Billing code 41006: Mouth lesion drainageMedicare rate & RVUs in Pennsylvania
Reports surgical drainage of a floor-of-mouth abscess, cyst, or hematoma reached through an external approach rather than through the mouth.
Medicare pays $329.69–$362.77 for 41006 in the office in Pennsylvania, from Rest Of Pennsylvania to Metropolitan Philadelphia. 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 41006 covers
This service is drainage of a collection in the floor of the mouth through an incision made externally, such as through the skin beneath the jaw. The surgeon opens the collection and evacuates its contents. Oral and maxillofacial surgeons and otolaryngologists may perform it in an operating room or, when clinically appropriate, another surgical setting. The external route distinguishes this service from drainage approached through the oral cavity.
Select the code based on the documented site and operative route; the record should identify the floor-of-mouth collection and the external approach. This major surgery code includes 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery billing 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 41006 pays more and less in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia | $362.77 | $223.69 |
| Rest Of Pennsylvania | $329.69 | $207.04 |
How the 41006 rate is calculated
Each of 41006’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 · 41006
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.26Practice expense 6.81Malpractice 0.38
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 41006
41006 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41006
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 · 41006
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
41006 without 51 · national office
$349.04
Mouth lesion drainage
41006-51 · Second procedure: 50%
$174.52
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%).
41006 compared with similar codes
Compare codes
41006 vs 41005 vs 41016 vs 41008: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 41005Oral drainage
- Both involve floor-of-mouth drainage; 41005 is selected for an intraoral route, while 41006 is selected for an external route.
- 41016Abscess drainage
- 41016 identifies drainage of a sublingual, submandibular, or submental space collection through an external approach. Use 41006 when the documented site is the floor of the mouth.
- 41008Tongue drainage
- 41008 is external drainage of a collection in the vestibule of the mouth, not the floor of the mouth.
41006 billing questions
How does this differ from 41005?
Both address drainage in the floor of the mouth. Use 41006 for an external approach and 41005 when the collection is drained through the oral cavity.
When is 41006 preferred over 41016?
41006 is for a floor-of-mouth collection reached externally. 41016 describes external drainage of a sublingual, submandibular, or submental space collection; choose by the documented anatomic space.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this code’s descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When may an assistant-at-surgery be paid?
CMS payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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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