or hematoma, involving the tongue through an incision made from inside the mouth. Oral and maxillofacial surgeons and other qualified surgeons may perform it in an operating room or another setting equipped for the procedure. The operative note should identify the tongue as the treated site and describe the intraoral route and drainage performed.

Choose this code when the collection is in the tongue and is accessed intraorally; a different site or an external approach points to a different code. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. 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.

How Delaware compares for 41008

Across 109 of 109 payment localities, the office rate for 41008 runs from $366.30 in Arkansas to $545.52 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). Delaware pays $409.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

41008 in Delaware vs other payment areas
  1. Delaware · this page$409.99
  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) · California$465.88+$55.89
  3. Dc + Md/Va Suburbs · District of Columbia$473.27+$63.28
  4. Miami · Florida$451.24+$41.25
  5. Chicago · Illinois$437.92+$27.93
  6. Manhattan · New York$477.56+$67.57
  7. Alaska* · Alaska$482.00+$72.01

Other areas in Delaware first, then benchmark localities. Bars start at $0.

Every other payment area

41008 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$371.70$223.24
ArkansasArkansas$366.30$220.55
ArizonaArizona$403.30$238.88
BakersfieldCalifornia$437.66$251.69
ChicoCalifornia$436.24$250.27
El CentroCalifornia$436.32$250.36
FresnoCalifornia$436.24$250.27
Hanford-CorcoranCalifornia$436.24$250.27

41008 rates by state

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

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.

$366.30

$490.88

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

View every state and territory as a table
41008 office rate range by state
State / territoryOffice rate rangeLocalities
AK$482.001
AL$371.701
AR$366.301
AZ$403.301
CA$436.24–$545.5229
CO$430.551
CT$442.181
DC$473.271
DE$409.991
FL$410.17–$451.243
GA$386.81–$422.702
GU$446.741
HI$446.741
IA$380.361
ID$383.031
IL$398.87–$437.924
IN$385.251
KS$378.971
KY$381.411
LA$380.98–$399.882
MA$428.12–$472.722
MD$417.72–$473.273
ME$385.47–$405.902
MI$391.77–$415.742
MN$411.261
MO$374.67–$400.833
MS$370.541
MT$414.471
NC$389.461
ND$404.781
NE$382.341
NH$424.171
NJ$446.87–$468.402
NM$394.091
NV$412.061
NY$395.37–$489.715
OH$389.791
OK$380.301
OR$408.50–$443.822
PA$390.19–$431.402
PR$417.401
RI$424.301
SC$390.351
SD$403.641
TN$380.941
TX$387.64–$429.438
UT$395.701
VA$404.84–$473.272
VI$417.401
VT$403.561
WA$427.19–$481.962
WI$391.191
WV$384.151
WY$410.251

See 41008 in every payment locality

How the 41008 rate is calculated

Each of 41008’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 · 41008

RVUs × geographic indexes × conversion factor

Work3.37

3.37 RVUs× 1.000 GPCI

Practice expense8.55

8.55 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

12.4100

Conversion factor

$33.4009

Medicare rate

$414.51

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,886

Code
41008
Physician work
3.37
Practice expense
8.55
Malpractice
0.49

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 41008 in Delaware
ComponentRVULocality factorAdjusted
Physician work3.37× 1.0053.3868
Practice expense8.55× 0.9888.4474
Malpractice0.49× 0.8990.4405
Total RVUs12.2748
Conversion factor× 33.4009

Office rate, Delaware$409.99

Office: (3.37 × 1.005 + 8.55 × 0.988 + 0.49 × 0.899) × $33.4009 = $409.99

Facility: (3.37 × 1.005 + 3.47 × 0.988 + 0.49 × 0.899) × $33.4009 = $242.35

Open 41008 in the RVU calculator

Payment rules and modifiers for 41008

41008 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41008

Tongue drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 41008

Tongue drainage

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

41008 without 51 · national office

$414.51

Tongue drainage

41008-51 · Second procedure: 50%

$207.26

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%).

When to use modifier 51

Codes related to 41008

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

Codes related to 41008
CodeHow it relatesOffice range, Delaware
Same family
41009Abscess drainageRelated tongue-drainage code for an external approach.$428.31
Used instead
41000Oral abscess drainageUsed for drainage involving dentoalveolar structures rather than the tongue.$157.62
41005Oral drainageAddresses drainage at the floor of the mouth by a sublingual approach.$228.61
41006Mouth lesion drainageAddresses drainage at the floor of the mouth by a submental approach.$345.57
41007Mouth lesion drainageAddresses drainage at the floor of the mouth by a submandibular approach.$333.34

How 41008 has changed in Delaware

41008 · Office / nonfacility

$409.99

Effective 2026-10-01

The base rate is $22.42 higher than on 2025-10-01, moving from $387.57 to $409.99 (5.8%).

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

    $387.57changed to$409.99

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.46 changed to 3.37
    • Practice expense RVU 8.10 changed to 8.55
    • Malpractice RVU 0.48 changed to 0.49
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $391.67changed to$387.57

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.94 changed to 8.10
    • Malpractice RVU 0.42 changed to 0.48

    Held through RVU25B, RVU25C, RVU25D.

