$225.15–$341.97
CPT 41115 describes excision of the lingual frenulum. Report 41520 when the operative service reconstructs or lengthens the tongue fold.
On this page
CMS RVU26D · Effective 2026-10-01
41520 Frenuloplasty Medicare reimbursement rates
Reconstructs the lingual frenulum to improve restricted tongue movement, commonly when ankyloglossia requires more than simple division or excision. Compare 41520 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 41520?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$318.56–$477.94
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $159.38 per service.
Facility setting
$206.37–$289.62
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $83.25 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 41520 pays more and less
109 payment localities
$318.56 to $477.94
Oral surgery
About 41520: Lingual frenulum reconstruction
Reconstructs the lingual frenulum to improve restricted tongue movement, commonly when ankyloglossia requires more than simple division or excision.
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.
CMS billing rules for 41520
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.76 · 26%
- Practice expense (office) RVU7.65 · 71%
- Malpractice RVU0.40 · 4%
32
Medicare services in 2024 · #5620 by national volume
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.
41520 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This is tongue-to-lip surgery, a distinct operation from lingual frenulum reconstruction. Choose according to the procedure actually performed.
No office rate
This code describes tongue suspension, not repair of the lingual frenulum. The operative target and technique determine the choice.
41599
No office rateUnlisted px tongue flr mouth
Use the unlisted tongue or floor-of-mouth code only when a specific code does not describe the operation; 41520 specifically covers tongue-fold reconstruction.
See how rates vary across the country
41520 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $417.77 | 1 |
| AL | $323.33 | 1 |
| AR | $318.56 | 1 |
| AZ | $351.22 | 1 |
| CA | $380.96–$477.94 | 29 |
| CO | $375.60 | 1 |
| CT | $385.39 | 1 |
| DC | $413.03 | 1 |
| DE | $357.11 | 1 |
| FL | $356.54–$391.97 | 3 |
| GA | $336.03–$368.11 | 2 |
| GU | $390.44 | 1 |
| HI | $390.44 | 1 |
| IA | $331.29 | 1 |
| ID | $333.58 | 1 |
| IL | $346.36–$380.29 | 4 |
| IN | $335.54 | 1 |
| KS | $329.91 | 1 |
| KY | $331.57 | 1 |
| LA | $331.12–$347.81 | 2 |
| MA | $373.37–$412.94 | 2 |
| MD | $363.96–$413.03 | 3 |
| ME | $335.57–$353.83 | 2 |
| MI | $340.56–$361.29 | 2 |
| MN | $359.07 | 1 |
| MO | $325.46–$348.83 | 3 |
| MS | $322.06 | 1 |
| MT | $361.04 | 1 |
| NC | $339.12 | 1 |
| ND | $353.13 | 1 |
| NE | $333.08 | 1 |
| NH | $369.87 | 1 |
| NJ | $389.55–$408.66 | 2 |
| NM | $342.54 | 1 |
| NV | $359.09 | 1 |
| NY | $344.32–$426.71 | 5 |
| OH | $338.94 | 1 |
| OK | $330.74 | 1 |
| OR | $356.07–$387.48 | 2 |
| PA | $339.38–$375.78 | 2 |
| PR | $363.67 | 1 |
| RI | $369.80 | 1 |
| SC | $339.64 | 1 |
| SD | $352.19 | 1 |
| TN | $331.63 | 1 |
| TX | $337.12–$374.55 | 8 |
| UT | $344.37 | 1 |
| VA | $352.79–$413.03 | 2 |
| VI | $363.67 | 1 |
| VT | $351.91 | 1 |
| WA | $372.61–$421.23 | 2 |
| WI | $341.09 | 1 |
| WV | $333.35 | 1 |
| WY | $357.59 | 1 |
Compare 41520 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $323.33 | Facility $209.05 |
