No office rate
Use 41135 for total glossectomy without radical neck dissection. This code includes bilateral radical neck dissection.
On this page
CMS RVU26D · Effective 2026-10-01
41145 Total glossectomy Medicare reimbursement rates in Wyoming
Reports complete tongue removal with bilateral radical neck dissection, with or without tracheostomy, typically for advanced oral cavity cancer. Compare 41145 office and facility rates across CMS payment localities in Wyoming.
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 41145 in Wyoming?
Wyoming 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
No supported rate
Facility setting
$2369.33
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Head and neck surgery
About 41145: Total glossectomy with bilateral neck dissection
Reports complete tongue removal with bilateral radical neck dissection, with or without tracheostomy, typically for advanced oral cavity cancer.
This code describes removal of the entire tongue together with radical neck dissections on both sides of the neck; a tracheostomy may or may not be performed. Head and neck surgeons typically perform this extensive operation in a hospital setting for advanced cancers involving the tongue. The defining distinction is the combination of total tongue removal and bilateral radical neck dissection, rather than tongue removal alone or a partial glossectomy.
Select the code when the operative report supports total glossectomy and bilateral radical neck dissection. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate because bilateral neck surgery is built into this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 41145
- 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 RVU36.98 · 51%
- Practice expense (office) RVU29.96 · 41%
- Malpractice RVU5.40 · 7%
18
Medicare services in 2024 · #5977 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.
41145 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Both codes describe total glossectomy with radical neck dissection; 41140 is unilateral, while this code is bilateral.
No office rate
41130 represents hemiglossectomy, not removal of the entire tongue with bilateral radical neck dissection.
Compare 41145 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$2369.33
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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 41145 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,909
- Code
- 41145
- Physician work
- 36.98
- Practice expense
- 29.96
- Malpractice
- 5.40
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 36.98 | × 1.000 | 36.9800 |
| Practice expense | 29.96 | × 1.000 | 29.9600 |
| Malpractice | 5.40 | × 0.740 | 3.9960 |
| Total RVUs | 70.9360 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$2369.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 36.98 | 1 |
| Practice expense | 29.96 | 1 |
| Malpractice | 5.4 | 0.74 |
(36.98 × 1 + 29.96 × 1 + 5.4 × 0.74) × $33.4009 = $2369.33
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.
41145 billing questions
How does this differ from 41140?
41145 includes radical neck dissection on both sides of the neck. Use 41140 when the total glossectomy is accompanied by unilateral radical neck dissection.
When is 41135 a better choice?
41135 describes total glossectomy without radical neck dissection. Choose 41145 when the operative report documents bilateral radical neck dissection as part of the operation.
Should modifier 50 be appended for the bilateral neck work?
No. Bilateral radical neck dissection is part of 41145, so modifier 50 is inappropriate.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be allowed for this operation. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,90641130,,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
4,91241155,,Tongue jaw & neck surgery,A,,43.19,28.61,NA,28.61,,6.44,78.24,78.24,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,