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CPT code 41115: Tongue-tie surgery, lingual frenum excision2026 Medicare rate & RVUs in Puerto Rico

Reports surgical removal of the lingual frenulum, commonly to release restrictive tongue movement associated with ankyloglossia.

CMS RVU26DEffective Oct 1, 2026One payment locality44 Medicare services in 2024

In Puerto Rico, Medicare pays $257.81 for 41115 in the office and $133.88 when it’s performed in a hospital or facility.

$257.81Office (non-facility)
$133.88Hospital or facility
+0.8%vs the national office rate ($255.85)

Check a contract rate as a % of Medicare · 41115 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 41115 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 41115 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 41115 covers

41115 describes surgically removing the band of tissue connecting the underside of the tongue to the floor of the mouth. It is commonly performed to release a restrictive lingual frenulum in a patient with ankyloglossia and limited tongue mobility. Oral and maxillofacial surgeons and otolaryngologists may perform the procedure in an office or operating-room setting.

The operative note should identify the lingual frenulum as the treated structure, document the clinical restriction and indication, and describe the excision performed. The code has a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery 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 41115

Across 109 of 109 payment localities, the office rate for 41115 runs from $225.15 in Arkansas to $341.97 in San Benito County, CA. Puerto Rico pays $257.81. The RVUs are the same everywhere; the geographic indexes change the dollars.

41115 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$257.81
  2. Los Angeles, CA · California$290.04+$32.23
  3. Washington, DC area · District of Columbia$293.60+$35.79
  4. Miami, FL · Florida$276.37+$18.56
  5. Chicago, IL · Illinois$268.02+$10.21
  6. Manhattan, NY · New York$295.11+$37.30
  7. Alaska · Alaska$293.62+$35.81

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

Every other payment area

41115 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$228.60$121.34
ArkansasArkansas$225.15$119.85
ArizonaArizona$248.79$130.01
Bakersfield, CACalifornia$271.85$137.50
Chico, CACalifornia$271.12$136.77
El Centro, CACalifornia$271.16$136.81
Fresno, CACalifornia$271.12$136.77
Hanford, CACalifornia$271.12$136.77

41115 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.

$225.15

$306.55

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

View every state and territory as a table
41115 office rate range by state
State / territoryOffice rate rangeLocalities
AK$293.621
AL$228.601
AR$225.151
AZ$248.791
CA$271.12–$341.9729
CO$266.821
CT$273.331
DC$293.601
DE$253.031
FL$251.73–$276.373
GA$237.04–$260.732
GU$278.241
HI$278.241
IA$234.751
ID$236.331
IL$244.10–$268.024
IN$237.761
KS$233.561
KY$234.161
LA$233.76–$245.832
MA$265.11–$294.002
MD$258.02–$293.603
ME$237.57–$251.072
MI$240.48–$254.962
MN$255.451
MO$229.55–$246.793
MS$227.391
MT$255.831
NC$240.171
ND$250.891
NE$236.101
NH$262.561
NJ$276.39–$290.352
NM$241.841
NV$254.651
NY$243.92–$302.485
OH$239.471
OK$233.761
OR$252.61–$275.632
PA$239.89–$266.272
PR$257.811
RI$262.301
SC$240.231
SD$250.311
TN$234.781
TX$238.24–$265.988
UT$243.661
VA$250.18–$293.602
VI$257.811
VT$249.841
WA$264.63–$300.162
WI$242.131
WV$234.681
WY$253.681

See 41115 in every payment locality

How the 41115 rate is calculated

Each of 41115’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 · 41115

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.75

1.75 RVUs× 1.000 GPCI

Practice expense5.66

5.66 RVUs× 1.000 GPCI

Malpractice0.25

0.25 RVUs× 1.000 GPCI

Adjusted RVUs

7.6600

Conversion factor

$33.4009

Medicare rate

$255.85

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

4,903

Code
41115
Physician work
1.75
Practice expense
5.66
Malpractice
0.25

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 41115 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.75× 1.0001.7500
Practice expense5.66× 1.0115.7223
Malpractice0.25× 0.9850.2462
Total RVUs7.7185
Conversion factor× 33.4009

Office rate, Puerto Rico$257.81

Office: (1.75 × 1 + 5.66 × 1.011 + 0.25 × 0.985) × $33.4009 = $257.81

Facility: (1.75 × 1 + 1.99 × 1.011 + 0.25 × 0.985) × $33.4009 = $133.88

Open 41115 in the RVU calculator

Payment rules and modifiers for 41115

41115 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41115

Tongue-tie surgery, lingual frenum excision

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 41115

Tongue-tie surgery, lingual frenum excision

10-day global period ends

Oct 11, 2026

Covers Oct 1, 2026 through Oct 11, 2026 (11 days).

Visit on Oct 31, 2026

After the global period ends: visits and procedures are billed normally.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

41115 without 51 · national office

$255.85

Tongue-tie surgery, lingual frenum excision

41115-51 · Second procedure: 50%

$127.93

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 41115

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

Codes related to 41115
CodeHow it relatesOffice range, Puerto Rico
Used instead
41520Frenuloplasty, for restricted tongue movementFrenoplasty is a reconstructive frenum revision rather than straightforward lingual frenum excision.$363.67
40806Lip frenum release, labial frenumIncision of a labial or buccal frenum treats a different oral frenum.$102.16
40819Frenum excision, lip or cheek foldExcision of a labial or buccal frenum treats a different oral frenum.$278.80

How 41115 has changed in Puerto Rico

41115 · Office / nonfacility

$257.81

Effective 2026-10-01

The base rate is $6.95 higher than on 2025-10-01, moving from $250.86 to $257.81 (2.8%).