| Alaska* | Office $417.77 | Facility $278.68 |
| Arizona | Office $351.22 | Facility $224.67 |
| Arkansas | Office $318.56 | Facility $206.37 |
| Atlanta | Office $368.11 | Facility $235.43 |
| Austin | Office $374.55 | Facility $236.37 |
| Bakersfield | Office $382.12 | Facility $238.99 |
| Baltimore/Surr. Cntys | Office $384.36 | Facility $244.23 |
| Beaumont | Office $337.12 | Facility $218.27 |
| Brazoria | Office $356.56 | Facility $227.14 |
| Chicago | Office $380.29 | Facility $249.04 |
| Chico | Office $380.96 | Facility $237.83 |
| Colorado | Office $375.60 | Facility $236.64 |
| Connecticut | Office $385.39 | Facility $244.73 |
| Dallas | Office $358.97 | Facility $228.90 |
| Dc + Md/Va Suburbs | Office $413.03 | Facility $259.19 |
| Delaware | Office $357.11 | Facility $228.08 |
| Detroit | Office $361.29 | Facility $235.26 |
| East St. Louis | Office $354.17 | Facility $234.02 |
| El Centro | Office $381.03 | Facility $237.89 |
| Fort Lauderdale | Office $375.18 | Facility $242.89 |
| Fort Worth | Office $356.59 | Facility $227.82 |
| Fresno | Office $380.96 | Facility $237.83 |
| Galveston | Office $357.71 | Facility $228.03 |
| Hanford-Corcoran | Office $380.96 | Facility $237.83 |
| Hawaii, Guam | Office $390.44 | Facility $241.96 |
| Houston | Office $365.04 | Facility $235.35 |
| Idaho | Office $333.58 | Facility $213.43 |
| Indiana | Office $335.54 | Facility $214.48 |
| Iowa | Office $331.29 | Facility $211.79 |
| Kansas | Office $329.91 | Facility $211.85 |
| Kentucky | Office $331.57 | Facility $215.46 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $407.11 | Facility $252.62 |
| Madera | Office $380.96 | Facility $237.83 |
| Manhattan | Office $416.19 | Facility $264.43 |
| Merced | Office $380.96 | Facility $237.83 |
| Metropolitan Boston | Office $412.94 | Facility $257.01 |
| Metropolitan Kansas City | Office $345.17 | Facility $222.54 |
| Metropolitan Philadelphia | Office $375.78 | Facility $239.83 |
| Metropolitan St. Louis | Office $348.83 | Facility $224.50 |
| Miami | Office $391.97 | Facility $256.02 |
| Minnesota | Office $359.07 | Facility $224.68 |
| Mississippi | Office $322.06 | Facility $209.62 |
| Modesto | Office $380.96 | Facility $237.83 |
| Montana** | Office $361.04 | Facility $230.44 |
| Napa | Office $441.55 | Facility $269.43 |
| Nebraska | Office $333.08 | Facility $212.54 |
| Nevada** | Office $359.09 | Facility $228.36 |
| New Hampshire | Office $369.87 | Facility $233.92 |
| New Mexico | Office $342.54 | Facility $222.78 |
| New Orleans | Office $347.81 | Facility $224.91 |
| North Carolina | Office $339.12 | Facility $217.27 |
| North Dakota** | Office $353.13 | Facility $222.53 |
| Northern Nj | Office $408.66 | Facility $257.17 |
| Nyc Suburbs/Long Island | Office $426.71 | Facility $271.43 |
| Ohio | Office $338.94 | Facility $219.71 |
| Oklahoma | Office $330.74 | Facility $214.12 |
| Oxnard-Thousand Oaks-Ventura | Office $405.11 | Facility $250.75 |
| Portland | Office $387.48 | Facility $242.39 |
| Poughkpsie/N Nyc Suburbs | Office $392.29 | Facility $249.29 |
| Puerto Rico | Office $363.67 | Facility $231.64 |
| Queens | Office $419.37 | Facility $265.01 |
| Redding | Office $380.96 | Facility $237.83 |
| Rest Of California | Office $380.96 | Facility $237.83 |
| Rest Of Florida | Office $356.54 | Facility $231.69 |
| Rest Of Georgia | Office $336.03 | Facility $219.54 |
