Billing code 41015: Mouth lesion drainageMedicare rate & RVUs in Massachusetts
Reports surgical drainage of an abscess, cyst, or hematoma in the floor of the mouth when the surgeon reaches the collection through an external incision.
Medicare pays $423.49–$465.23 for 41015 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 41015 covers
This service drains a collection in the floor of the mouth through an incision made outside the mouth. Oral and maxillofacial surgeons and other surgeons treating deep oral infections may perform it, commonly in a facility when the collection requires external access. The operative report should identify the floor-of-mouth site and document the external approach and drainage performed; the code is distinguished from procedures that reach a collection through the oral cavity or target another space.
Report the service for the documented site and approach, not simply because a patient has an oral abscess. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment requires documentation of 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 41015 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | $465.23 | $309.29 |
| Rest Of Massachusetts | $423.49 | $285.97 |
How the 41015 rate is calculated
Each of 41015’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 · 41015
RVUs × geographic indexes × conversion factor
Work3.98
3.98 RVUs× 1.000 GPCI
Practice expense7.86
7.86 RVUs× 1.000 GPCI
Malpractice0.45
0.45 RVUs× 1.000 GPCI
Adjusted RVUs
12.2900
Conversion factor
$33.4009
Medicare rate
$410.50
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 41015
41015 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41015
Mouth lesion 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 · 41015
Mouth lesion 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
41015 without 51 · national office
$410.50
Mouth lesion drainage
41015-51 · Second procedure: 50%
$205.25
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%).
41015 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 41005Oral drainage
- 41005 is for drainage through a lingual approach to a tongue or floor-of-mouth collection. Choose 41015 when the documented route is external.
- 41006Mouth lesion drainage
- 41006 describes a sublingual approach to a tongue or floor-of-mouth collection; 41015 describes external access.
- 41007Mouth lesion drainage
- 41007 targets a submandibular-space collection. Use 41015 for a floor-of-mouth collection drained through an external incision.
- 41017Lesion drainage
- 41017 is for extraoral drainage of a masticator-space collection. The documented collection site, rather than the external route alone, separates it from 41015.
41015 billing questions
When is this code chosen over an intraoral drainage code?
Use it when the operative documentation identifies a floor-of-mouth collection and the surgeon drains it through an external incision. Drainage reached through the mouth is coded to the applicable intraoral service.
How is this distinguished from 41007?
The distinction is the documented target and approach: 41015 describes external access to a floor-of-mouth collection, while 41007 is for drainage of a submandibular-space collection.
What should the operative report document?
Document the collection's anatomic site, the external route of access, and the drainage performed. A general diagnosis of mouth abscess without the site and approach is not enough to establish this specific service.
Can modifier 50 be used for bilateral drainage?
No. CMS identifies bilateral adjustment as inappropriate for this code's descriptor and anatomy.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment requires medical-necessity documentation.
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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