CPT 41150 Glossectomy Reimbursement & Benchmarks | OpenPayer

Summary & Overview

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

CPT code 41150 represents an extensive head and neck oncologic resection in which all or part of the tongue is removed along with adjacent mandible and floor-of-mouth tissue via combined extraoral and intraoral approaches. The procedure is typically used for management of oral cavity cancers and is a high-acuity surgical service with significant implications for perioperative care, reconstructive planning, and postoperative functional outcomes. Nationally, this code captures complex ablative surgery that drives inpatient surgical utilization, multidisciplinary care coordination, and resource-intensive recovery.

Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical settings, a summary of common modifiers associated with high-acuity surgical billing (input provided), and an outline of issues that affect coding and payment for major head and neck oncologic resections. The publication addresses benchmark metrics, coding nuances, and policy considerations relevant to hospitals, surgical practices, and payers. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 41150head and neck surgeryglossectomyoncologic surgeryinpatient surgerymandibulectomyoral cavity cancersurgical coding

Billing Code Overview

CPT code 41150 describes a surgical procedure that removes all or part of the tongue along with part of the jaw bone and the tissue of the floor of the mouth using both extraoral (outside the mouth) and intraoral (inside the mouth) incisions. This operation is most often performed to treat malignant disease and does not include radical neck dissection.

Service type: Major head and neck ablative surgery
Typical site of service: Inpatient hospital surgical suite or tertiary care operating room with postoperative inpatient recovery

Clinical & Coding Specifications

Clinical Context

A 62-year-old male with a history of tobacco and heavy alcohol use presents with a biopsy-proven squamous cell carcinoma of the anterior lateral tongue with deep invasion into the floor of mouth and cortical involvement of the ipsilateral mandibular body. Imaging demonstrates no distant metastasis but requires en bloc resection of the involved tongue, adjacent portion of the mandible, and floor of mouth soft tissues. The multidisciplinary team (otolaryngology/head and neck surgery, medical oncology, radiation oncology, and maxillofacial prosthetics) coordinates preoperative staging, anesthesia evaluation, and planning for possible free flap reconstruction.

The patient is taken to the operating room for an ablative procedure performed using combined extraoral and intraoral incisions to remove the primary tumor with a segmental mandibulectomy and partial glossectomy. Radical neck dissection is not performed at the same operative session. Intraoperative frozen section may be used to assess margins. If necessary, immediate reconstruction with a microvascular free flap is planned in a staged or concurrent manner. Postoperative care includes airway monitoring, pain control, nutritional support (enteral feeding if oral intake is not feasible), and oncology follow-up for adjuvant radiation or chemoradiation based on final pathology.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, and complexity substantially exceed typical for the procedure due to extensive resection or reconstruction beyond usual scope.

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

CPT-41110-TONGUE-LESION-EXCISION

CPT 41110: Excision of Lesion from Tongue

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

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

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

CPT 41116: Excision of Lesion, Floor of Mouth

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

CPT 41114: Tongue Lesion Excision with Local Flap Repair

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

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

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

CPT 41130: Partial Glossectomy, Lateral Half of Tongue

CPT-41135-PARTIAL-GLOSSECTOMY-UNILATERAL-NECK-DISSECTION

CPT 41135: Partial Glossectomy with Unilateral Neck Dissection

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

CPT 41115: Excision of Lingual Frenum at Base of Tongue

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
207L00000X	Otolaryngology (ENT)	Primary specialty performing head and neck ablative surgery.
207P00000X	Oral and Maxillofacial Surgery	Commonly performs mandibulectomy components and reconstruction.
2080P0202X	General Surgery - Head and Neck Surgical Oncology	Surgeons specializing in head and neck oncology who perform complex resections.
208100000X	Plastic Surgery	Often performs microvascular free flap reconstruction of oral cavity defects.
367500000X	Radiation Oncology	Not a surgical taxonomy but part of the multidisciplinary team for adjuvant therapy planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C02.3`	Malignant neoplasm of anterior two-thirds of tongue	Primary indication for partial or hemiglossectomy with associated floor-of-mouth resection.
`C02.4`	Malignant neoplasm of lingual septum	Involvement of central tongue structures requiring resection that may extend to floor of mouth.
`C04.0`	Malignant neoplasm of floor of mouth, anterior two-thirds	Commonly requires combined intraoral and extraoral surgical approaches for adequate margins.
`C41.9`	Malignant neoplasm of bone and articular cartilage of unspecified site (mandible specific codes: see C41.1)	Mandibular bone involvement by primary tumor or invasion requiring partial mandibulectomy.
`C41.1`	Malignant neoplasm of mandible	Direct tumor invasion of mandibular bone necessitating segmental mandibulectomy with tumor resection.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`20955`	Reconstruction of mandibular defect with nonvascularized bone graft (includes obtaining graft)	May be used when smaller mandibular defects are reconstructed with nonvascularized bone grafts following segmental mandibulectomy.
`20969`	Reconstruction of mandible with vascularized free bone flap with microvascular anastomosis	Used when immediate microvascular free flap reconstruction (e.g., fibula free flap) is performed to restore mandibular continuity after resection.
`21246`	Reconstruction of mandible, partial, with internal rigid fixation	Used for fixation of mandibular segments or reconstruction plates placed during or after mandibulectomy.
`42830`	Excision of tumor of floor of mouth, transoral, single lesion	May be performed for smaller floor-of-mouth lesions via intraoral approach; larger combined extraoral/intraoral resections are coded with `41150`.
`41899`	Unlisted procedure, maxillofacial bones and joints	Used for procedures without an exact code or for adjunctive complex maxillofacial work performed at the same time.

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