Billing code 41019: Needle placementMedicare rate & RVUs in Washington
Reports surgical placement of needles or similar devices in head and neck tissue to prepare a site for interstitial radiation therapy.
CMS doesn’t publish an office rate for 41019 in Washington.
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 41019 covers
This service involves placing needles, catheters, or other devices into head and neck tissue so radioactive material can be delivered within or near a treatment site. It is typically performed by a surgeon, such as an otolaryngologist or oral and maxillofacial surgeon, in coordination with the radiation oncology team. Placement is distinct from delivering radiation or applying the radioactive source; the treatment plan determines the target and device arrangement.
Report the service when the record supports interstitial device placement in the head or neck for radiation treatment. Document the treated site, the placement performed, and its relationship to the radiation plan. The 0-day global period includes same-day preoperative and postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this code. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeon and team-surgery payment require supporting documentation.
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 41019 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $409.18 |
| Seattle (King Cnty) | Unavailable | $437.67 |
How the 41019 rate is calculated
Each of 41019’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 · 41019
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.62Practice expense 2.85Malpractice 0.68
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 41019
The CMS indicators that decide how 41019 is paid alongside other services.
CMS payment indicators · 41019
Needle placement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
41019 without 51 · national facility
$405.82
Needle placement
41019-51 · Second procedure: 50%
$202.91
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%).
41019 compared with similar codes
Compare codes
41019 vs 55920 vs 55875 vs 57155: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 55920Needle placement
- This code is for interstitial radiation-device placement in the head or neck. Code 55920 describes placement in pelvic organs or genitalia, excluding the prostate.
- 55875Prostate brachytherapy
- Use this code for head and neck placement; 55875 describes transperineal needle or catheter placement for prostate treatment.
- 57155Brachytherapy applicator
- This code concerns interstitial placement in head and neck tissue. Code 57155 is for placing uterine or vaginal applicators for intracavitary brachytherapy.
41019 billing questions
When is this code appropriate instead of a pelvic placement code?
Use this code for interstitial radiation-device placement in the head or neck. Pelvic-organ and prostate placements are described by separate codes.
Does this code include radiation delivery?
It reports device placement, not radiation delivery or application of the radioactive source. Report other treatment services only when they are performed and separately supported.
Should modifier 50 be appended for placement on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; do not use modifier 50.
How does the multiple-procedure reduction affect payment?
When procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
What documentation supports this service?
Record the head or neck treatment site, the devices placed, and how the placement supports the interstitial radiation plan. Assistant-at-surgery payment requires medical-necessity documentation, while co-surgeon and team-surgery payment require 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 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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