| Rest Of Illinois | Office $346.36 | Facility $227.12 |
| Rest Of Louisiana | Office $331.12 | Facility $215.54 |
| Rest Of Maine | Office $335.57 | Facility $215.42 |
| Rest Of Maryland | Office $363.96 | Facility $231.79 |
| Rest Of Massachusetts | Office $373.37 | Facility $235.85 |
| Rest Of Michigan | Office $340.56 | Facility $221.32 |
| Rest Of Missouri | Office $325.46 | Facility $212.88 |
| Rest Of New Jersey | Office $389.55 | Facility $246.94 |
| Rest Of New York | Office $344.32 | Facility $220.25 |
| Rest Of Oregon | Office $356.07 | Facility $226.00 |
| Rest Of Pennsylvania | Office $339.38 | Facility $219.49 |
| Rest Of Texas | Office $346.74 | Facility $222.80 |
| Rest Of Washington | Office $372.61 | Facility $235.09 |
| Rhode Island | Office $369.80 | Facility $234.90 |
| Riverside-San Bernardino-Ontario | Office $385.29 | Facility $242.15 |
| Sacramento-Roseville-Folsom | Office $399.83 | Facility $247.95 |
| Salinas | Office $398.35 | Facility $246.99 |
| San Diego-Chula Vista-Carlsbad | Office $407.79 | Facility $251.60 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $467.36 | Facility $283.21 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $466.90 | Facility $282.76 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $477.94 | Facility $289.62 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $476.09 | Facility $287.76 |
| San Luis Obispo-Paso Robles | Office $391.95 | Facility $243.20 |
| Santa Cruz-Watsonville | Office $411.74 | Facility $253.06 |
| Santa Maria-Santa Barbara | Office $399.86 | Facility $247.58 |
| Santa Rosa-Petaluma | Office $415.89 | Facility $255.51 |
| Seattle (King Cnty) | Office $421.23 | Facility $260.99 |
| South Carolina | Office $339.64 | Facility $218.97 |
| South Dakota** | Office $352.19 | Facility $221.59 |
| Southern Maine | Office $353.83 | Facility $224.41 |
| Stockton | Office $380.96 | Facility $237.83 |
| Suburban Chicago | Office $378.92 | Facility $244.80 |
| Tennessee | Office $331.63 | Facility $212.91 |
| Utah | Office $344.37 | Facility $221.61 |
| Vallejo | Office $440.90 | Facility $268.77 |
| Vermont | Office $351.91 | Facility $222.62 |
| Virgin Islands | Office $363.67 | Facility $231.64 |
| Virginia | Office $352.79 | Facility $224.41 |
| Visalia | Office $380.96 | Facility $237.83 |
| West Virginia | Office $333.35 | Facility $219.86 |
| Wisconsin | Office $341.09 | Facility $215.97 |
| Wyoming** | Office $357.59 | Facility $226.99 |
| Yuba City | Office $380.96 | Facility $237.83 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,93341510,,Tongue to lip surgery,A,,3.42,9.00,NA,9.00,,0.48,12.90,12.90,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,93441512,,Tongue suspension,A,,6.69,10.85,NA,10.85,,0.99,18.53,18.53,0,090,0.10,0.76,0.14,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,9354151F,,Pt not recvng antiv hep c,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,93641520,,Reconstruction tongue fold,A,,2.76,7.65,,3.74,,0.40,10.81,6.90,0,090,0.09,0.81,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,93741530,,Tongue base vol reduction,A,,3.41,23.64,,6.94,,0.48,27.53,10.83,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,9384153F,,Combo pegintf/rib rx,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,9394155F,,Hep a vac series prev recvd,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00