$219.75
Both involve floor-of-mouth drainage; 41005 is selected for an intraoral route, while 41006 is selected for an external route.
On this page
CMS RVU26D · Effective 2026-10-01
41006 Mouth lesion drainage Medicare reimbursement rates in Wisconsin
Reports surgical drainage of a floor-of-mouth abscess, cyst, or hematoma reached through an external approach rather than through the mouth. Compare 41006 office and facility rates across CMS payment localities in Wisconsin.
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 41006 in Wisconsin?
Wisconsin 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
$330.70
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
Facility setting
$202.71
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 41006: Extraoral floor-of-mouth abscess drainage
Reports surgical drainage of a floor-of-mouth abscess, cyst, or hematoma reached through an external approach rather than through the mouth.
This service is drainage of a collection in the floor of the mouth through an incision made externally, such as through the skin beneath the jaw. The surgeon opens the collection and evacuates its contents. Oral and maxillofacial surgeons and otolaryngologists may perform it in an operating room or, when clinically appropriate, another surgical setting. The external route distinguishes this service from drainage approached through the oral cavity.
Select the code based on the documented site and operative route; the record should identify the floor-of-mouth collection and the external approach. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 41006
- 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 RVU3.26 · 31%
- Practice expense (office) RVU6.81 · 65%
- Malpractice RVU0.38 · 4%
665
Medicare services in 2024 · #3312 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.
41006 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$456.91
41016 identifies drainage of a sublingual, submandibular, or submental space collection through an external approach. Use 41006 when the documented site is the floor of the mouth.
$391.19
41008 is external drainage of a collection in the vestibule of the mouth, not the floor of the mouth.
Compare 41006 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
Wisconsin →
Office / nonfacility
$330.70
Facility
$202.71
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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 41006 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
4,884
- Code
- 41006
- Physician work
- 3.26
- Practice expense
- 6.81
- Malpractice
- 0.38
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.26 | × 1.000 | 3.2600 |
| Practice expense | 6.81 | × 0.958 | 6.5240 |
| Malpractice | 0.38 | × 0.308 | 0.1170 |
| Total RVUs | 9.9010 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wisconsin$330.70
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.26 | 1 |
| Practice expense | 6.81 | 0.958 |
| Malpractice | 0.38 | 0.308 |
(3.26 × 1 + 6.81 × 0.958 + 0.38 × 0.308) × $33.4009 = $330.70
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.26 | 1 |
| Practice expense | 2.81 | 0.958 |
| Malpractice | 0.38 | 0.308 |
(3.26 × 1 + 2.81 × 0.958 + 0.38 × 0.308) × $33.4009 = $202.71
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.
41006 billing questions
How does this differ from 41005?
Both address drainage in the floor of the mouth. Use 41006 for an external approach and 41005 when the collection is drained through the oral cavity.
When is 41006 preferred over 41016?
41006 is for a floor-of-mouth collection reached externally. 41016 describes external drainage of a sublingual, submandibular, or submental space collection; choose by the documented anatomic space.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this code’s descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When may an assistant-at-surgery be paid?
CMS payment for an assistant at surgery requires documentation of medical necessity. 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.
4,8814095F,,Pt not rcvng epo thxpy,I,,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
4,88241000,,Drainage of mouth lesion,A,,1.32,3.27,,1.58,,0.18,4.77,3.08,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,88341005,,Drainage of mouth lesion,A,,1.28,5.48,,1.91,,0.16,6.92,3.35,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,88441006,,Drainage of mouth lesion,A,,3.26,6.81,,2.81,,0.38,10.45,6.45,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,88541007,,Drainage of mouth lesion,A,,3.12,6.60,,2.70,,0.36,10.08,6.18,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,88641008,,Drainage of mouth lesion,A,,3.37,8.55,,3.47,,0.49,12.41,7.33,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,88741009,,Drainage of mouth lesion,A,,3.62,8.86,,3.81,,0.48,12.96,7.91,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,