Billing code 41251: Tongue repairMedicare rate & RVUs

Medicare pays $427.87 for 41251 nationally in the office and $226.79 in a hospital or facility. Local office rates run $371.86–$575.28.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 41251 covers

This service covers repair of a complicated laceration of the tongue. It is commonly performed by an emergency physician, otolaryngologist, or oral and maxillofacial surgeon in an emergency department or hospital setting. The record should identify the tongue wound and describe its extent, depth, tissue disruption, and repair technique sufficiently to support the complicated level; the fact that sutures were placed alone does not establish that level.

Select this code based on the documented complexity of the tongue wound and repair, distinguishing it from the simple repair code and the other tongue-repair family entry. Related postoperative visits during the 10-day global period 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of 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.

Where 41251 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

41251 rates by state

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

How the 41251 rate is calculated

Each of 41251’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.

Payment rules and modifiers for 41251

41251 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

41251 compared with similar codes

How to choose

41250Tongue repair

41250 is for simple tongue-laceration repair. Choose 41251 when the documentation supports a complicated repair.

41252Tongue repair

41252 is another distinct tongue-laceration repair entry. Select between the family codes using the specific wound and repair circumstances in the applicable descriptor.

40831Laceration repair

40831 describes complicated repair at the oral vestibule. A laceration of the tongue is reported with the applicable tongue-repair code instead.

Codes related to 41251

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

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

Open CMS sourceHow we calculate rates