Billing code 41114: Tongue excisionMedicare rate & RVUs in Guam
Reports extensive removal of a tongue lesion involving more than one-third of the tongue when the surgical wound is closed.
CMS doesn’t publish an office rate for 41114 in Guam.
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 41114 covers
Code 41114 describes removal of a substantial tongue lesion with closure when the excision involves more than one-third of the tongue. The service may address a sizable benign or suspicious lesion requiring therapeutic removal rather than a diagnostic sample alone. Otolaryngologists and oral and maxillofacial surgeons commonly perform it in an operating room or other surgical setting, with the excised tissue typically submitted for histologic examination.
Select this code when the operative report supports the extent of the lesion and excision, the portion of tongue involved, and closure of the surgical site. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 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 50% reduction. Assistant-at-surgery payment requires documented medical necessity; CMS does not permit co-surgeon or team-surgery payment for this service.
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.
41114 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $560.74 |
How the 41114 rate is calculated
Each of 41114’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 · 41114
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.60Practice expense 6.56Malpractice 1.26
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 41114
41114 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41114
Tongue 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) | 0 | Not paid without supporting documentation. |
| 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 · 41114
Tongue 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
41114 without 51 · national facility
$548.44
Tongue excision
41114-51 · Second procedure: 50%
$274.22
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%).
41114 compared with similar codes
Compare codes
41114 vs 41110 vs 41112 vs 41113 vs 41120: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 41110Tongue lesion excision
- 41110 describes tongue lesion excision without closure. Choose 41114 when the excision is extensive and the wound is closed.
- 41112Tongue excision
- 41112 is the closure code for lesions in the anterior two-thirds of the tongue; 41114 is for an extensive excision involving more than one-third.
- 41113Tongue lesion excision
- 41113 identifies closure of a lesion in the posterior one-third of the tongue. 41114 describes the extensive excision level.
- 41120Partial glossectomy
- 41120 describes partial glossectomy. Use 41114 when the documented service is extensive lesion removal with closure, rather than partial removal of the tongue.
41114 billing questions
How does 41114 differ from 41112 or 41113?
41114 describes an extensive excision involving more than one-third of the tongue. Codes 41112 and 41113 distinguish closure cases by the tongue region involved.
When is 41114 preferable to 41110?
Use 41114 for an extensive lesion excision with closure. Code 41110 describes tongue lesion excision without closure.
Should a tongue biopsy code be used for definitive lesion removal?
A biopsy code describes diagnostic tissue sampling. When the service removes the lesion, select the excision code supported by the operative extent and closure.
What should the operative report document?
Document the lesion's site and extent, how much of the tongue was involved, the tissue removed, and closure of the operative wound.
How does the global period affect postoperative billing?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeon or team-surgery payment for this service.
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
Fee sheets
Put 41114 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →