CPT code 41115: Tongue-tie surgery, lingual frenum excision2026 Medicare rate & RVUs in South Dakota
Reports surgical removal of the lingual frenulum, commonly to release restrictive tongue movement associated with ankyloglossia.
In South Dakota, Medicare pays $250.31 for 41115 in the office and $127.73 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $250.31. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$250.31
- Los Angeles, CA · California$290.04+$39.73
- Washington, DC area · District of Columbia$293.60+$43.29
- Miami, FL · Florida$276.37+$26.06
- Chicago, IL · Illinois$268.02+$17.71
- Manhattan, NY · New York$295.11+$44.80
- Alaska · Alaska$293.62+$43.31
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $271.12 | $136.77 |
| Merced, CACalifornia | $271.12 | $136.77 |
| Modesto, CACalifornia | $271.12 | $136.77 |
| Napa, CACalifornia | $315.54 | $153.98 |
| Oxnard, CACalifornia | $288.75 | $143.86 |
| Redding, CACalifornia | $271.12 | $136.77 |
| Rest of CaliforniaCalifornia | $271.12 | $136.77 |
| Riverside, CACalifornia | $273.82 | $139.48 |
| Sacramento, CACalifornia | $284.90 | $142.33 |
| Salinas, CACalifornia | $283.85 | $141.78 |
| San Diego, CACalifornia | $290.83 | $144.23 |
| Marin County, CACalifornia | $334.40 | $161.56 |
| San Francisco, CACalifornia | $334.11 | $161.27 |
| San Benito County, CACalifornia | $341.97 | $165.20 |
| Santa Clara County, CACalifornia | $340.81 | $164.04 |
| San Luis Obispo, CACalifornia | $279.25 | $139.63 |
| Santa Cruz, CACalifornia | $293.85 | $144.91 |
| Santa Maria, CACalifornia | $285.00 | $142.07 |
| Santa Rosa, CACalifornia | $296.83 | $146.30 |
| Stockton, CACalifornia | $271.12 | $136.77 |
| Vallejo, CACalifornia | $315.13 | $153.57 |
| Visalia, CACalifornia | $271.12 | $136.77 |
| Yuba City, CACalifornia | $271.12 | $136.77 |
| ColoradoColorado | $266.82 | $136.40 |
| ConnecticutConnecticut | $273.33 | $141.31 |
| DelawareDelaware | $253.03 | $131.92 |
| Fort Lauderdale, FLFlorida | $265.06 | $140.88 |
| Rest of FloridaFlorida | $251.73 | $134.55 |
| Atlanta, GAGeorgia | $260.73 | $136.19 |
| Rest of GeorgiaGeorgia | $237.04 | $127.69 |
| Hawaii, Guam, HIHawaii | $278.24 | $138.86 |
| IowaIowa | $234.75 | $122.58 |
| IdahoIdaho | $236.33 | $123.55 |
| East St. Louis, ILIllinois | $249.19 | $136.42 |
| Rest of IllinoisIllinois | $244.10 | $132.19 |
| Suburban Chicago, ILIllinois | $267.81 | $141.92 |
| IndianaIndiana | $237.76 | $124.13 |
| KansasKansas | $233.56 | $122.75 |
| KentuckyKentucky | $234.16 | $125.18 |
| New Orleans, LALouisiana | $245.83 | $130.48 |
| Rest of LouisianaLouisiana | $233.76 | $125.28 |
| Metropolitan Boston, MAMassachusetts | $294.00 | $147.64 |
| Rest of MassachusettsMassachusetts | $265.11 | $136.03 |
| Baltimore area, MDMaryland | $272.57 | $141.04 |
| Rest of MarylandMaryland | $258.02 | $133.97 |
| Rest of MaineMaine | $237.57 | $124.80 |
| Southern Maine, MEMaine | $251.07 | $129.59 |
| Detroit, MIMichigan | $254.96 | $136.67 |
| Rest of MichiganMichigan | $240.48 | $128.56 |
| MinnesotaMinnesota | $255.45 | $129.32 |
| Metropolitan Kansas City, MOMissouri | $244.13 | $129.02 |
| Metropolitan St. Louis, MOMissouri | $246.79 | $130.10 |
| Rest of MissouriMissouri | $229.55 | $123.88 |
| MississippiMississippi | $227.39 | $121.85 |
| MontanaMontana | $255.83 | $133.25 |
| North CarolinaNorth Carolina | $240.17 | $125.80 |
| North DakotaNorth Dakota | $250.89 | $128.31 |
| NebraskaNebraska | $236.10 | $122.96 |
| New HampshireNew Hampshire | $262.56 | $134.95 |
| Northern New JerseyNew Jersey | $290.35 | $148.15 |
| Rest of New JerseyNew Jersey | $276.39 | $142.53 |
| New MexicoNew Mexico | $241.84 | $129.43 |
| NevadaNevada | $254.65 | $131.94 |
| NYC suburbs and Long Island, NYNew York | $302.48 | $156.73 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $278.19 | $143.97 |
| Queens, NYNew York | $297.69 | $152.80 |
| Rest of New YorkNew York | $243.92 | $127.47 |
| OhioOhio | $239.47 | $127.55 |
| OklahomaOklahoma | $233.76 | $124.30 |
| Portland, OROregon | $275.63 | $139.45 |
| Rest of OregonOregon | $252.61 | $130.52 |
| Metropolitan Philadelphia, PAPennsylvania | $266.27 | $138.66 |
| Rest of PennsylvaniaPennsylvania | $239.89 | $127.36 |
| Puerto RicoPuerto Rico | $257.81 | $133.88 |
| Rhode IslandRhode Island | $262.30 | $135.67 |
| South CarolinaSouth Carolina | $240.23 | $126.97 |
| TennesseeTennessee | $234.78 | $123.35 |
| Austin, TXTexas | $265.98 | $136.29 |
| Beaumont, TXTexas | $238.24 | $126.69 |
| Brazoria, TXTexas | $252.78 | $131.30 |
| Dallas, TXTexas | $254.44 | $132.34 |
| Fort Worth, TXTexas | $252.65 | $131.79 |
| Galveston, TXTexas | $253.56 | $131.84 |
| Houston, TXTexas | $258.13 | $136.41 |
| Rest of TexasTexas | $245.40 | $129.07 |
| UtahUtah | $243.66 | $128.43 |
| VirginiaVirginia | $250.18 | $129.68 |
| Virgin Islands, VIUnited States Virgin Islands | $257.81 | $133.88 |
| VermontVermont | $249.84 | $128.48 |
| Rest of WashingtonWashington | $264.63 | $135.56 |
| King County, WAWashington | $300.16 | $149.75 |
| WisconsinWisconsin | $242.13 | $124.70 |
| West VirginiaWest Virginia | $234.68 | $128.16 |
| WyomingWyoming | $253.68 | $131.10 |
41115 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.
$225.15
$306.55
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $293.62 | 1 |
| AL | $228.60 | 1 |
| AR | $225.15 | 1 |
| AZ | $248.79 | 1 |
| CA | $271.12–$341.97 | 29 |
| CO | $266.82 | 1 |
| CT | $273.33 | 1 |
| DC | $293.60 | 1 |
| DE | $253.03 | 1 |
| FL | $251.73–$276.37 | 3 |
| GA | $237.04–$260.73 | 2 |
| GU | $278.24 | 1 |
| HI | $278.24 | 1 |
| IA | $234.75 | 1 |
| ID | $236.33 | 1 |
| IL | $244.10–$268.02 | 4 |
| IN | $237.76 | 1 |
| KS | $233.56 | 1 |
| KY | $234.16 | 1 |
| LA | $233.76–$245.83 | 2 |
| MA | $265.11–$294.00 | 2 |
| MD | $258.02–$293.60 | 3 |
| ME | $237.57–$251.07 | 2 |
| MI | $240.48–$254.96 | 2 |
| MN | $255.45 | 1 |
| MO | $229.55–$246.79 | 3 |
| MS | $227.39 | 1 |
| MT | $255.83 | 1 |
| NC | $240.17 | 1 |
| ND | $250.89 | 1 |
| NE | $236.10 | 1 |
| NH | $262.56 | 1 |
| NJ | $276.39–$290.35 | 2 |
| NM | $241.84 | 1 |
| NV | $254.65 | 1 |
| NY | $243.92–$302.48 | 5 |
| OH | $239.47 | 1 |
| OK | $233.76 | 1 |
| OR | $252.61–$275.63 | 2 |
| PA | $239.89–$266.27 | 2 |
| PR | $257.81 | 1 |
| RI | $262.30 | 1 |
| SC | $240.23 | 1 |
| SD | $250.31 | 1 |
| TN | $234.78 | 1 |
| TX | $238.24–$265.98 | 8 |
| UT | $243.66 | 1 |
| VA | $250.18–$293.60 | 2 |
| VI | $257.81 | 1 |
| VT | $249.84 | 1 |
| WA | $264.63–$300.16 | 2 |
| WI | $242.13 | 1 |
| WV | $234.68 | 1 |
| WY | $253.68 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.75 | × 1.000 | 1.7500 |
| Practice expense | 5.66 | × 1.000 | 5.6600 |
| Malpractice | 0.25 | × 0.336 | 0.0840 |
| Total RVUs | 7.4940 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$250.31
Office: (1.75 × 1 + 5.66 × 1 + 0.25 × 0.336) × $33.4009 = $250.31
Facility: (1.75 × 1 + 1.99 × 1 + 0.25 × 0.336) × $33.4009 = $127.73
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share 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.
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%).
