Billing code 41252: Tongue repairMedicare rate & RVUs in Alabama
Repair a complicated tongue laceration when the injury requires more involved closure than a straightforward repair, such as after significant oral trauma.
Medicare pays $308.43 for 41252 in the office in Alabama (Alabama). Which amount applies depends on the service address.
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 9 sections
What 41252 covers
This service involves closing a complicated laceration of the tongue, often after trauma such as a fall, bite, or impact to the mouth. Emergency physicians, otolaryngologists, oral surgeons, and trauma surgeons may perform the repair in an emergency department or operating room. The injury may require more involved tissue approximation than a simple closure; the record should make the wound’s complexity and the work performed clear.
Select this code based on the complexity of the repair, not simply because the wound is on the tongue. Document the location and extent of the laceration, relevant tissue involvement, repair technique, and why the closure was complicated. This minor procedure has a 10-day global period, which includes related postoperative visits during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure 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.
41252 in Alabama
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $308.43 | $178.09 |
How the 41252 rate is calculated
Each of 41252’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 · 41252
RVUs × geographic indexes × conversion factor
Work2.94
2.94 RVUs× 1.000 GPCI
Practice expense6.87
6.87 RVUs× 1.000 GPCI
Malpractice0.50
0.50 RVUs× 1.000 GPCI
Adjusted RVUs
10.3100
Conversion factor
$33.4009
Medicare rate
$344.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 41252
41252 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 41252
Tongue repair
| 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 · 41252
Tongue repair
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
41252 without 51 · national office
$344.36
Tongue repair
41252-51 · Second procedure: 50%
$172.18
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%).
41252 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 41250Tongue repair
- 41252 represents a complicated tongue repair. Use 41250 when the repair meets its simpler category rather than assuming every tongue laceration qualifies for 41252.
- 41251Tongue repair
- Both codes concern tongue laceration repair, but 41252 identifies a complicated repair. Use the applicable 41251 category when the repair does not meet the complicated criteria.
- 40831Laceration repair
- 40831 concerns a complicated laceration in the vestibule of the mouth. 41252 is for a complicated laceration repair of the tongue.
41252 billing questions
How does 41252 differ from 41250 or 41251?
41252 is for a complicated tongue laceration repair. Choose 41250 or 41251 when the repair fits the simpler category or the applicable wound-size distinction; document the basis for the selection.
What documentation supports a complicated repair?
Describe the laceration’s location and extent, the tissue involved, the closure technique, and the work that made the repair complicated. A diagnosis of tongue laceration alone does not establish complexity.
Are related postoperative visits separately billable?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can 41252 be reported with another procedure performed in the same session?
It may be reported when a distinct additional procedure is performed and separately reportable. The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction.
Can modifier 50 or an assistant-at-surgery modifier be used?
Modifier 50 is inappropriate for this code. Assistant-at-surgery payment is available only when medical necessity is documented.
Can co-surgeons or a surgical team report this repair?
No. Co-surgeons and team surgery are not permitted for this service.
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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