$448.51–$495.94
This code is for the parapharyngeal space; 41017 is for the masticator space. Select according to the documented site of the drained collection.
On this page
CMS RVU26D · Effective 2026-10-01
41018 Abscess drainage Medicare reimbursement rates in Texas
Reports surgical drainage of an abscess in the parapharyngeal space through an external approach, typically for a deep neck infection requiring operative access. Compare 41018 office and facility rates across CMS payment localities in Texas.
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 41018 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$514.83–$566.65
8 of 8 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.
Where 41018 pays more and less in Texas
8 payment localities
$514.83 to $566.65
Oral and maxillofacial surgery
About 41018: External drainage of parapharyngeal abscess
Reports surgical drainage of an abscess in the parapharyngeal space through an external approach, typically for a deep neck infection requiring operative access.
This service involves surgically opening and draining an infected collection in the parapharyngeal space through an external, typically transcervical, approach. It is generally performed by an otolaryngologist or oral and maxillofacial surgeon in an operating room when the infection’s location or extent calls for operative access to this deep space. The operative work addresses the parapharyngeal collection, rather than a more superficial mouth or neck abscess.
Report the code when the documented site is the parapharyngeal space and the surgeon performs external drainage. The operative note should identify the involved space, approach, and drainage performed; a general diagnosis of a neck abscess alone does not establish the specific service. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other 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 requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 41018
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.09 · 31%
- Practice expense (office) RVU10.62 · 65%
- Malpractice RVU0.71 · 4%
165
Medicare services in 2024 · #4491 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.
41018 compared with similar codes
Office rates for Texas, from the same CMS release.
$452.77–$500.83
41016 identifies drainage of a floor-of-mouth abscess by a submandibular approach. This code identifies external drainage of a parapharyngeal-space collection.
$387.64–$429.43
41008 is for intraoral drainage of a peritonsillar collection. This code is for external drainage of a collection in the parapharyngeal space.
Compare 41018 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $566.65 | Facility $382.89 |
| Beaumont | Office $514.83 | Facility $356.78 |
| Brazoria | Office $541.39 | Facility $369.27 |
| Dallas | Office $545.19 | Facility $372.20 |
| Fort Worth | Office $541.95 | Facility $370.69 |
| Galveston | Office $543.24 | Facility $370.77 |
| Houston | Office $556.24 | Facility $383.77 |
| Rest Of Texas | Office $528.05 | Facility $363.23 |
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.
41018 billing questions
How is this distinguished from drainage of a masticator-space abscess?
Use this code for drainage of a parapharyngeal-space collection by an external approach. A collection in the masticator space belongs to the code for that space, even when the infection is also described as a deep neck infection.
Does an intraoral drainage approach qualify?
This code describes external drainage. Confirm the documented operative approach and the infected space rather than selecting the code from the diagnosis alone.
What documentation supports reporting this code?
The operative report should identify the parapharyngeal space, describe the external approach, and document that the collection was surgically drained.
Is the related postoperative care separately reported during the global period?
The 90-day global period includes the day-before preoperative visit and related postoperative care. The code’s global period does not make unrelated services part of that package.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
How is payment adjusted when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and the other procedure or procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate 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.
4,89041015,,Drainage of mouth lesion,A,,3.98,7.86,,3.95,,0.45,12.29,8.38,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,89141016,,Drainage of mouth lesion,A,,4.09,9.83,,5.09,,0.56,14.48,9.74,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,89241017,,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