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

    $250.86changed to$257.81

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.79 changed to 1.75
    • Practice expense RVU 5.68 changed to 5.66
    • 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

    $263.18changed to$250.86

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.83 changed to 5.68

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $258.89changed to$263.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $269.85changed to$258.89

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.88 changed to 5.83
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $268.39changed to$269.85

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

  6. January 1, 2023

    RVU23A

    $274.89changed to$268.39

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.86 changed to 5.88
    • 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

    $274.71changed to$274.89

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.79 changed to 5.86

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $263.05changed to$274.71

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.21 changed to 5.79
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $259.60changed to$263.05

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.12 changed to 5.21
    • Malpractice RVU 0.26 changed to 0.25
    • 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

    $254.24changed to$259.60

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.98 changed to 5.12

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $225.37changed to$254.24

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.05 changed to 4.98
    • 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

    $196.98changed to$225.37

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.14 changed to 5.05
    • Malpractice RVU 0.30 changed to 0.26
    • 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

    $196.62changed to$196.98

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.11 changed to 5.14
    • Malpractice RVU 0.27 changed to 0.30

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $195.64changed to$196.62

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $194.17changed to$195.64

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.16 changed to 5.11
    • Malpractice RVU 0.22 changed to 0.27
    • 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

    $195.95changed to$194.17

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.77 changed to 5.16
    • Malpractice RVU 0.23 changed to 0.22
    • 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: $195.95

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$257.81$133.88RVU26D
2026-07-01$257.81$133.88RVU26C
2026-04-01$257.81$133.88RVU26B
2026-01-01$257.81$133.88RVU26A
2025-10-01$250.86$143.36RVU25D
2025-07-01$250.86$143.36RVU25C
2025-04-01$250.86$143.36RVU25B
2025-01-01$250.86$143.36RVU25A
2024-10-01$263.18$147.54RVU24D
2024-07-01$263.18$147.54RVU24C
2024-04-01$263.18$147.54RVU24B
2024-03-09$263.18$147.54RVU24AR
2024-01-01$258.89$145.13RVU24A
2023-10-01$269.85$149.61RVU23D
2023-07-01$268.39$149.10RVU23C
2023-04-01$268.39$149.10RVU23B
2023-01-01$268.39$149.10RVU23A
2022-10-01$274.89$150.36RVU22D
2022-07-01$274.89$150.36RVU22C
2022-04-01$274.89$150.36RVU22B
2022-01-01$274.89$150.36RVU22A
2021-10-01$274.71$149.49RVU21D
2021-07-01$274.71$149.49RVU21C
2021-04-01$274.71$149.49RVU21B
2021-01-01$274.71$149.49RVU21A
2020-10-01$263.05$150.64RVU20D
2020-07-01$263.05$150.64RVU20C
2020-04-01$263.05$150.64RVU20B
2020-01-01$263.05$150.64RVU20A
2019-10-01$259.60$150.72RVU19D
2019-07-01$259.60$150.72RVU19C
2019-04-01$259.60$150.72RVU19B
2019-01-01$259.60$150.72RVU19A
2018-10-01$254.24$150.20RVU18D
2018-07-01$254.24$150.20RVU18C
2018-04-01$254.24$150.20RVU18B
2018-01-01$254.24$150.20RVU18AR1
2017-10-01$225.37$136.59RVU17D
2017-07-01$225.37$136.59RVU17C
2017-04-01$225.37$136.59RVU17B
2017-01-01$225.37$136.59RVU17A
2016-10-01$196.98$127.82RVU16D
2016-07-01$196.98$127.82RVU16C
2016-04-01$196.98$127.82RVU16B
2016-01-01$196.98$127.82RVU16A
2015-10-01$196.62$122.90RVU15D
2015-07-01$196.62$122.90RVU15C
2015-04-01$195.64$122.29RVU15B
2015-01-01$195.64$122.29RVU15A
2014-10-01$194.17$126.50RVU14D
2014-07-01$194.17$126.50RVU14C
2014-04-01$194.17$126.50RVU14B
2014-01-01$194.17$126.50RVU14A
2013-10-01$195.95$119.83RVU13D
2013-07-01$195.95$119.83RVU13C
2013-04-01$195.95$119.83RVU13B
2013-01-01$195.95$119.83RVU13AR

Price 41115 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

41115 billing questions

When is 41115 appropriate instead of a frenoplasty code?

Use 41115 when the service is excision of the lingual frenulum. A frenoplasty code is considered when the surgeon performs a reconstructive revision of the frenum rather than straightforward excision.

How does 41115 differ from tongue-lesion excision?

41115 treats the lingual frenulum, the tissue band beneath the tongue. Tongue-lesion excision codes apply when the target is a separate lesion on the tongue.

Can modifier 50 be reported for bilateral treatment?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Are postoperative visits separately reported during the global period?

Related postoperative visits during the 10-day global period are included in the procedure.

Can an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

How are other procedures paid when performed in the same session?

The highest-valued procedure is paid in full, and the other procedures are subject to the standard multiple-procedure reduction.

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 41115PPRRVU2026_Oct_nonQPP.csv, line 4,903 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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