CPT 41800
Global 010 ActiveDrainage of gum lesion
CPT 41800 Billing & Documentation Guide
CPT code 41800 (Drainage of gum lesion) is classified under Surgery (Digestive) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.24, a non-facility practice expense RVU of 9.98, and a malpractice RVU of 0.26, a total non-facility RVU of 11.48 and facility RVU of 5.66. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $397.58, though rates vary from $332.23 to $531.31 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 41800, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 41800 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 41800 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 41800
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.24 | 1.24 |
| Practice Expense RVU | 9.98 | 4.16 |
| Malpractice RVU | 0.26 | 0.26 |
| Total RVU | 11.48 | 5.66 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 41800
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $442.05 | $212.02 | $412.12 - $531.31 | 29 |
| Florida | $392.77 | $197.73 | $373.14 - $410.39 | 3 |
| Georgia | $369.88 | $184.43 | $349.11 - $390.65 | 2 |
| Illinois | $380.25 | $192.42 | $359.33 - $399.44 | 4 |
| Michigan | $366.65 | $184.11 | $355.56 - $377.73 | 2 |
| North Carolina | $357.97 | $176.6 | $357.97 - $357.97 | 1 |
| New York | $427.06 | $210.2 | $364.2 - $456.54 | 5 |
| Ohio | $354.51 | $177.03 | $354.51 - $354.51 | 1 |
| Pennsylvania | $377.58 | $187.18 | $355.63 - $399.53 | 2 |
| Texas | $377.89 | $186.51 | $352.83 - $401.87 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 41800
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 41800 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00170 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 41800
What does CPT code 41800 mean? +
CPT code 41800 represents: Drainage of gum lesion. It's in the Surgery (Digestive) category with a global period of 010.
What is the Medicare reimbursement for CPT 41800? +
The 2026 Medicare national average non-facility payment for CPT 41800 is $397.58. Rates range from $332.23 to $531.31 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 41800? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 41800? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 16, 2026.
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