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CPT code 41112: Tongue excision, anterior two-thirds, with closure2026 Medicare rate & RVUs in Puerto Rico

Surgical excision of a lesion in the anterior two-thirds of the tongue with wound closure, reported when the surgeon removes tissue rather than taking a diagnostic sample.

CMS RVU26DEffective Oct 1, 2026One payment locality2.8K Medicare services in 2024

In Puerto Rico, Medicare pays $344.78 for 41112 in the office and $226.93 when it’s performed in a hospital or facility.

$344.78Office (non-facility)
$226.93Hospital or facility
+0.7%vs the national office rate ($342.36)

Check a contract rate as a % of Medicare · 41112 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 41112 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 41112 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 41112 covers

41112 reports surgical removal of a lesion from the anterior two-thirds of the tongue when the wound is closed. The surgeon removes the target tissue rather than taking a limited sample solely for diagnosis; the specimen is typically submitted for histopathologic examination. Otolaryngologists, oral and maxillofacial surgeons, and head-and-neck surgeons may perform this procedure in an office operating room, ambulatory surgery center, or hospital operating room, depending on the lesion and patient needs.

Choose this code when the operative report supports excision in the specified tongue region with closure. Document the lesion location, tissue removed, closure, and operative findings; use a biopsy code when the service is diagnostic sampling rather than excision. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Medicare does not pay an assistant at surgery; co-surgeon and team-surgery billing are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 41112

Across 109 of 109 payment localities, the office rate for 41112 runs from $302.72 in Arkansas to $451.58 in San Benito County, CA. Puerto Rico pays $344.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

41112 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$344.78
  2. Los Angeles, CA · California$385.33+$40.55
  3. Washington, DC area · District of Columbia$391.04+$46.26
  4. Miami, FL · Florida$371.50+$26.72
  5. Chicago, IL · Illinois$360.63+$15.85
  6. Manhattan, NY · New York$394.17+$49.39
  7. Alaska · Alaska$398.19+$53.41

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

41112 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$307.17$205.17
ArkansasArkansas$302.72$202.59
ArizonaArizona$333.17$220.21
Bakersfield, CACalifornia$361.95$234.19
Chico, CACalifornia$360.84$233.08
El Centro, CACalifornia$360.90$233.14
Fresno, CACalifornia$360.84$233.08
Hanford, CACalifornia$360.84$233.08

41112 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$302.72

$406.21

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
41112 office rate range by state
State / territoryOffice rate rangeLocalities
AK$398.191
AL$307.171
AR$302.721
AZ$333.171
CA$360.84–$451.5829
CO$355.881
CT$365.151
DC$391.041
DE$338.691
FL$338.29–$371.503
GA$319.15–$348.992
GU$369.551
HI$369.551
IA$314.521
ID$316.671
IL$328.84–$360.634
IN$318.501
KS$313.271
KY$314.921
LA$314.52–$330.072
MA$353.84–$390.812
MD$345.09–$391.043
ME$318.56–$335.542
MI$323.34–$342.752
MN$340.311
MO$309.26–$330.993
MS$306.041
MT$342.331
NC$321.871
ND$334.821
NE$316.181
NH$350.511
NJ$369.13–$387.032
NM$325.201
NV$340.481
NY$326.72–$404.025
OH$321.801
OK$314.121
OR$337.64–$366.952
PA$322.19–$356.202
PR$344.781
RI$350.581
SC$322.411
SD$333.931
TN$314.871
TX$320.08–$354.878
UT$326.821
VA$334.59–$391.042
VI$344.781
VT$333.711
WA$353.11–$398.552
WI$323.601
WV$316.721
WY$339.061

See 41112 in every payment locality

How the 41112 rate is calculated

Each of 41112’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 41112

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.76

2.76 RVUs× 1.000 GPCI

Practice expense7.11

7.11 RVUs× 1.000 GPCI

Malpractice0.38

0.38 RVUs× 1.000 GPCI

Adjusted RVUs

10.2500

Conversion factor

$33.4009

Medicare rate

$342.36

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,900

Code
41112
Physician work
2.76
Practice expense
7.11
Malpractice
0.38

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 41112 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.76× 1.0002.7600
Practice expense7.11× 1.0117.1882
Malpractice0.38× 0.9850.3743
Total RVUs10.3225
Conversion factor× 33.4009

Office rate, Puerto Rico$344.78

Office: (2.76 × 1 + 7.11 × 1.011 + 0.38 × 0.985) × $33.4009 = $344.78

Facility: (2.76 × 1 + 3.62 × 1.011 + 0.38 × 0.985) × $33.4009 = $226.93

Open 41112 in the RVU calculator

Payment rules and modifiers for 41112

41112 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41112

Tongue excision, anterior two-thirds, with closure

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 41112

Tongue excision, anterior two-thirds, with closure

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

41112 without 51 · national office

$342.36

Tongue excision, anterior two-thirds, with closure

41112-51 · Second procedure: 50%

$171.18

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 41112

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 41112
CodeHow it relatesOffice range, Puerto Rico
Same family
41110Tongue lesion excision, without closureTongue lesion excision when the wound is left without closure.$228.55
41113Tongue lesion excision, complicated closureTongue lesion excision with closure for the posterior one-third.$370.57
41114Tongue excision, extensive excision with closureFor extensive tongue lesion excision requiring flap reconstruction.No office rate
Used instead
41100Tongue biopsy, anterior two-thirdsTongue biopsy for diagnostic sampling rather than lesion excision.$189.44

