CPT 41135 Partial Glossectomy Reimbursement | OpenPayer

Summary & Overview

CPT 41135: Partial Glossectomy with Unilateral Neck Dissection

CPT code 41135 represents a partial glossectomy combined with unilateral neck dissection — a head and neck oncologic surgery used to remove part of the tongue and associated regional lymphatic tissue, typically to treat oral cavity cancers. This code matters nationally because it captures a high-acuity, resource-intensive surgical service with implications for surgical quality, postoperative care pathways, and payer reimbursement across major commercial insurers and Medicare. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, common sites of service, and the expected care setting. The publication also summarizes benchmark considerations and payer coverage patterns, highlights relevant billing and coding nuances, and flags policy developments that affect surgical oncology services and postoperative billing practices. This overview equips hospital revenue-cycle staff, surgical teams, and policy analysts with the core facts needed to align clinical documentation with billing requirements and to anticipate coverage-related questions for this category of procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 41135partial glossectomyhead and neck surgeryneck dissectionsurgical oncologyambulatory surgical centerhospital operating roompostoperative care

Billing Code Overview

CPT code 41135 describes a surgical procedure in which the provider removes part of the patient's tongue (partial glossectomy) along with lymph nodes and other tissues from one side of the neck. This procedure is most commonly used for the treatment of oral cavity cancers and related malignant lesions.

Service type: Head and neck surgical oncology procedure involving partial glossectomy with unilateral neck dissection
Typical site of service: Hospital operating room or ambulatory surgical center with inpatient or outpatient post-anesthesia recovery, depending on clinical complexity and need for inpatient care

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A 62-year-old male presents with a persistent ulcerated mass on the lateral tongue and ipsilateral enlarged cervical lymph nodes. Biopsy of the tongue lesion confirms moderately differentiated squamous cell carcinoma. Imaging (contrast CT or MRI) shows a primary lesion invading the anterior two-thirds of the tongue without crossing midline and a single ipsilateral level I–III lymph node measuring 2.5 cm. The multidisciplinary tumor board recommends surgical management consisting of a partial glossectomy with ipsilateral modified radical neck dissection to achieve oncologic margins and regional lymph node control.

Preoperative workflow includes staging with imaging, preoperative anesthesia evaluation, informed consent discussing risks (bleeding, infection, airway compromise, swallowing and speech changes), and coordination with speech‑language pathology and nutrition. Intraoperative steps include tumor resection with frozen-section margin assessment, selective removal of cervical lymph node levels on the affected side, hemostasis and reconstruction as needed (primary closure, local flap, or free flap depending on defect). Postoperative care involves airway monitoring, pain control, early swallow assessment, pathology review for margin status and nodal involvement, and planning for adjuvant therapy (radiation or chemoradiation) if indicated.

Coding Specifications

Modifier	Description	When to Use
`50`	Bilateral procedure	Not typically used for unilateral neck dissection; would apply only if procedure performed on both sides during same session.

CPT 41113: Excision of Lesion, Posterior One-Third of Tongue

CPT-41145-TOTAL-GLOSSECTOMY-UNILATERAL-NECK-DISSECTION

CPT 41145: Total Glossectomy with Unilateral Neck Dissection

CPT-41155-RADICAL-TONGUE-AND-MANDIBLE-RESECTION-UNILATERAL-NECK-DISSECTION

CPT 41155: Radical Tongue and Mandible Resection with Unilateral Neck Dissection

CPT-41110-TONGUE-LESION-EXCISION

CPT 41110: Excision of Lesion from Tongue

CPT-41100-TONGUE-EXCISIONAL-BIOPSY-ANTERIOR-TWO-THIRDS

CPT 41100: Excisional Tongue Biopsy, Anterior Two Thirds

CPT-41150-PARTIAL-OR-TOTAL-GLOSSECTOMY-WITH-MANDIBULECTOMY-FLOOR-MOUTH

CPT 41150: Glossectomy with Mandible and Floor-of-Mouth Resection

CPT-41114-TONGUE-LESION-EXCISION-LOCAL-FLAP-REPAIR

CPT 41114: Tongue Lesion Excision with Local Flap Repair

CPT-41115-LINGUAL-FRENUM-EXCISION-BASE-OF-TONGUE

CPT 41115: Excision of Lingual Frenum at Base of Tongue

CPT-41140-TOTAL-GLOSSECTOMY-WITH-TRACHEOSTOMY

CPT 41140: Total Glossectomy with Tracheostomy

CPT-41112-TONGUE-LESION-EXCISION-ANTERIOR-TWO-THIRDS

CPT 41112: Excision of Lesion, Anterior Two-Thirds of Tongue

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Taxonomy Code	Specialty	Notes
207L00000X	Otolaryngology (ENT)	Primary surgical specialty performing glossectomy and neck dissection.
207P00000X	Oral and Maxillofacial Surgery	Performs resection and reconstruction for oral cavity cancers in some settings.
2080P0207X	General Surgery — Surgical Oncology	Surgical oncologists who manage head and neck cancer resections and neck dissections.
207K00000X	Plastic and Reconstructive Surgery	Often involved when complex reconstruction (local flap or free flap) is required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C02.3`	Malignant neoplasm of posterior third of tongue	Primary site for squamous cell carcinoma that may require partial glossectomy with neck dissection.
`C02.4`	Malignant neoplasm of tongue, overlapping lesion of tongue	Used when the tumor spans adjacent anatomic subsites of the tongue impacting resection planning.
`C02.9`	Malignant neoplasm of tongue, unspecified	When the tongue cancer site is documented as malignant tongue neoplasm without further specification.
`C01`	Malignant neoplasm of base of tongue	Tumors of the base of tongue frequently require combined resection and neck dissection.
`C00.3`	Malignant neoplasm of upper lip, inner aspect	Included as adjacent oral cavity primaries that may require similar resections and nodal management.
`C09.0`	Malignant neoplasm of tonsillar pillar	Oropharyngeal primaries that commonly require partial resections and neck dissections.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`41899`	Unlisted procedure, jaw/mandible; used for oral procedures not described by other codes	Sometimes used for atypical intraoral procedures or adjunct work not captured by standard head and neck codes.
`21423`	Reconstruction of mandible or maxilla, partial with bone graft; segmental	May be performed if the resection involves osseous structures requiring reconstruction (less common for partial glossectomy alone).
`21195`	Reconstruction, composite (eg, bone and soft tissue); mandible or maxilla, segmental	Relevant when composite defects after tumor resection need complex reconstruction.
`43820`	Resection of lesion of tongue; partial glossectomy	This code is closely related and may be used to report the primary tongue resection component depending on documentation and code selection.
`38724`	Ligation, external carotid artery	Performed selectively intraoperatively for hemorrhage control in head and neck oncologic procedures.

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