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CPT code 41520: Frenuloplasty, for restricted tongue movement2026 Medicare rate & RVUs in Metropolitan Philadelphia, PA

Reconstructs the lingual frenulum to improve restricted tongue movement, commonly when ankyloglossia requires more than simple division or excision.

CMS RVU26DEffective Oct 1, 2026One payment locality32 Medicare services in 2024

In Metropolitan Philadelphia, PA, Medicare pays $375.78 for 41520 in the office and $239.83 when it’s performed in a hospital or facility.

$375.78Office (non-facility)
$239.83Hospital or facility
+4.1%vs the national office rate ($361.06)

Check a contract rate as a % of Medicare · 41520 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 41520 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Metropolitan Philadelphia, PA
  2. What 41520 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 41520 covers

CPT 41520 describes surgical reconstruction of the lingual frenulum, the fold of tissue beneath the tongue. It is commonly used for ankyloglossia when restricted tongue movement calls for frenuloplasty rather than simple division or removal of the frenulum. Otolaryngologists and oral and maxillofacial surgeons may perform the procedure in an office or operating-room setting, depending on the patient and the planned repair.

Select the code when the operative work reconstructs or lengthens the tongue fold; document the functional restriction, relevant anatomy, and repair performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 50% reduction. Modifier 50 is inappropriate. 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 Metropolitan Philadelphia, PA compares for 41520

Across 109 of 109 payment localities, the office rate for 41520 runs from $318.56 in Arkansas to $477.94 in San Benito County, CA. Metropolitan Philadelphia, PA pays $375.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

41520 in Metropolitan Philadelphia, PA vs other payment areas
  1. Metropolitan Philadelphia, PA · this page$375.78
  2. Rest of Pennsylvania · Pennsylvania$339.38−$36.40
  3. Los Angeles, CA · California$407.11+$31.33
  4. Washington, DC area · District of Columbia$413.03+$37.25
  5. Miami, FL · Florida$391.97+$16.19
  6. Chicago, IL · Illinois$380.29+$4.51
  7. Manhattan, NY · New York$416.19+$40.41

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

Every other payment area

41520 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$417.77$278.68
AlabamaAlabama$323.33$209.05
ArkansasArkansas$318.56$206.37
ArizonaArizona$351.22$224.67
Bakersfield, CACalifornia$382.12$238.99
Chico, CACalifornia$380.96$237.83
El Centro, CACalifornia$381.03$237.89
Fresno, CACalifornia$380.96$237.83

41520 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.

$318.56

$429.45

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

View every state and territory as a table
41520 office rate range by state
State / territoryOffice rate rangeLocalities
AK$417.771
AL$323.331
AR$318.561
AZ$351.221
CA$380.96–$477.9429
CO$375.601
CT$385.391
DC$413.031
DE$357.111
FL$356.54–$391.973
GA$336.03–$368.112
GU$390.441
HI$390.441
IA$331.291
ID$333.581
IL$346.36–$380.294
IN$335.541
KS$329.911
KY$331.571
LA$331.12–$347.812
MA$373.37–$412.942
MD$363.96–$413.033
ME$335.57–$353.832
MI$340.56–$361.292
MN$359.071
MO$325.46–$348.833
MS$322.061
MT$361.041
NC$339.121
ND$353.131
NE$333.081
NH$369.871
NJ$389.55–$408.662
NM$342.541
NV$359.091
NY$344.32–$426.715
OH$338.941
OK$330.741
OR$356.07–$387.482
PA$339.38–$375.782
PR$363.671
RI$369.801
SC$339.641
SD$352.191
TN$331.631
TX$337.12–$374.558
UT$344.371
VA$352.79–$413.032
VI$363.671
VT$351.911
WA$372.61–$421.232
WI$341.091
WV$333.351
WY$357.591

See 41520 in every payment locality

How the 41520 rate is calculated

Each of 41520’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 · 41520

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.76

2.76 RVUs× 1.000 GPCI

Practice expense7.65

7.65 RVUs× 1.000 GPCI

Malpractice0.40

0.40 RVUs× 1.000 GPCI

Adjusted RVUs

10.8100

Conversion factor

$33.4009

Medicare rate

$361.06

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

The exact Metropolitan Philadelphia, PA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,936

Code
41520
Physician work
2.76
Practice expense
7.65
Malpractice
0.40

GPCI2026.csv

89

Locality
Metropolitan Philadelphia, PA
Physician work
1.018
Practice expense
1.041
Malpractice
1.193
Office calculation for 41520 in Metropolitan Philadelphia, PA
ComponentRVULocality factorAdjusted
Physician work2.76× 1.0182.8097
Practice expense7.65× 1.0417.9636
Malpractice0.40× 1.1930.4772
Total RVUs11.2505
Conversion factor× 33.4009

Office rate, Metropolitan Philadelphia, PA$375.78

Office: (2.76 × 1.018 + 7.65 × 1.041 + 0.4 × 1.193) × $33.4009 = $375.78

Facility: (2.76 × 1.018 + 3.74 × 1.041 + 0.4 × 1.193) × $33.4009 = $239.83

Open 41520 in the RVU calculator

Payment rules and modifiers for 41520

41520 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 41520

Frenuloplasty, for restricted tongue movement

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)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)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 41520

Frenuloplasty, for restricted tongue movement

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

41520 without 51 · national office

$361.06

Frenuloplasty, for restricted tongue movement

41520-51 · Second procedure: 50%

$180.53

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 41520

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

Codes related to 41520
CodeHow it relatesOffice range, Metropolitan Philadelphia, PA
Used instead
41115Tongue-tie surgery, lingual frenum excisionLingual frenulum excision; distinguish removal from the reconstruction reported with 41520.$266.27
41599Name pendingUnlisted tongue or floor-of-mouth procedure when no specific code describes the operation.No office rate

How 41520 has changed in Metropolitan Philadelphia, PA

41520 · Office / nonfacility

$375.78

Effective 2026-10-01

The base rate is $4.46 higher than on 2025-10-01, moving from $371.32 to $375.78 (1.2%).

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

    $371.32changed to$375.78

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.83 changed to 2.76
    • Practice expense RVU 7.68 changed to 7.65
    • Malpractice RVU 0.42 changed to 0.40
    • Work GPCI 1.024 changed to 1.018
    • Practice expense GPCI 1.053 changed to 1.041
    • Malpractice GPCI 1.177 changed to 1.193

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $386.59changed to$371.32

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.83 changed to 7.68
    • Malpractice RVU 0.40 changed to 0.42

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $380.28changed to$386.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $398.31changed to$380.28

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.85 changed to 7.83
    • Work GPCI 1.023 changed to 1.024
    • Practice expense GPCI 1.068 changed to 1.053
    • Malpractice GPCI 1.188 changed to 1.177

  5. January 1, 2023

    RVU23A

    $407.15changed to$398.31

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.75 changed to 7.85
    • Work GPCI 1.022 changed to 1.023
    • Practice expense GPCI 1.083 changed to 1.068
    • Malpractice GPCI 1.199 changed to 1.188

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $405.57changed to$407.15

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.63 changed to 7.75
    • Malpractice RVU 0.39 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $392.77changed to$405.57

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.94 changed to 7.63
    • Practice expense GPCI 1.079 changed to 1.083
    • Malpractice GPCI 1.289 changed to 1.199

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $390.52changed to$392.77

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.87 changed to 6.94
    • Malpractice RVU 0.41 changed to 0.39
    • Practice expense GPCI 1.074 changed to 1.079
    • Malpractice GPCI 1.379 changed to 1.289

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $383.80changed to$390.52

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.72 changed to 6.87
    • Malpractice RVU 0.40 changed to 0.41

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $394.65changed to$383.80

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.91 changed to 6.72
    • Malpractice RVU 0.48 changed to 0.40
    • Practice expense GPCI 1.081 changed to 1.074
    • Malpractice GPCI 1.322 changed to 1.379

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $399.56changed to$394.65

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.05 changed to 6.91
    • Work GPCI 1.021 changed to 1.022
    • Practice expense GPCI 1.087 changed to 1.081
    • Malpractice GPCI 1.264 changed to 1.322

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $400.61changed to$399.56

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.04 changed to 7.05

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $398.62changed to$400.61

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $391.26changed to$398.62

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.05 changed to 7.04
    • Malpractice RVU 0.33 changed to 0.48
    • Work GPCI 1.018 changed to 1.021
    • Practice expense GPCI 1.073 changed to 1.087
    • Malpractice GPCI 1.444 changed to 1.264

