CPT code 41113: Tongue lesion excision, complicated closure2026 Medicare rate & RVUs in North Dakota

Reports surgical removal of a tongue lesion when the operative service includes a complicated closure, rather than a routine closure or no closure.

CMS RVU26DEffective Oct 1, 2026One payment locality584 Medicare services in 2024

In North Dakota, Medicare pays $359.55 for 41113 in the office and $236.30 when it’s performed in a hospital or facility.

$359.55Office (non-facility)
$236.30Hospital or facility
−2.3%vs the national office rate ($368.08)

Check a contract rate as a % of Medicare · 41113 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 41113 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 41113 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 41113 covers

41113 describes surgical removal of a lesion from the tongue followed by a complicated closure. An otolaryngologist, oral and maxillofacial surgeon, or head-and-neck surgeon may perform the procedure in an operating room or another appropriate surgical setting. The operative report should identify the tongue site, describe the excision and closure, and support why the closure was complicated. The code is selected by the work performed, not by the lesion’s diagnosis alone.

Use 41112 for tongue-lesion excision with a routine closure and 41110 when the excision requires no closure. Medicare treats 41113 as major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is not appropriate. Medicare does not pay an assistant at surgery for this service, and 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 North Dakota compares for 41113

Across 109 of 109 payment localities, the office rate for 41113 runs from $326.36 in Arkansas to $482.16 in San Benito County, CA. North Dakota pays $359.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

41113 in North Dakota vs other payment areas
  1. North Dakota · this page$359.55
  2. Los Angeles, CA · California$412.76+$53.21
  3. Washington, DC area · District of Columbia$419.37+$59.82
  4. Miami, FL · Florida$400.14+$40.59
  5. Chicago, IL · Illinois$388.66+$29.11
  6. Manhattan, NY · New York$423.29+$63.74
  7. Alaska · Alaska$431.26+$71.71

Other areas in North Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

41113 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$331.03$223.19
ArkansasArkansas$326.36$220.48
ArizonaArizona$358.37$238.94
Bakersfield, CACalifornia$388.16$253.08
Chico, CACalifornia$386.90$251.82
El Centro, CACalifornia$386.97$251.89
Fresno, CACalifornia$386.90$251.82
Hanford, CACalifornia$386.90$251.82

41113 rates by state

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

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.

$326.36

$434.53

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

View every state and territory as a table
41113 office rate range by state
State / territoryOffice rate rangeLocalities
AK$431.261
AL$331.031
AR$326.361
AZ$358.371
CA$386.90–$482.1629
CO$382.001
CT$392.221
DC$419.371
DE$364.211
FL$364.46–$400.143
GA$344.21–$375.232
GU$395.801
HI$395.801
IA$338.471
ID$340.791
IL$354.72–$388.664
IN$342.701
KS$337.291
KY$339.501
LA$339.13–$355.492
MA$379.94–$418.712
MD$370.93–$419.373
ME$342.93–$360.562
MI$348.49–$369.302
MN$365.121
MO$333.69–$356.273
MS$330.071
MT$368.051
NC$346.381
ND$359.551
NE$340.161
NH$376.391
NJ$396.44–$415.252
NM$350.511
NV$365.931
NY$351.49–$433.845
OH$346.751
OK$338.501
OR$362.83–$393.482
PA$347.08–$382.892
PR$370.571
RI$376.701
SC$347.191
SD$358.541
TN$339.001
TX$344.87–$380.958
UT$351.821
VA$359.66–$419.372
VI$370.571
VT$358.521
WA$379.10–$426.772
WI$347.791
WV$341.981
WY$364.341

See 41113 in every payment locality

How the 41113 rate is calculated

Each of 41113’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 · 41113

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.21

3.21 RVUs× 1.000 GPCI

Practice expense7.38

7.38 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

11.0200

Conversion factor

$33.4009

Medicare rate

$368.08

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

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,901

Code
41113
Physician work
3.21
Practice expense
7.38
Malpractice
0.43

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 41113 in North Dakota
ComponentRVULocality factorAdjusted
Physician work3.21× 1.0003.2100
Practice expense7.38× 1.0007.3800
Malpractice0.43× 0.4060.1746
Total RVUs10.7646
Conversion factor× 33.4009

Office rate, North Dakota$359.55

Office: (3.21 × 1 + 7.38 × 1 + 0.43 × 0.406) × $33.4009 = $359.55

Facility: (3.21 × 1 + 3.69 × 1 + 0.43 × 0.406) × $33.4009 = $236.30

Open 41113 in the RVU calculator

Payment rules and modifiers for 41113

41113 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41113

Tongue lesion excision, complicated 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 · 41113

Tongue lesion excision, complicated 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

41113 without 51 · national office

$368.08

Tongue lesion excision, complicated closure

41113-51 · Second procedure: 50%

$184.04

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

How 41113 has changed in North Dakota

41113 · Office / nonfacility

$359.55

Effective 2026-10-01

The base rate is $14.36 higher than on 2025-10-01, moving from $345.19 to $359.55 (4.2%).

