CPT® Code 41150

A glossectomy is a surgical procedure that involves the removal of part or all of the tongue. In the case of CPT® Code 41150, this procedure is performed as a composite operation, which means it includes additional surgical interventions such as the resection of the floor of the mouth and a mandibular resection. This type of surgery is primarily indicated for patients diagnosed with cancer affecting the tongue and oropharynx, particularly when the malignancy has spread to involve the mandible, the lower jawbone. The procedure begins with the resection of the mandible, which is crucial for accessing the affected areas. A visor flap technique is utilized to facilitate this access, requiring an incision along the lower gingival buccal sulcus adjacent to the mandible. Following this, the periosteum, a dense layer of connective tissue covering the bone, is carefully undermined, and the skin of the chin and lower lip is elevated to expose the mandible. The involved section of the mandible is then excised. Subsequently, the mucosa of the floor of the mouth is incised to remove the diseased tissue, ensuring that a margin of healthy tissue is also excised to minimize the risk of cancer recurrence. This resection typically includes the soft tissue beneath the sublingual glands and may involve transection of the Wharton duct, which drains saliva from the submandibular gland. The procedure also entails the removal of the affected portion of the tongue, again with a margin of healthy tissue. After the completion of these resections, the resulting defects are often repaired through additional reconstructive surgeries, which may involve techniques such as skin grafts, free flap grafts, or mandibular reconstruction. It is important to note that CPT® Code 41150 is specifically designated for cases where the procedure is performed without a radical neck dissection, distinguishing it from other codes that include variations of neck dissection procedures.