$332.48
41252 represents a complicated tongue repair. Use 41250 when the repair meets its simpler category rather than assuming every tongue laceration qualifies for 41252.
On this page
CMS RVU26D · Effective 2026-10-01
41252 Tongue repair Medicare reimbursement rates in Delaware
Repair a complicated tongue laceration when the injury requires more involved closure than a straightforward repair, such as after significant oral trauma. Compare 41252 office and facility rates across CMS payment localities in Delaware.
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 41252 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$340.41
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$193.23
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
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.
Oral surgery
About 41252: Complicated tongue laceration repair
Repair a complicated tongue laceration when the injury requires more involved closure than a straightforward repair, such as after significant oral trauma.
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.
CMS billing rules for 41252
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU2.94 · 29%
- Practice expense (office) RVU6.87 · 67%
- Malpractice RVU0.50 · 5%
148
Medicare services in 2024 · #4572 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.
41252 compared with similar codes
Office rates for Delaware, from the same CMS release.
$422.38
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.
$309.30
40831 concerns a complicated laceration in the vestibule of the mouth. 41252 is for a complicated laceration repair of the tongue.
Compare 41252 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.
1 of 1 payment localities
Delaware →
Office / nonfacility
$340.41
Facility
$193.23
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 41252 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
4,918
- Code
- 41252
- Physician work
- 2.94
- Practice expense
- 6.87
- Malpractice
- 0.50
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.94 | × 1.005 | 2.9547 |
| Practice expense | 6.87 | × 0.988 | 6.7876 |
| Malpractice | 0.50 | × 0.899 | 0.4495 |
| Total RVUs | 10.1918 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$340.41
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.94 | 1.005 |
| Practice expense | 6.87 | 0.988 |
| Malpractice | 0.5 | 0.899 |
(2.94 × 1.005 + 6.87 × 0.988 + 0.5 × 0.899) × $33.4009 = $340.41
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.94 | 1.005 |
| Practice expense | 2.41 | 0.988 |
| Malpractice | 0.5 | 0.899 |
(2.94 × 1.005 + 2.41 × 0.988 + 0.5 × 0.899) × $33.4009 = $193.23
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
4,9154124F,,Antibiot not rxd/given,M,,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
4,91641250,,Repair tongue laceration,A,,1.91,7.75,,2.66,,0.42,10.08,4.99,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,91741251,,Repair tongue laceration,A,,2.26,10.00,,3.98,,0.55,12.81,6.79,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,91841252,,Repair tongue laceration,A,,2.94,6.87,,2.41,,0.50,10.31,5.85,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,9194130F,,Topical prep rx aoe,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
4,9204131F,,Syst antimicrobial thx 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
4,9214132F,,No syst antimicrobial thx 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
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503