Billing code 41100: Tongue biopsyMedicare rate & RVUs in Delaware
Reports tissue sampling from a lesion in the anterior two-thirds of the tongue for microscopic diagnosis, rather than complete lesion removal.
Medicare pays $186.01 for 41100 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 9 sections
What 41100 covers
This service samples tissue from the front two-thirds of the tongue, from the tip through the body, for pathologic examination. An otolaryngologist, oral and maxillofacial surgeon, or other qualified clinician may perform it in an office or facility. Common reasons include evaluating a persistent tongue ulcer or a suspicious white or red mucosal patch. The biopsy obtains diagnostic tissue; it is not reported in place of an excision that removes the lesion.
Document the exact tongue site, the clinical concern, and the tissue obtained for examination. Choose the posterior-tongue biopsy code when the sampled site is in the back third, and use a floor-of-mouth code for tissue from that separate site. 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 the others at 50%. Modifier 50 is inappropriate. 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.
41100 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $186.01 | $96.58 |
How the 41100 rate is calculated
Each of 41100’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 · 41100
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.38Practice expense 4.06Malpractice 0.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 41100
41100 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41100
Tongue biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 41100
Tongue biopsy
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
41100 without 51 · national office
$188.05
Tongue biopsy
41100-51 · Second procedure: 50%
$94.03
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%).
41100 compared with similar codes
Compare codes
41100 vs 41105 vs 41108 vs 41110: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 41105Tongue biopsy
- Use 41100 for a biopsy from the anterior two-thirds of the tongue; 41105 is for a biopsy from the posterior third.
- 41108Oral biopsy
- 41108 applies to a biopsy of the floor of the mouth. Use 41100 only when the sampled tissue is tongue tissue.
- 41110Tongue lesion excision
- 41100 represents diagnostic tissue sampling. 41110 is for excision of a tongue lesion rather than a biopsy.
41100 billing questions
How does 41100 differ from 41105?
41100 is for sampling the anterior two-thirds of the tongue. Use 41105 when the biopsy site is in the posterior third.
Should 41100 be used when the entire lesion is removed?
No. This code describes diagnostic tissue sampling; select the applicable tongue-lesion excision code when the lesion is removed.
Can the pathology examination be billed separately?
The tissue examination is a separate laboratory service when performed and reported by the laboratory. The biopsy claim represents the clinician's sampling procedure.
Is modifier 50 appropriate for biopsies on both sides of the tongue?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the remaining procedures at 50%. Related postoperative visits are included for 10 days.
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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