  3. October 1, 2024

    RVU24D

    $407.97changed to$391.67

    • Conversion factor 34.6062 changed to 33.2875
    • Practice expense RVU 7.77 changed to 7.94
    • Malpractice RVU 0.40 changed to 0.42
    • Work GPCI 1.005 changed to 1.009
    • Practice expense GPCI 1.022 changed to 0.992
    • Malpractice GPCI 0.927 changed to 0.949

  4. July 1, 2022

    RVU22C

    $412.85changed to$407.97

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.83 changed to 7.77
    • Malpractice RVU 0.38 changed to 0.40

  5. January 1, 2021

    RVU21A

    $403.11changed to$412.85

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.18 changed to 7.83
    • Malpractice RVU 0.35 changed to 0.38
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B.

  6. January 1, 2020

    RVU20A

    $407.42changed to$403.11

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.06 changed to 7.18
    • Malpractice RVU 0.56 changed to 0.35
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  7. January 1, 2019

    RVU19A

    $402.57changed to$407.42

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.94 changed to 7.06

    Held through RVU19B, RVU19C, RVU19D.

  8. January 1, 2018

    RVU18AR1

    $406.18changed to$402.57

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.02 changed to 6.94
    • Malpractice RVU 0.57 changed to 0.56
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  9. January 1, 2017

    RVU17A

    $407.72changed to$406.18

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.05 changed to 7.02
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  10. January 1, 2016

    RVU16A

    $409.15changed to$407.72

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.07 changed to 7.05
    • Malpractice RVU 0.55 changed to 0.57

    Held through RVU16B, RVU16C, RVU16D.

  11. July 1, 2015

    RVU15C

    $407.12changed to$409.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  12. January 1, 2015

    RVU15A

    $400.05changed to$407.12

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.03 changed to 7.07
    • Malpractice RVU 0.42 changed to 0.55
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  13. January 1, 2014

    RVU14A

    $401.28changed to$400.05

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.66 changed to 7.03
    • Malpractice RVU 0.44 changed to 0.42
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  14. January 1, 2013

    RVU13AR

    Earliest loaded release: $401.28

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$409.99$242.35RVU26D
2026-07-01$409.99$242.35RVU26C
2026-04-01$409.99$242.35RVU26B
2026-01-01$409.99$242.35RVU26A
2025-10-01$387.57$257.62RVU25D
2025-07-01$387.57$257.62RVU25C
2025-04-01$387.57$257.62RVU25B
2025-01-01$387.57$257.62RVU25A
2024-10-01$391.67$257.93RVU24D
2022-07-01$407.97$262.26RVU22C
2021-04-01$412.85$265.21RVU21B
2021-01-01$412.85$265.21RVU21A
2020-10-01$403.11$272.67RVU20D
2020-07-01$403.11$272.67RVU20C
2020-04-01$403.11$272.67RVU20B
2020-01-01$403.11$272.67RVU20A
2019-10-01$407.42$284.76RVU19D
2019-07-01$407.42$284.76RVU19C
2019-04-01$407.42$284.76RVU19B
2019-01-01$407.42$284.76RVU19A
2018-10-01$402.57$287.39RVU18D
2018-07-01$402.57$287.39RVU18C
2018-04-01$402.57$287.39RVU18B
2018-01-01$402.57$287.39RVU18AR1
2017-10-01$406.18$291.04RVU17D
2017-07-01$406.18$291.04RVU17C
2017-04-01$406.18$291.04RVU17B
2017-01-01$406.18$291.04RVU17A
2016-10-01$407.72$291.81RVU16D
2016-07-01$407.72$291.81RVU16C
2016-04-01$407.72$291.81RVU16B
2016-01-01$407.72$291.81RVU16A
2015-10-01$409.15$291.71RVU15D
2015-07-01$409.15$291.71RVU15C
2015-04-01$407.12$290.26RVU15B
2015-01-01$407.12$290.26RVU15A
2014-10-01$400.05$285.89RVU14D
2014-07-01$400.05$285.89RVU14C
2014-04-01$400.05$285.89RVU14B
2014-01-01$400.05$285.89RVU14A
2013-10-01$401.28$279.09RVU13D
2013-07-01$401.28$279.09RVU13C
2013-04-01$401.28$279.09RVU13B
2013-01-01$401.28$279.09RVU13AR

Price 41008 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Delaware

41008 billing questions

When should this code be chosen over 41009?

Use 41008 for drainage of a tongue collection reached through the mouth. Code 41009 is the related alternative for an external approach.

Does this code cover drainage of a tooth-related abscess?

No. When the treated collection is in dentoalveolar structures rather than the tongue, consider 41000.

What should the operative note identify?

Document the tongue as the site, the intraoral route, and the incision and drainage performed. This supports distinguishing the service from drainage at another oral site or by an external approach.

Can modifier 50 be used?

No. The code's descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.

How does the global period affect postoperative billing?

The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.

When is assistant-at-surgery payment allowed?

Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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
RVUs for 41008PPRRVU2026_Oct_nonQPP.csv, line 4,886 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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