$195.94–$216.78
Use 41100 for a biopsy from the anterior two-thirds of the tongue; 41105 is for a biopsy from the posterior third.
On this page
CMS RVU26D · Effective 2026-10-01
41100 Tongue biopsy Medicare reimbursement rates in Massachusetts
Reports tissue sampling from a lesion in the anterior two-thirds of the tongue for microscopic diagnosis, rather than complete lesion removal. Compare 41100 office and facility rates across CMS payment localities in Massachusetts.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 41100 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$194.68–$215.55
2 of 2 localities have a supported rate.
Facility setting
$99.37–$107.47
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Oral surgery
About 41100: Anterior tongue tissue biopsy
Reports tissue sampling from a lesion in the anterior two-thirds of the tongue for microscopic diagnosis, rather than complete lesion removal.
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.
CMS billing rules for 41100
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.38 · 25%
- Practice expense (office) RVU4.06 · 72%
- Malpractice RVU0.19 · 3%
6.6K
Medicare services in 2024 · #1696 by national volume
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 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$176.42–$196.00
41108 applies to a biopsy of the floor of the mouth. Use 41100 only when the sampled tissue is tongue tissue.
$235.14–$260.89
41100 represents diagnostic tissue sampling. 41110 is for excision of a tongue lesion rather than a biopsy.
Compare 41100 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$215.55
Facility
$107.47
Rest Of Massachusetts →
Office / nonfacility
$194.68
Facility
$99.37
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,89241017,,Drainage of mouth lesion,A,,4.09,9.70,,4.98,,0.55,14.34,9.62,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,89341018,,Drainage of mouth lesion,A,,5.09,10.62,,5.42,,0.71,16.42,11.22,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,89441019,,Place needles h&n for rt,A,,8.62,2.85,NA,2.85,,0.68,12.15,12.15,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,89541100,,Biopsy of tongue,A,,1.38,4.06,,1.35,,0.19,5.63,2.92,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,89641105,,Biopsy of tongue,A,,1.43,4.04,,1.38,,0.20,5.67,3.01,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,89741108,,Biopsy of floor of mouth,A,,1.07,3.87,,1.30,,0.15,5.09,2.52,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,8984110F,,Int mam art used for cabg,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00