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CPT code 41520: Frenuloplasty, for restricted tongue movement2026 Medicare rate & RVUs in Virginia

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 Virginia, Medicare pays $352.79 for 41520 in the office and $224.41 when it’s performed in a hospital or facility.

$352.79Office (non-facility)
$224.41Hospital or facility
−2.3%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 Virginia
  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 Virginia 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. Virginia pays $352.79. The RVUs are the same everywhere; the geographic indexes change the dollars.

41520 in Virginia vs other payment areas
  1. Virginia · this page$352.79
  2. Los Angeles, CA · California$407.11+$54.32
  3. Washington, DC area · District of Columbia$413.03+$60.24
  4. Miami, FL · Florida$391.97+$39.18
  5. Chicago, IL · Illinois$380.29+$27.50
  6. Manhattan, NY · New York$416.19+$63.40
  7. Alaska · Alaska$417.77+$64.98

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

Every other payment area

41520 in every other Medicare payment locality
Payment localityOfficeFacility
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
Hanford, 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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 41520 in Virginia
ComponentRVULocality factorAdjusted
Physician work2.76× 1.0002.7600
Practice expense7.65× 0.9837.5200
Malpractice0.40× 0.7060.2824
Total RVUs10.5623
Conversion factor× 33.4009

Office rate, Virginia$352.79

Office: (2.76 × 1 + 7.65 × 0.983 + 0.4 × 0.706) × $33.4009 = $352.79

Facility: (2.76 × 1 + 3.74 × 0.983 + 0.4 × 0.706) × $33.4009 = $224.41

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, Virginia
Used instead
41115Tongue-tie surgery, lingual frenum excisionLingual frenulum excision; distinguish removal from the reconstruction reported with 41520.$250.18
41599Unlisted oral surgery, tongue or floor of mouthUnlisted tongue or floor-of-mouth procedure when no specific code describes the operation.No office rate

How 41520 has changed in Virginia

41520 · Office / nonfacility

$352.79

Effective 2026-10-01

The base rate is $6.36 higher than on 2025-10-01, moving from $346.43 to $352.79 (1.8%).

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

    $346.43changed to$352.79

    • 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 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $360.92changed to$346.43

    • 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

    $355.03changed to$360.92

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $370.45changed to$355.03

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.85 changed to 7.83
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $377.21changed to$370.45

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.75 changed to 7.85
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $375.86changed to$377.21

    • 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

    $363.05changed to$375.86

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.94 changed to 7.63
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $359.53changed to$363.05

    • 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 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $353.48changed to$359.53

    • 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

    $360.75changed to$353.48

    • 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 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $363.62changed to$360.75

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.05 changed to 6.91
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $364.58changed to$363.62

    • 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

    $362.76changed to$364.58

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $358.08changed to$362.76

    • 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
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $358.61changed to$358.08

    • 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
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $358.61

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$352.79$224.41RVU26D
2026-07-01$352.79$224.41RVU26C
2026-04-01$352.79$224.41RVU26B
2026-01-01$352.79$224.41RVU26A
2025-10-01$346.43$241.71RVU25D
2025-07-01$346.43$241.71RVU25C
2025-04-01$346.43$241.71RVU25B
2025-01-01$346.43$241.71RVU25A
2024-10-01$360.92$247.91RVU24D
2024-07-01$360.92$247.91RVU24C
2024-04-01$360.92$247.91RVU24B
2024-03-09$360.92$247.91RVU24AR
2024-01-01$355.03$243.87RVU24A
2023-10-01$370.45$252.70RVU23D
2023-07-01$370.45$252.70RVU23C
2023-04-01$370.45$252.70RVU23B
2023-01-01$370.45$252.70RVU23A
2022-10-01$377.21$254.63RVU22D
2022-07-01$377.21$254.63RVU22C
2022-04-01$377.21$254.63RVU22B
2022-01-01$377.21$254.63RVU22A
2021-10-01$375.86$252.61RVU21D
2021-07-01$375.86$252.61RVU21C
2021-04-01$375.86$252.61RVU21B
2021-01-01$375.86$252.61RVU21A
2020-10-01$363.05$252.90RVU20D
2020-07-01$363.05$252.90RVU20C
2020-04-01$363.05$252.90RVU20B
2020-01-01$363.05$252.90RVU20A
2019-10-01$359.53$252.93RVU19D
2019-07-01$359.53$252.93RVU19C
2019-04-01$359.53$252.93RVU19B
2019-01-01$359.53$252.93RVU19A
2018-10-01$353.48$250.90RVU18D
2018-07-01$353.48$250.90RVU18C
2018-04-01$353.48$250.90RVU18B
2018-01-01$353.48$250.90RVU18AR1
2017-10-01$360.75$265.31RVU17D
2017-07-01$360.75$265.31RVU17C
2017-04-01$360.75$265.31RVU17B
2017-01-01$360.75$265.31RVU17A
2016-10-01$363.62$266.83RVU16D
2016-07-01$363.62$266.83RVU16C
2016-04-01$363.62$266.83RVU16B
2016-01-01$363.62$266.83RVU16A
2015-10-01$364.58$267.09RVU15D
2015-07-01$364.58$267.09RVU15C
2015-04-01$362.76$265.76RVU15B
2015-01-01$362.76$265.76RVU15A
2014-10-01$358.08$262.24RVU14D
2014-07-01$358.08$262.24RVU14C
2014-04-01$358.08$262.24RVU14B
2014-01-01$358.08$262.24RVU14A
2013-10-01$358.61$258.89RVU13D
2013-07-01$358.61$258.89RVU13C
2013-04-01$358.61$258.89RVU13B
2013-01-01$358.61$258.89RVU13AR

Price 41520 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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