Billing code 41009: Abscess drainageMedicare rate & RVUs in Massachusetts
Reports surgical drainage through the mouth for a deep infection involving the retropharyngeal or parapharyngeal space.
Medicare pays $447.24–$493.48 for 41009 in the office in Massachusetts, from Rest Of Massachusetts to Metropolitan Boston. 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 41009 covers
This service drains a deep collection in the retropharyngeal or parapharyngeal space through an intraoral approach. It is typically performed by an oral and maxillofacial surgeon or another surgeon treating a deep head-and-neck infection, often in an operating-room setting. A common clinical context is spread of an odontogenic infection into a deep pharyngeal space; the documented space and surgical route distinguish this service from drainage of an oral vestibule or floor-of-mouth collection.
Report the code when the operative record supports drainage of the specified deep space by the intraoral route. Document the involved anatomy, approach, and findings. CMS classifies the service as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures receive the standard multiple-procedure reduction. Modifier 50 is inappropriate. 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.
Where 41009 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | $493.48 | $292.08 |
| Rest Of Massachusetts | $447.24 | $269.63 |
How the 41009 rate is calculated
Each of 41009’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 · 41009
RVUs × geographic indexes × conversion factor
Work3.62
3.62 RVUs× 1.000 GPCI
Practice expense8.86
8.86 RVUs× 1.000 GPCI
Malpractice0.48
0.48 RVUs× 1.000 GPCI
Adjusted RVUs
12.9600
Conversion factor
$33.4009
Medicare rate
$432.88
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 41009
41009 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41009
Abscess drainage
| 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 · 41009
Abscess 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
41009 without 51 · national office
$432.88
Abscess drainage
41009-51 · Second procedure: 50%
$216.44
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%).
41009 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 41005Oral drainage
- Use 41005 for an intraoral vestibular collection. This code is for drainage of a retropharyngeal or parapharyngeal space.
- 41006Mouth lesion drainage
- Use 41006 when the documented collection is in the floor of the mouth. This code identifies a deeper pharyngeal-space site.
- 41018Abscess drainage
- Both concern deep pharyngeal-space drainage, but the approach differs: this code is intraoral, while 41018 is extraoral.
41009 billing questions
How does this differ from code 41018?
The key distinction is the surgical route: this code describes intraoral access to a retropharyngeal or parapharyngeal space. Code 41018 is for drainage of a deep pharyngeal space by an extraoral approach.
When would 41005 or 41006 be more appropriate?
Choose based on the collection's documented location. Those codes describe drainage in the oral vestibule or floor of the mouth, rather than a retropharyngeal or parapharyngeal space.
What documentation supports reporting this code?
The operative note should identify the retropharyngeal or parapharyngeal space involved and state that drainage was performed through an intraoral approach.
Does the 90-day global period include related postoperative care?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in this major-surgery global period.
Can modifier 50 be reported for bilateral drainage?
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 other procedures are paid at 50%. Assistant-at-surgery payment requires documented medical necessity.
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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