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

    $345.19changed to$359.55

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.29 changed to 3.21
    • Practice expense RVU 7.18 changed to 7.38
    • Malpractice RVU 0.39 changed to 0.43
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $356.23changed to$345.19

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.21 changed to 7.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $350.42changed to$356.23

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $364.63changed to$350.42

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.29 changed to 7.21
    • Malpractice RVU 0.38 changed to 0.39
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $369.87changed to$364.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.23 changed to 7.29
    • Malpractice RVU 0.39 changed to 0.38
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $372.29changed to$369.87

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.22 changed to 7.23
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $368.45changed to$372.29

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.74 changed to 7.22
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $370.15changed to$368.45

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.70 changed to 6.74
    • Malpractice RVU 0.52 changed to 0.37
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $370.82changed to$370.15

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.73 changed to 6.70

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $373.04changed to$370.82

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.82 changed to 6.73
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $375.00changed to$373.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 6.89 changed to 6.82
    • Malpractice RVU 0.53 changed to 0.52
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $376.15changed to$375.00

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.52 changed to 0.53

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $374.28changed to$376.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $372.00changed to$374.28

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.88 changed to 6.89
    • Malpractice RVU 0.40 changed to 0.52
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $375.86changed to$372.00

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.54 changed to 6.88
    • Malpractice RVU 0.42 changed to 0.40
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $375.86

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$359.55$236.30RVU26D
2026-07-01$359.55$236.30RVU26C
2026-04-01$359.55$236.30RVU26B
2026-01-01$359.55$236.30RVU26A
2025-10-01$345.19$253.00RVU25D
2025-07-01$345.19$253.00RVU25C
2025-04-01$345.19$253.00RVU25B
2025-01-01$345.19$253.00RVU25A
2024-10-01$356.23$258.37RVU24D
2024-07-01$356.23$258.37RVU24C
2024-04-01$356.23$258.37RVU24B
2024-03-09$356.23$258.37RVU24AR
2024-01-01$350.42$254.15RVU24A
2023-10-01$364.63$262.63RVU23D
2023-07-01$364.63$262.63RVU23C
2023-04-01$364.63$262.63RVU23B
2023-01-01$364.63$262.63RVU23A
2022-10-01$369.87$263.98RVU22D
2022-07-01$369.87$263.98RVU22C
2022-04-01$369.87$263.98RVU22B
2022-01-01$369.87$263.98RVU22A
2021-10-01$372.29$265.87RVU21D
2021-07-01$372.29$265.87RVU21C
2021-04-01$372.29$265.87RVU21B
2021-01-01$372.29$265.87RVU21A
2020-10-01$368.45$273.18RVU20D
2020-07-01$368.45$273.18RVU20C
2020-04-01$368.45$273.18RVU20B
2020-01-01$368.45$273.18RVU20A
2019-10-01$370.15$278.97RVU19D
2019-07-01$370.15$278.97RVU19C
2019-04-01$370.15$278.97RVU19B
2019-01-01$370.15$278.97RVU19A
2018-10-01$370.82$282.99RVU18D
2018-07-01$370.82$282.99RVU18C
2018-04-01$370.82$282.99RVU18B
2018-01-01$370.82$282.99RVU18AR1
2017-10-01$373.04$285.47RVU17D
2017-07-01$373.04$285.47RVU17C
2017-04-01$373.04$285.47RVU17B
2017-01-01$373.04$285.47RVU17A
2016-10-01$375.00$286.92RVU16D
2016-07-01$375.00$286.92RVU16C
2016-04-01$375.00$286.92RVU16B
2016-01-01$375.00$286.92RVU16A
2015-10-01$376.15$287.04RVU15D
2015-07-01$376.15$287.04RVU15C
2015-04-01$374.28$285.61RVU15B
2015-01-01$374.28$285.61RVU15A
2014-10-01$372.00$284.95RVU14D
2014-07-01$372.00$284.95RVU14C
2014-04-01$372.00$284.95RVU14B
2014-01-01$372.00$284.95RVU14A
2013-10-01$375.86$283.99RVU13D
2013-07-01$375.86$283.99RVU13C
2013-04-01$375.86$283.99RVU13B
2013-01-01$375.86$283.99RVU13AR

Price 41113 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

41113 billing questions

How is 41113 distinguished from 41112?

Both describe tongue-lesion excision with closure. Choose 41113 when the operative documentation supports a complicated closure; 41112 is for a routine closure.

When should 41110 be used instead?

Use 41110 when the tongue lesion is excised without closure. The closure performed, not simply the lesion’s location, distinguishes it from 41113.

What documentation supports 41113?

Document the tongue site, the lesion excision, the closure performed, and the operative details supporting its complicated nature.

Can modifier 50 be reported for lesions on both sides of the tongue?

No. Modifier 50 is not appropriate for 41113, including when the operative documentation describes bilateral tongue sites.

How does the 90-day global period affect postoperative visits?

The day-before preoperative visit and 90 days of related postoperative care are included in the global surgery payment.

Can an assistant or co-surgeon be billed for this procedure?

Medicare does not pay an assistant at surgery for 41113. Co-surgeon and team-surgery billing are not permitted.

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 41113PPRRVU2026_Oct_nonQPP.csv, line 4,901 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 41113 pays in North Dakota?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 41113 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist