$183.56
41100 describes biopsy of the anterior two-thirds of the tongue. Use 41105 when the sampled tissue is from the posterior one-third.
On this page
CMS RVU26D · Effective 2026-10-01
41105 Tongue biopsy Medicare reimbursement rates in Vermont
Reports tissue sampling from the posterior one-third of the tongue to evaluate a suspicious lesion or other abnormal tissue. Compare 41105 office and facility rates across CMS payment localities in Vermont.
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 41105 in Vermont?
Vermont 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
$184.73
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$96.78
1 of 1 localities have a supported rate.
Payment area: Vermont
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 41105: Posterior tongue biopsy
Reports tissue sampling from the posterior one-third of the tongue to evaluate a suspicious lesion or other abnormal tissue.
This service is a tissue sample taken from the posterior one-third of the tongue for diagnostic evaluation, such as investigation of a suspicious ulcer, mass, or mucosal change. An otolaryngologist, head-and-neck surgeon, or oral and maxillofacial surgeon may perform it in an office, procedure room, or operating room, depending on access and the patient’s needs. The sample is submitted for pathologic examination; this code describes the biopsy procedure, not the pathology interpretation.
Choose this code for a biopsy from the posterior tongue, rather than the anterior two-thirds or the floor of the mouth. The note should identify the sampled site and the lesion or abnormal tissue prompting the biopsy. It has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures subject to the standard reduction are performed in the same session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 41105
- 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 RVU1.43 · 25%
- Practice expense (office) RVU4.04 · 71%
- Malpractice RVU0.20 · 4%
1.3K
Medicare services in 2024 · #2804 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.
41105 compared with similar codes
Office rates for Vermont, from the same CMS release.
$166.24
41108 is for tissue sampled from the floor of the mouth, not the tongue. Select by the documented specimen site.
$221.64
41105 represents diagnostic sampling of posterior tongue tissue. 41110 is an excision code for removing a tongue lesion without closure.
Compare 41105 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
Vermont →
Office / nonfacility
$184.73
Facility
$96.78
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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 41105 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
4,896
- Code
- 41105
- Physician work
- 1.43
- Practice expense
- 4.04
- Malpractice
- 0.20
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.43 | × 1.000 | 1.4300 |
| Practice expense | 4.04 | × 0.990 | 3.9996 |
| Malpractice | 0.20 | × 0.506 | 0.1012 |
| Total RVUs | 5.5308 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$184.73
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.43 | 1 |
| Practice expense | 4.04 | 0.99 |
| Malpractice | 0.2 | 0.506 |
(1.43 × 1 + 4.04 × 0.99 + 0.2 × 0.506) × $33.4009 = $184.73
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.43 | 1 |
| Practice expense | 1.38 | 0.99 |
| Malpractice | 0.2 | 0.506 |
(1.43 × 1 + 1.38 × 0.99 + 0.2 × 0.506) × $33.4009 = $96.78
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.
41105 billing questions
How is 41105 distinguished from 41100?
41105 is for a biopsy of the posterior one-third of the tongue; 41100 is for the anterior two-thirds. The documentation should identify which part of the tongue was sampled.
Can 41105 be used for a floor-of-mouth biopsy?
No. A biopsy of the floor of the mouth is reported with 41108; 41105 is for the posterior tongue.
When would a tongue lesion excision code be more appropriate?
Use a biopsy code when tissue is sampled for diagnosis. When the lesion is removed rather than sampled, consider the applicable tongue lesion excision code, such as 41110.
Is modifier 50 appropriate for a biopsy of both sides of the tongue?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not append modifier 50.
Are related postoperative visits included?
Yes. Related postoperative visits during the 10-day global period are included in the procedure.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. 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 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.
4,89341018,,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
4,89741108,,Biopsy of floor of mouth,A,,1.07,3.87,,1.30,,0.15,5.09,2.52,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,8984110F,,Int mam art used for cabg,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,89941110,,Excision of tongue lesion,A,,1.52,5.06,,1.83,,0.21,6.79,3.56,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817