No office rate
Use 41135 for complete or total glossectomy without radical neck dissection. 41140 includes a unilateral radical neck dissection.
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CMS RVU26D · Effective 2026-10-01
41140 Total glossectomy Medicare reimbursement rates in Texas
Reports complete or total tongue removal performed with a unilateral radical neck dissection, commonly for advanced tongue cancer requiring an extensive oncologic operation. Compare 41140 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 41140 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
No 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 41140 pays more and less in Texas
Head and neck surgery
About 41140: Total glossectomy with unilateral radical neck dissection
Reports complete or total tongue removal performed with a unilateral radical neck dissection, commonly for advanced tongue cancer requiring an extensive oncologic operation.
This operation removes the entire tongue and includes a radical neck dissection on one side. Head and neck oncologic surgeons typically perform it for advanced oral tongue or tongue-base malignancy when the planned resection requires total rather than partial tongue removal and unilateral radical neck treatment. A tracheostomy may be performed, but its presence does not change selection of this code.
Report 41140 when the operative record supports complete or total glossectomy together with unilateral radical neck dissection. Documentation should identify the extent of tongue resection, the side and extent of the neck dissection, and the clinical indication. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 41140
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU28.42 · 49%
- Practice expense (office) RVU25.14 · 44%
- Malpractice RVU4.14 · 7%
48
Medicare services in 2024 · #5377 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.
41140 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Both include total glossectomy and radical neck dissection; 41145 describes bilateral neck dissection, while 41140 describes unilateral dissection.
No office rate
41130 is for hemiglossectomy, not removal of the entire tongue with unilateral radical neck dissection.
No office rate
41153 describes a composite resection involving the tongue, floor of mouth, and mandible with unilateral radical neck dissection. 41140 does not describe that composite resection.
Compare 41140 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 Unavailable | Facility $1962.07 |
| Beaumont | Office Unavailable | Facility $1841.84 |
| Brazoria | Office Unavailable | Facility $1896.85 |
| Dallas | Office Unavailable | Facility $1912.78 |
| Fort Worth | Office Unavailable | Facility $1906.18 |
| Galveston | Office Unavailable | Facility $1905.16 |
| Houston | Office Unavailable | Facility $1980.94 |
| Rest Of Texas | Office Unavailable | Facility $1870.99 |
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41140 billing questions
How does 41140 differ from 41135?
Both describe complete or total glossectomy. 41140 includes a unilateral radical neck dissection; 41135 describes the total glossectomy without radical neck dissection.
Can 41140 be reported with modifier 50 for bilateral neck dissection?
No. Modifier 50 is inappropriate for 41140. The code for total glossectomy with bilateral radical neck dissection is 41145.
Does a tracheostomy change the code selection?
No. The code includes total glossectomy whether or not a tracheostomy is performed.
What documentation supports reporting 41140?
The operative report should establish complete or total tongue removal and a unilateral radical neck dissection, including the side treated.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90 days after surgery are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with supporting documentation.
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.
4,90541120,,Partial removal of tongue,A,,10.86,16.80,NA,16.80,,1.61,29.27,29.27,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,90641130,,Partial removal of tongue,A,,15.35,17.84,NA,17.84,,2.28,35.47,35.47,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,90741135,,Tongue and neck surgery,A,,29.39,23.64,NA,23.64,,4.36,57.39,57.39,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,90841140,,Removal of tongue,A,,28.42,25.14,NA,25.14,,4.14,57.70,57.70,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,90941145,,Tongue removal neck surgery,A,,36.98,29.96,NA,29.96,,5.40,72.34,72.34,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,91041150,,Tongue mouth jaw surgery,A,,29.11,24.73,NA,24.73,,4.31,58.15,58.15,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,91141153,,Tongue mouth neck surgery,A,,32.75,25.33,NA,25.33,,4.84,62.92,62.92,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00