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $391.88changed to$391.26

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.63 changed to 7.05
    • Malpractice RVU 0.35 changed to 0.33
    • Work GPCI 1.014 changed to 1.018
    • Practice expense GPCI 1.059 changed to 1.073
    • Malpractice GPCI 1.624 changed to 1.444

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $391.88

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$375.78$239.83RVU26D
2026-07-01$375.78$239.83RVU26C
2026-04-01$375.78$239.83RVU26B
2026-01-01$375.78$239.83RVU26A
2025-10-01$371.32$259.25RVU25D
2025-07-01$371.32$259.25RVU25C
2025-04-01$371.32$259.25RVU25B
2025-01-01$371.32$259.25RVU25A
2024-10-01$386.59$265.66RVU24D
2024-07-01$386.59$265.66RVU24C
2024-04-01$386.59$265.66RVU24B
2024-03-09$386.59$265.66RVU24AR
2024-01-01$380.28$261.33RVU24A
2023-10-01$398.31$271.28RVU23D
2023-07-01$398.31$271.28RVU23C
2023-04-01$398.31$271.28RVU23B
2023-01-01$398.31$271.28RVU23A
2022-10-01$407.15$273.72RVU22D
2022-07-01$407.15$273.72RVU22C
2022-04-01$407.15$273.72RVU22B
2022-01-01$407.15$273.72RVU22A
2021-10-01$405.57$271.42RVU21D
2021-07-01$405.57$271.42RVU21C
2021-04-01$405.57$271.42RVU21B
2021-01-01$405.57$271.42RVU21A
2020-10-01$392.77$272.83RVU20D
2020-07-01$392.77$272.83RVU20C
2020-04-01$392.77$272.83RVU20B
2020-01-01$392.77$272.83RVU20A
2019-10-01$390.52$274.40RVU19D
2019-07-01$390.52$274.40RVU19C
2019-04-01$390.52$274.40RVU19B
2019-01-01$390.52$274.40RVU19A
2018-10-01$383.80$272.06RVU18D
2018-07-01$383.80$272.06RVU18C
2018-04-01$383.80$272.06RVU18B
2018-01-01$383.80$272.06RVU18AR1
2017-10-01$394.65$289.90RVU17D
2017-07-01$394.65$289.90RVU17C
2017-04-01$394.65$289.90RVU17B
2017-01-01$394.65$289.90RVU17A
2016-10-01$399.56$292.53RVU16D
2016-07-01$399.56$292.53RVU16C
2016-04-01$399.56$292.53RVU16B
2016-01-01$399.56$292.53RVU16A
2015-10-01$400.61$292.80RVU15D
2015-07-01$400.61$292.80RVU15C
2015-04-01$398.62$291.35RVU15B
2015-01-01$398.62$291.35RVU15A
2014-10-01$391.26$286.33RVU14D
2014-07-01$391.26$286.33RVU14C
2014-04-01$391.26$286.33RVU14B
2014-01-01$391.26$286.33RVU14A
2013-10-01$391.88$283.79RVU13D
2013-07-01$391.88$283.79RVU13C
2013-04-01$391.88$283.79RVU13B
2013-01-01$391.88$283.79RVU13AR

Price 41520 for an earlier date of service

Where the Metropolitan Philadelphia, PA rate applies

Metropolitan Philadelphia, PA is a Medicare payment area, not a city. Our Census mapping connects it to 201 cities and communities in Pennsylvania. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Pennsylvania

41520 billing questions

How does 41520 differ from lingual frenulum excision?

Use 41520 for reconstruction or lengthening of the tongue fold. CPT 41115 describes excision of the lingual frenulum; choose based on the operative work documented.

What documentation supports 41520?

Document the restricted tongue movement and relevant frenulum anatomy, along with the reconstructive technique performed. The note should make clear why the service was reconstruction rather than simple division or excision.

Is modifier 50 appropriate for this procedure?

No. The anatomy and descriptor make bilateral adjustment inappropriate.

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

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

Can an assistant or another surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and 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 41520PPRRVU2026_Oct_nonQPP.csv, line 4,936 (RVU26D)
Geographic factors for Metropolitan Philadelphia, PAGPCI2026.csv, line 89 (RVU26D)

Open CMS sourceHow we calculate rates

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