How 41112 has changed in Puerto Rico

41112 · Office / nonfacility

$344.78

Effective 2026-10-01

The base rate is $14.76 higher than on 2025-10-01, moving from $330.02 to $344.78 (4.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $330.02changed to$344.78

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.83 changed to 2.76
    • Practice expense RVU 6.98 changed to 7.11
    • Malpractice RVU 0.35 changed to 0.38
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $341.29changed to$330.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.02 changed to 6.98
    • Malpractice RVU 0.36 changed to 0.35

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $335.72changed to$341.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $348.39changed to$335.72

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.05 changed to 7.02
    • Malpractice RVU 0.35 changed to 0.36
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $346.67changed to$348.39

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $352.67changed to$346.67

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.97 changed to 7.05
    • Malpractice RVU 0.34 changed to 0.35
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $352.80changed to$352.67

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.91 changed to 6.97
    • Malpractice RVU 0.32 changed to 0.34

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $347.09changed to$352.80

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.42 changed to 6.91
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $349.23changed to$347.09

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.38 changed to 6.42
    • Malpractice RVU 0.44 changed to 0.32
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $348.11changed to$349.23

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.35 changed to 6.38
    • Malpractice RVU 0.45 changed to 0.44

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $309.47changed to$348.11

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.43 changed to 6.35
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $270.37changed to$309.47

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.51 changed to 6.43
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $270.84changed to$270.37

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.49 changed to 6.51

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $269.49changed to$270.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $266.16changed to$269.49

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.51 changed to 6.49
    • Malpractice RVU 0.35 changed to 0.45
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $264.12changed to$266.16

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.14 changed to 6.51
    • Malpractice RVU 0.37 changed to 0.35
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $264.12

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$344.78$226.93RVU26D
2026-07-01$344.78$226.93RVU26C
2026-04-01$344.78$226.93RVU26B
2026-01-01$344.78$226.93RVU26A
2025-10-01$330.02$239.46RVU25D
2025-07-01$330.02$239.46RVU25C
2025-04-01$330.02$239.46RVU25B
2025-01-01$330.02$239.46RVU25A
2024-10-01$341.29$244.75RVU24D
2024-07-01$341.29$244.75RVU24C
2024-04-01$341.29$244.75RVU24B
2024-03-09$341.29$244.75RVU24AR
2024-01-01$335.72$240.75RVU24A
2023-10-01$348.39$248.30RVU23D
2023-07-01$346.67$247.38RVU23C
2023-04-01$346.67$247.38RVU23B
2023-01-01$346.67$247.38RVU23A
2022-10-01$352.67$249.42RVU22D
2022-07-01$352.67$249.42RVU22C
2022-04-01$352.67$249.42RVU22B
2022-01-01$352.67$249.42RVU22A
2021-10-01$352.80$249.39RVU21D
2021-07-01$352.80$249.39RVU21C
2021-04-01$352.80$249.39RVU21B
2021-01-01$352.80$249.39RVU21A
2020-10-01$347.09$254.69RVU20D
2020-07-01$347.09$254.69RVU20C
2020-04-01$347.09$254.69RVU20B
2020-01-01$347.09$254.69RVU20A
2019-10-01$349.23$261.04RVU19D
2019-07-01$349.23$261.04RVU19C
2019-04-01$349.23$261.04RVU19B
2019-01-01$349.23$261.04RVU19A
2018-10-01$348.11$264.01RVU18D
2018-07-01$348.11$264.01RVU18C
2018-04-01$348.11$264.01RVU18B
2018-01-01$348.11$264.01RVU18AR1
2017-10-01$309.47$238.50RVU17D
2017-07-01$309.47$238.50RVU17C
2017-04-01$309.47$238.50RVU17B
2017-01-01$309.47$238.50RVU17A
2016-10-01$270.37$211.31RVU16D
2016-07-01$270.37$211.31RVU16C
2016-04-01$270.37$211.31RVU16B
2016-01-01$270.37$211.31RVU16A
2015-10-01$270.84$211.31RVU15D
2015-07-01$270.84$211.31RVU15C
2015-04-01$269.49$210.26RVU15B
2015-01-01$269.49$210.26RVU15A
2014-10-01$266.16$208.64RVU14D
2014-07-01$266.16$208.64RVU14C
2014-04-01$266.16$208.64RVU14B
2014-01-01$266.16$208.64RVU14A
2013-10-01$264.12$204.61RVU13D
2013-07-01$264.12$204.61RVU13C
2013-04-01$264.12$204.61RVU13B
2013-01-01$264.12$204.61RVU13AR

Price 41112 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

41112 billing questions

How is excision different from a tongue biopsy?

41112 describes removal of a lesion with closure, while a biopsy code is for diagnostic tissue sampling. The operative report should support which service was performed.

When should the posterior-tongue sibling be used?

Use 41113 when the excised lesion is in the posterior one-third of the tongue and the wound is closed. 41112 is for the anterior two-thirds.

Can wound closure be billed separately?

Closure is part of the service represented by 41112; it is not a separate closure procedure for the same excision.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing are not permitted.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 41112PPRRVU2026_Oct_nonQPP.csv, line 4,900 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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