How 41115 has changed in South Dakota
41115 · Office / nonfacility
$250.31
Effective 2026-10-01
The base rate is $5.59 higher than on 2025-10-01, moving from $244.72 to $250.31 (2.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$244.72changed to$250.31
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$256.83changed to$244.72
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 5.83 changed to 5.68
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$252.64changed to$256.83
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$263.00changed to$252.64
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 5.88 changed to 5.83
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$267.74changed to$263.00
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 5.86 changed to 5.88
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$267.52changed to$267.74
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 5.79 changed to 5.86
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$255.95changed to$267.52
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 5.21 changed to 5.79
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$252.68changed to$255.95
- 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
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$247.36changed to$252.68
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.98 changed to 5.12
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$249.16changed to$247.36
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 5.05 changed to 4.98
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$252.42changed to$249.16
- 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
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$251.82changed to$252.42
- 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.
July 1, 2015
RVU15C
$250.57changed to$251.82
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$252.25changed to$250.57
- 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
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$260.59changed to$252.25
- 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
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $260.59
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $250.31 | $127.73 | RVU26D |
| 2026-07-01 | $250.31 | $127.73 | RVU26C |
| 2026-04-01 | $250.31 | $127.73 | RVU26B |
| 2026-01-01 | $250.31 | $127.73 | RVU26A |
| 2025-10-01 | $244.72 | $137.97 | RVU25D |
| 2025-07-01 | $244.72 | $137.97 | RVU25C |
| 2025-04-01 | $244.72 | $137.97 | RVU25B |
| 2025-01-01 | $244.72 | $137.97 | RVU25A |
| 2024-10-01 | $256.83 | $141.99 | RVU24D |
| 2024-07-01 | $256.83 | $141.99 | RVU24C |
| 2024-04-01 | $256.83 | $141.99 | RVU24B |
| 2024-03-09 | $256.83 | $141.99 | RVU24AR |
| 2024-01-01 | $252.64 | $139.67 | RVU24A |
| 2023-10-01 | $263.00 | $143.72 | RVU23D |
| 2023-07-01 | $263.00 | $143.72 | RVU23C |
| 2023-04-01 | $263.00 | $143.72 | RVU23B |
| 2023-01-01 | $263.00 | $143.72 | RVU23A |
| 2022-10-01 | $267.74 | $144.20 | RVU22D |
| 2022-07-01 | $267.74 | $144.20 | RVU22C |
| 2022-04-01 | $267.74 | $144.20 | RVU22B |
| 2022-01-01 | $267.74 | $144.20 | RVU22A |
| 2021-10-01 | $267.52 | $143.30 | RVU21D |
| 2021-07-01 | $267.52 | $143.30 | RVU21C |
| 2021-04-01 | $267.52 | $143.30 | RVU21B |
| 2021-01-01 | $267.52 | $143.30 | RVU21A |
| 2020-10-01 | $255.95 | $144.43 | RVU20D |
| 2020-07-01 | $255.95 | $144.43 | RVU20C |
| 2020-04-01 | $255.95 | $144.43 | RVU20B |
| 2020-01-01 | $255.95 | $144.43 | RVU20A |
| 2019-10-01 | $252.68 | $144.56 | RVU19D |
| 2019-07-01 | $252.68 | $144.56 | RVU19C |
| 2019-04-01 | $252.68 | $144.56 | RVU19B |
| 2019-01-01 | $252.68 | $144.56 | RVU19A |
| 2018-10-01 | $247.36 | $144.04 | RVU18D |
| 2018-07-01 | $247.36 | $144.04 | RVU18C |
| 2018-04-01 | $247.36 | $144.04 | RVU18B |
| 2018-01-01 | $247.36 | $144.04 | RVU18AR1 |
| 2017-10-01 | $249.16 | $145.45 | RVU17D |
| 2017-07-01 | $249.16 | $145.45 | RVU17C |
| 2017-04-01 | $249.16 | $145.45 | RVU17B |
| 2017-01-01 | $249.16 | $145.45 | RVU17A |
| 2016-10-01 | $252.42 | $154.32 | RVU16D |
| 2016-07-01 | $252.42 | $154.32 | RVU16C |
| 2016-04-01 | $252.42 | $154.32 | RVU16B |
| 2016-01-01 | $252.42 | $154.32 | RVU16A |
| 2015-10-01 | $251.82 | $147.26 | RVU15D |
| 2015-07-01 | $251.82 | $147.26 | RVU15C |
| 2015-04-01 | $250.57 | $146.52 | RVU15B |
| 2015-01-01 | $250.57 | $146.52 | RVU15A |
| 2014-10-01 | $252.25 | $154.45 | RVU14D |
| 2014-07-01 | $252.25 | $154.45 | RVU14C |
| 2014-04-01 | $252.25 | $154.45 | RVU14B |
| 2014-01-01 | $252.25 | $154.45 | RVU14A |
| 2013-10-01 | $260.59 | $148.32 | RVU13D |
| 2013-07-01 | $260.59 | $148.32 | RVU13C |
| 2013-04-01 | $260.59 | $148.32 | RVU13B |
| 2013-01-01 | $260.59 | $148.32 | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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