CPT 41140 Total Glossectomy Reimbursement | OpenPayer

Summary & Overview

CPT 41140: Total Glossectomy with Tracheostomy

CPT code 41140 represents a total glossectomy — complete surgical removal of the tongue — frequently accompanied by a tracheostomy to secure an airway for postoperative breathing. This major head-and-neck oncologic procedure is clinically significant due to its high complexity, substantial perioperative risk, and important implications for functional outcomes such as speech, swallowing, and airway management. Nationally, accurate coding and consistent coverage policy for this procedure affect hospital resource planning, surgical team readiness, and post-acute care coordination.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how these payers typically classify and reimburse major oncologic head-and-neck surgeries, and highlights common billing considerations tied to inpatient surgical services and airway procedures.

Readers will find: concise clinical context for CPT code 41140; benchmarks and typical site-of-service expectations; payer coverage framing and common billing modifiers used with major surgical procedures; and policy-relevant points that affect coding accuracy and claims processing. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare41140CPTglossectomyhead and neck surgeryoncologic surgerytracheostomyinpatient surgerysurgical codingperioperative care

Billing Code Overview

CPT code 41140 describes a surgical procedure for glossectomy with total removal of the tongue, which may include a tracheostomy to establish an artificial airway for postoperative breathing support. The procedure explicitly does not include radical neck dissection and is most often performed for treatment of oral cavity cancer.

Service type: Major surgical procedure of the head and neck involving extirpation of the tongue and potential airway management.
Typical site of service: Hospital inpatient setting or specialized surgical center with postoperative intensive airway and nutrition management capabilities.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 60‑year‑old with locally advanced squamous cell carcinoma of the oral tongue who has failed organ‑preserving therapy or presents with extensive primary tumor invading deep musculature and/or bone. The surgical team (head and neck surgeon, anesthesiologist, and nursing staff) evaluates the patient preoperatively with imaging (CT/MRI and PET as indicated), airway assessment, and multidisciplinary tumor board review. On the day of surgery, the patient undergoes general anesthesia with planned CPT 41140—total glossectomy with possible concurrent tracheostomy to secure the airway postoperatively. Intraoperative tasks include tumor extirpation with clear margins, hemostasis, and assessment for immediate reconstruction (free flap or regional flap) if indicated; note that radical neck dissection is not included in this procedure and would be coded separately if performed. Postoperative care involves ICU or step‑down monitoring given airway and nutritional concerns, speech‑language pathology for swallowing and communication support, pain control, wound care, enteral feeding planning (eg, nasogastric or gastrostomy tube), and oncology follow‑up for adjuvant therapy decisions.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when intraoperative complexity or difficulty substantially increases work beyond typical total glossectomy.

Related Codes

CPT-41110-TONGUE-LESION-EXCISION

CPT 41110: Excision of Lesion from Tongue

CPT-41130-PARTIAL-GLOSSECTOMY-LATERAL-TONGUE-RESECTION

CPT 41130: Partial Glossectomy, Lateral Half of Tongue

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

CPT 41115: Excision of Lingual Frenum at Base of Tongue

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

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

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

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

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

CPT 41145: Total Glossectomy with Unilateral Neck Dissection

CPT-41113-EXCISION-LESION-POSTERIOR-TONGUE

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

CPT-41153-GLOSSECTOMY-FLOOR-OF-MOUTH-SUPRAHYOID-NECK-DISSECTION

CPT 41153: Glossectomy with Floor of Mouth Resection and Suprahyoid Neck Dissection

CPT-41116-FLOOR-OF-MOUTH-LESION-EXCISION

CPT 41116: Excision of Lesion, Floor of Mouth

CPT-41108-FLOOR-OF-MOUTH-BIOPSY-EXCISION

CPT 41108: Biopsy, Incision and Excision of Floor of Mouth Tissue

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Taxonomy Code	Specialty	Notes
207RH0000X	Otolaryngology (Head & Neck Surgery)	Primary specialty performing total glossectomy and airway management.
2084P0800X	Oral and Maxillofacial Surgery	May perform extensive oral cavity resections and reconstructions.
2080P0200X	General Surgery – Surgical Oncology	Surgical oncologists who manage complex head and neck tumors and resections.
2086S0125X	Plastic and Reconstructive Surgery	Performs immediate reconstruction such as free flap coverage following glossectomy.
207K00000X	Thoracic Surgery / ENT critical care (when tracheostomy complex)	Involved when tracheostomy or complex airway surgery is required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C02.9`	Malignant neoplasm of unspecified part of tongue	Common primary diagnosis indicating tongue cancer requiring partial or total glossectomy.
`C02.0`	Dorsal surface of tongue	Specific location of tongue malignancy that may necessitate extensive resection.
`C02.1`	Border of tongue	Lesions here can progress to require wide excision or total glossectomy based on spread.
`C02.2`	Ventral surface of tongue	Ventral tumors may invade deep tissues prompting total glossectomy.
`C09.0`	Tonsillar fossa, malignant neoplasm	Nearby or synchronous head and neck tumors may influence surgical planning.
`C11.3`	Posterior wall of nasopharynx	Represents regional head and neck malignancies considered in staging and management.
`Z85.0`	Personal history of malignant neoplasm of lip, oral cavity and pharynx	Relevant for surveillance and potential recurrent disease considerations.
`R13.10`	Dysphagia, unspecified	Common presenting symptom leading to diagnosis and subsequent surgical intervention.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`31600`	Tracheostomy, planned (separate procedure)	May be performed concurrently or immediately post‑glossectomy to secure airway; if performed, billed separately when not included in `CPT` `41140` per payer rules.
`20969`	Muscle, myocutaneous or fasciocutaneous flap with microvascular anastomosis (free flap)	Commonly used for reconstruction of oral cavity defects after total glossectomy; billed in cases with immediate free flap reconstruction.
`43246`	Upper gastrointestinal endoscopy with dilation, not typically related but example of enteral access planning	Not typically directly related; include only if enteral access or endoscopy is performed during the same episode (Data not available in the input.)
`42800`	Excision of lesion of tongue, partial glossectomy	Performed for smaller lesions; contrasted with `CPT` `41140` (total glossectomy) to show scope of resection.
`38745`	Ligation, internal jugular vein (example vascular procedure)	May be relevant if vascular control is required intraoperatively or during neck work, typically billed separately if performed.

Note: If additional related codes such as neck dissection (CPT codes for radical neck dissection) or feeding tube placement are performed, those are billed separately; those specific codes are not provided in the input.