$394.29
41800 represents drainage of a gum lesion. Use 41825 when the documented procedure excises the lesion rather than opening it to drain.
On this page
CMS RVU26D · Effective 2026-10-01
41825 Gum lesion excision Medicare reimbursement rates in Rhode Island
Surgical removal of a localized gum lesion, reported when the provider excises abnormal gingival tissue rather than draining a collection or removing a foreign body. Compare 41825 office and facility rates across CMS payment localities in Rhode Island.
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 41825 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$221.06
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$113.06
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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 41825: Excision of gingival lesion
Surgical removal of a localized gum lesion, reported when the provider excises abnormal gingival tissue rather than draining a collection or removing a foreign body.
An oral surgeon or other qualified dental or medical provider uses this service to surgically remove a localized lesion arising in the gum tissue. A typical clinical situation is removal of a discrete gingival growth, such as a fibrous or irritation-related lesion, in an office or surgical setting. The code concerns excision; drainage of a fluid collection and removal of a foreign body are different services.
Choose this code when the operative documentation identifies the gingival lesion and describes its excision. Record the site, the tissue removed, and the procedure performed so the service can be distinguished from quadrant-based gum removal or excision of a gingival flap. CMS assigns a 10-day global period, including related postoperative visits during that period. 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 multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 41825
- 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 RVU1.37 · 21%
- Practice expense (office) RVU4.90 · 76%
- Malpractice RVU0.18 · 3%
610
Medicare services in 2024 · #3378 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.
41825 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
41820
No office rateExcision gum each quadrant
41820 describes gum-tissue excision by quadrant. Use 41825 for excision of a localized gum lesion, not a quadrant-based removal.
41821
No office rateExcision of gum flap
41821 is for excision of a gingival flap. Use 41825 when the operative report describes removal of a gum lesion instead of a flap.
Compare 41825 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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
$221.06
Facility
$113.06
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 41825 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
4,967
- Code
- 41825
- Physician work
- 1.37
- Practice expense
- 4.90
- Malpractice
- 0.18
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.37 | × 1.019 | 1.3960 |
| Practice expense | 4.90 | × 1.033 | 5.0617 |
| Malpractice | 0.18 | × 0.892 | 0.1606 |
| Total RVUs | 6.6183 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$221.06
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1.019 |
| Practice expense | 4.9 | 1.033 |
| Malpractice | 0.18 | 0.892 |
(1.37 × 1.019 + 4.9 × 1.033 + 0.18 × 0.892) × $33.4009 = $221.06
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.37 | 1.019 |
| Practice expense | 1.77 | 1.033 |
| Malpractice | 0.18 | 0.892 |
(1.37 × 1.019 + 1.77 × 1.033 + 0.18 × 0.892) × $33.4009 = $113.06
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
41825 billing questions
How is this different from drainage of a gum lesion?
Report 41825 for excision of gingival tissue. Code 41800 describes drainage, such as opening a collection to release its contents.
Is this the same as quadrant-based gum excision?
No. Code 41820 is defined by excision of gum tissue by quadrant; 41825 concerns excision of a gum lesion. The operative note should support the service actually performed.
Can modifier 50 be used for lesions on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not report modifier 50.
Are related postoperative visits included?
Yes. The code has a 10-day global period, so related postoperative visits during those 10 days are included.
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 other procedures are reduced to 50% when performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is statutorily restricted. 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 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.
4,96441821,,Excision of gum flap,R,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,96541822,,Excision of gum lesion,R,,2.35,8.66,,2.86,,0.43,11.44,5.64,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,96641823,,Excision of gum lesion,R,,3.68,12.84,,6.32,,0.68,17.20,10.68,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,96741825,,Excision of gum lesion,A,,1.37,4.90,,1.77,,0.18,6.45,3.32,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,96841826,,Excision of gum lesion,A,,2.35,6.35,,2.72,,0.29,8.99,5.36,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,96941827,,Excision of gum lesion,A,,3.73,8.77,,3.71,,0.47,12.97,7.91,0,090,0.09,0.81,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,97041828,,Excision of gum lesion,R,,3.06,7.74,,2.38,,0.56,11.36,6.00,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537