Billing code 41008: Tongue drainageMedicare rate & RVUs in Nebraska

Reports incision and drainage of a collection involving the tongue when the surgeon reaches the site through the mouth.

CMS RVU26DEffective Oct 1, 20261 payment locality220 Medicare services in 2024

Medicare pays $382.34 for 41008 in the office in Nebraska (Nebraska). Which amount applies depends on the service address.

$382.34Office (non-facility)
$225.72Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 41008 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Nebraska
  2. What 41008 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 41008 covers

This procedure drains a localized collection, such as an abscess, cyst, or hematoma, involving the tongue through an incision made from inside the mouth. Oral and maxillofacial surgeons and other qualified surgeons may perform it in an operating room or another setting equipped for the procedure. The operative note should identify the tongue as the treated site and describe the intraoral route and drainage performed.

Choose this code when the collection is in the tongue and is accessed intraorally; a different site or an external approach points to a different code. The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. 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.

41008 in Nebraska

41008 office and facility rates by payment locality
Payment localityOfficeFacility
Nebraska$382.34$225.72

How the 41008 rate is calculated

Each of 41008’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 · 41008

RVUs × geographic indexes × conversion factor

Work3.37

3.37 RVUs× 1.000 GPCI

Practice expense8.55

8.55 RVUs× 1.000 GPCI

Malpractice0.49

0.49 RVUs× 1.000 GPCI

Adjusted RVUs

12.4100

Conversion factor

$33.4009

Medicare rate

$414.51

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 41008

41008 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41008

Tongue drainage

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 41008

Tongue 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

41008 without 51 · national office

$414.51

Tongue drainage

41008-51 · Second procedure: 50%

$207.26

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%).

When to use modifier 51

41008 compared with similar codes

Compare codes · National

4 codes, side by side

  • 41008

    Tongue drainage3.37 wRVU

    $414.51

  • 41009

    Abscess drainage3.62 wRVU

    $432.88+$18.37

  • 41000

    Oral abscess drainage1.32 wRVU

    $159.32−$255.19

  • 41005

    Oral drainage1.28 wRVU

    $231.13−$183.38

How to choose

41009Abscess drainage
Both concern drainage of a tongue collection, but 41008 is for access through the mouth and 41009 for an external approach.
41000Oral abscess drainage
41008 identifies a tongue collection. Use 41000 when the collection involves dentoalveolar structures instead.
41005Oral drainage
41005 concerns drainage at the floor of the mouth through a sublingual approach; 41008 concerns a tongue collection reached intraorally.

41008 billing questions

When should this code be chosen over 41009?

Use 41008 for drainage of a tongue collection reached through the mouth. Code 41009 is the related alternative for an external approach.

Does this code cover drainage of a tooth-related abscess?

No. When the treated collection is in dentoalveolar structures rather than the tongue, consider 41000.

What should the operative note identify?

Document the tongue as the site, the intraoral route, and the incision and drainage performed. This supports distinguishing the service from drainage at another oral site or by an external approach.

Can modifier 50 be used?

No. The code's descriptor and anatomy make bilateral reporting with modifier 50 inappropriate.

How does the global period affect postoperative billing?

The 90-day global period includes the day-before preoperative visit and related postoperative care through day 90.

When is assistant-at-surgery payment allowed?

Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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
RVUs for 41008PPRRVU2026_Oct_nonQPP.csv, line 4,886 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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